The bill aims to enhance the contractual relationship between dental healthcare providers and insurers by implementing specific regulations regarding claims and audits. It mandates that any review, audit, or investigation related to claims that result in the recoupment of funds must be completed within six months of the initial payment. Additionally, the bill prohibits insurers from denying claims for procedures that have received prior authorization, except under certain conditions, such as changes in the patient's condition or documentation issues.

Furthermore, the bill amends K.S.A. 40-2,185 to ensure that contracts between health insurers and dentists do not impose fees for non-covered services and prevent insurers from disallowing services that would typically be covered while also prohibiting dentists from billing patients for necessary services. The existing section of K.S.A. 40-2,185 is repealed, and the new provisions are designed to protect dentists and ensure fair practices in the insurance claims process.

Statutes affected:
As introduced: 40-2