AN ACT Relating to insurance coverage of dental procedures; adding a new section to chapter 48.43 RCW; and providing an effective date.

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

NEW SECTION.  Sec. 1.  A new section is added to chapter 48.43 RCW to read as follows:

(1)(a) A health carrier offering a dental only plan may not deny a claim for a covered dental service provided by a treating dentist to a covered person if the service was provided within the standard of care.  

(b) If the commissioner determines that a health carrier denied a claim for a covered dental service that was provided within the standard of care:

(i) The dentist may bill the covered person for the cost of the service; and

(ii) The carrier may not advertise in promotional materials sent to prospective or current members that the carrier covers the dental service.

(c) In determining whether a dental service was performed within the standard of care, the commissioner shall consult with the dental quality assurance commission established in RCW 18.32.0351.

(2) For purposes of this section, "health carrier," in addition to the definition in RCW 48.43.005, also includes health care service contractors, limited health care service contractors, and disability insurers offering dental only coverage.

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