The bill amends the "Unfair Claims Settlement Practices Act" to include specific provisions related to unfair practices in dental insurance claims. It establishes that it is an unfair claims practice for a dental insurer to refuse to honor a direction to pay executed by an insured or claimant for dental services, regardless of whether the dental service provider is contracted with the insurer, provided that the dental service provider meets the insurer's credentialing criteria and has not been previously terminated as a participating provider.

The bill prohibits insurers from modifying the amount of benefits paid directly to the dental service provider compared to what is paid to the majority of participating providers. Insurers are also required to inform dental service providers of alternative payment methods and cannot mandate that payments be accepted solely through virtual credit cards.

Additionally, the bill allows insurers to review the records of the dental service provider to confirm that the services were rendered, while ensuring that the insurer cannot reduce the benefits paid. The act emphasizes compliance with these requirements when settling claims for dental services in Rhode Island, regardless of the state where the health benefit plan, policy, or contract was issued. The bill will take effect upon passage.

Statutes affected:
7113: 27-9.1-4