BILL REQ. #:  S-0863.1 

Read first time 02/01/2005.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to participation of denturists in preferred provider networks; and amending RCW 48.20.418, 48.21.148, 48.44.500, and 48.46.570.

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

Sec. 1   RCW 48.20.418 and 1995 c 1 s 21 are each amended to read as follows:
     Notwithstanding any provision of any disability insurance contract covering dental care as provided for in this chapter, effective January 1, 1995, benefits shall not be denied thereunder for any service performed by a denturist licensed under chapter 18.30 RCW if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a dentist licensed under chapter 18.32 RCW. An insurer shall allow a denturist to participate in any preferred provider network to the same extent, and under the same terms and conditions, as a dentist.

Sec. 2   RCW 48.21.148 and 1995 c 1 s 22 are each amended to read as follows:
     Notwithstanding any provision of any group disability insurance contract or blanket disability insurance contract covering dental care as provided for in this chapter, effective January 1, 1995, benefits shall not be denied thereunder for any service performed by a denturist licensed under chapter 18.30 RCW if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a dentist licensed under chapter 18.32 RCW. An insurer shall allow a denturist to participate in any preferred provider network to the same extent, and under the same terms and conditions, as a dentist.

Sec. 3   RCW 48.44.500 and 1995 c 1 s 24 are each amended to read as follows:
     (1) Notwithstanding any provision of any health care service contract covering dental care as provided for in this chapter, effective January 1, 1995, benefits shall not be denied thereunder for any service performed by a denturist licensed under chapter 18.30 RCW if (((1))) (a) the service performed was within the lawful scope of such person's license, and (((2))) (b) such contract would have provided benefits if such service had been performed by a dentist licensed under chapter 18.32 RCW.
     (2) Except as provided in subsection (3) of this section, a health care service contractor shall allow a denturist to participate in any preferred provider network to the same extent, and under the same terms and conditions, as a dentist.
     (3) Subsection (2) of this section does not apply to a health care service contractor that employs one or more denturists and contracts with a group dental practice on a reciprocal exclusive basis.

Sec. 4   RCW 48.46.570 and 1995 c 1 s 25 are each amended to read as follows:
     (1) Notwithstanding any provision of any health maintenance organization agreement covering dental care as provided for in this chapter, effective January 1, 1995, benefits shall not be denied thereunder for any service performed by a denturist licensed under chapter 18.30 RCW if (((1))) (a) the service performed was within the lawful scope of such person's license, and (((2))) (b) such agreement would have provided benefits if such service had been performed by a dentist licensed under chapter 18.32 RCW.
     (2) Except as provided in subsection (3) of this section, a health maintenance organization shall allow a denturist to participate in any preferred provider network to the same extent, and under the same terms and conditions, as a dentist.
     (3) Subsection (2) of this section does not apply to a health maintenance organization that employs one or more denturists and contracts with a group dental practice on a reciprocal exclusive basis.