Every Category of Provider. Under the Every Category of Provider law, health carriers must permit every category of health care provider to provide health services or care included in the Basic Essential Health Benefits Benchmark Plan (BHP) established by the Office of the Insurance Commissioner (OIC) provided that the services or care are within the providers' permitted scope of practice; the plan covers the services or care in the BHP; and the providers agree to health plan standards related to the provision of care, utilization review, cost containment, management and administrative procedures, and the provision of cost-effective and clinically efficacious care.

All medical providers who are licensed, registered, or certified by the Department of Health are covered by the Every Category of Provider law. Certain health plans are not covered, including self-funded employer plans, Medicare supplemental plans, long-term care insurance, workers' compensation coverage, disability income, short-term medical plans, and limited health plans, such as dental, vision, specific disease, or accident-only plans.

Denturists. Denturists are licensed by the Secretary of Health and disciplined by the Board of Denturists. Licensed denturists are authorized to make, place, construct, alter, reproduce, or repair dentures and nonorthodontic removable oral devices, and provide teeth whitening services. Denturists are authorized to take impressions and furnish or supply a denture directly to a person or advise the use of a denture and maintain a facility for the same.

Every health carrier offering dental-only coverage or offering dental only coverage in addition to a health plan delivered, issued, or renewed on or after January 1, 2024, must permit licensed denturists to provide dental services or care within that provider's scope included in the carrier's benefit package to the extent that the providers agree to abide by standards related to the provision of care, utilization review, cost containment, management and administrative procedures, and the provision of cost-effective and clinically efficacious care. The provisions do not apply to a plan that offers dental-only coverage when the plan relies solely on employees of the health carrier for provision of the benefits.

These requirements do not apply to a licensed health care profession if the licensing statute for the profession states that such requirements do not apply.

The committee recommended a different version of the bill than what was heard. PRO:  Denturists are specialist providers and there should be access to their services. Patients currently have to pay out of pocket or find a dentist to provide these services.