This bill introduces changes 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. Contracts between healthcare entities and dentists are addressed, specifying that dentists cannot be forced to provide services at a fee determined by the 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 stipulation that any reduction in benefits for non-participating dentists cannot exceed five percent less than what is paid to participating dentists.

The bill amends Section 27-41-66 of the General Laws in Chapter 27-41, "Health Maintenance Organizations," to include provisions for dental insurance and the assignment of benefits. Health maintenance organizations must allow covered individuals to direct their dental service benefits to non-contracted dental care providers who meet the credentialing criteria. The entity may reduce benefits paid to non-participating dentists by no more than five percent compared to participating dentists and retains the right to review the dentist's records. The bill ensures that dental services and treatment are reimbursed according to state standards and extends coverage to minors for dental services in outpatient surgery centers, with an effective date of January 1, 2025.

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