The bill addresses contracts between health insurers and dental healthcare providers, specifically prohibiting certain terms that could disadvantage dentists. It mandates that any review, audit, or investigation by a nonprofit dental service corporation regarding healthcare provider claims must be completed within six months of the claims being paid, with exceptions for cases involving fraud, inappropriate billing patterns, coordination of benefits, or federal regulations that allow for longer review periods. Additionally, the bill defines "prior authorization" and "utilization review entity," and stipulates that claims for procedures included in prior authorizations cannot be denied unless specific conditions are met.

Furthermore, the bill amends K.S.A. 40-2,185 to ensure that contracts between health insurers and dentists do not require dentists to provide services at fees set by the insurer unless those services are covered. It also prohibits contracts from limiting fees for non-covered services and from including provisions that would allow insurers to deny payment for services that should be covered while preventing dentists from billing patients for necessary services. The existing section of K.S.A. 40-2,185 is repealed, and the act will take effect upon publication in the statute book.

Statutes affected:
As introduced: 40-2