CERTIFICATION OF ENROLLMENT

SUBSTITUTE HOUSE BILL 2686

Chapter 228, Laws of 2010

61st Legislature
2010 Regular Session



DENTAL INSURANCE--DENTAL SERVICE FEES



EFFECTIVE DATE: 06/10/10

Passed by the House March 6, 2010
  Yeas 95   Nays 0

FRANK CHOPP
________________________________________    
Speaker of the House of Representatives


Passed by the Senate March 2, 2010
  Yeas 45   Nays 1


BRAD OWEN
________________________________________    
President of the Senate
 
CERTIFICATE

I, Barbara Baker, Chief Clerk of the House of Representatives of the State of Washington, do hereby certify that the attached is SUBSTITUTE HOUSE BILL 2686 as passed by the House of Representatives and the Senate on the dates hereon set forth.


BARBARA BAKER
________________________________________    
Chief Clerk
Approved March 26, 2010, 10:56 a.m.








CHRISTINE GREGOIRE
________________________________________    
Governor of the State of Washington
 
FILED
March 26, 2010







Secretary of State
State of Washington


_____________________________________________ 

SUBSTITUTE HOUSE BILL 2686
_____________________________________________

AS AMENDED BY THE SENATE

Passed Legislature - 2010 Regular Session
State of Washington61st Legislature2010 Regular Session

By House Health Care & Wellness (originally sponsored by Representatives Driscoll, Hinkle, Condotta, Moeller, and Goodman)

READ FIRST TIME 02/03/10.   



     AN ACT Relating to fees for dental services that are not covered services under dental insurance or dental health care service contracts; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; and adding a new section to chapter 48.44 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 48.20 RCW to read as follows:
     (1) Notwithstanding any other provisions of law, no disability insurance policy of any disability insurer as provided in this chapter subject to the jurisdiction of the state of Washington that covers any dental services, and no contract or participating provider agreement with a dentist may:
     (a) Require, directly or indirectly, that a dentist who is a participating provider provide services to a subscriber at a fee set by, or at a fee subject to the approval of, the disability insurer unless the dental services are covered services, including services that would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods, or frequency limitations, under the applicable disability insurance policy; nor
     (b) Prohibit, directly or indirectly, a dentist who is a participating provider from offering or providing to a subscriber dental services that are not covered services on any terms or conditions acceptable to the dentist and the subscriber.
     (2) For the purposes of this section, "covered services" means dental services that are reimbursable under the applicable insurance policy or subscriber agreement or would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods or frequency limitations.

NEW SECTION.  Sec. 2   A new section is added to chapter 48.21 RCW to read as follows:
     (1) Notwithstanding any other provisions of law, no group disability insurance contract or blanket disability insurance contract of any disability insurer as provided for in this chapter subject to the jurisdiction of the state of Washington that covers any dental services, and no contract or participating provider agreement with a dentist may:
     (a) Require, directly or indirectly, that a dentist who is a participating provider provide services to a subscriber at a fee set by, or at a fee subject to the approval of, the disability insurer unless the dental services are covered services, including services that would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods, or frequency limitations, under the applicable group plan or disability insurance policy; nor
     (b) Prohibit, directly or indirectly, a dentist who is a participating provider from offering or providing to a subscriber dental services that are not covered services on any terms or conditions acceptable to the dentist and the subscriber.
     (2) For the purposes of this section, "covered services" means dental services that are reimbursable under the applicable insurance policy, group plan, or subscriber agreement or would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods or frequency limitations.

NEW SECTION.  Sec. 3   A new section is added to chapter 48.44 RCW to read as follows:
     (1) Notwithstanding any other provisions of law, no contract of any health care service contractor subject to the jurisdiction of the state of Washington that covers any dental services, and no contract or participating provider agreement with a dentist may:
     (a) Require, directly or indirectly, that a dentist who is a participating provider provide services to an enrolled participant at a fee set by, or at a fee subject to the approval of, the health care service contractor unless the dental services are covered services, including services that would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods, or frequency limitations, under the applicable group contract or individual contract; nor
     (b) Prohibit, directly or indirectly, a dentist who is a participating provider from offering or providing to an enrolled participant dental services that are not covered services on any terms or conditions acceptable to the dentist and the enrolled participant.
     (2) For the purposes of this section, "covered services" means dental services that are reimbursable under the applicable subscriber agreement or would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods or frequency limitations.


         Passed by the House March 6, 2010.
         Passed by the Senate March 2, 2010.
         Approved by the Governor March 26, 2010.
         Filed in Office of Secretary of State March 26, 2010.