The bill proposes amendments to the General Laws concerning dental insurance and services. It prohibits dentists from being required to indemnify or hold harmless insurance providers for management decisions or utilization review provisions. The bill also mandates that dental services in Rhode Island, including those for minors in outpatient surgery centers, be reimbursed according to Rhode Island's standards. It further specifies that dentists cannot be compelled to provide services at a fee determined by a healthcare entity unless the services are covered by the subscriber agreement. Additionally, the bill allows insured individuals to direct their insurance benefits to be paid directly to dental care providers who meet certain criteria, even if they are not contracted with the insuring entity, with a maximum reduction in benefits for non-participating dentists capped at five percent less than what is paid to participating dentists.

The bill amends Section 27-41-66 to require health maintenance organizations to permit covered individuals to direct dental service benefits to non-contracted dental care providers who meet credentialing criteria. The permissible reduction in benefits for non-participating dentists is similarly capped at five percent less than the amount paid to participating dentists. The bill ensures that dental services provided to patients in Rhode Island are reimbursed according to state standards and extends coverage to minors receiving dental services in outpatient surgery centers. The bill is set to take effect on January 1, 2025, with the intent to standardize reimbursement for dental services and expand coverage for minors.

Statutes affected:
2965: 27-18-56, 27-18.8-4, 27-19-54, 27-20-49, 27-20.1-3, 27-41-66