The bill amends the Wyoming insurance code to establish specific regulations regarding dental billing practices. It prohibits insurers and entities contracting with dentists from requiring them to provide services at a fee set by the contract unless those services are covered. Additionally, the bill introduces definitions for "bundling" and "downcoding," which refer to the practices of combining separate dental procedures for billing and adjusting claims to less complex procedures, respectively. The bill also allows dentists to bill and collect payment from insured patients for services that may not be covered, provided they notify the patient of potential reimbursement issues and obtain written consent.

Furthermore, the bill explicitly prohibits the use of bundling and downcoding in ways that would prevent dentists from billing for the actual services performed. It applies to all contracts, policies, or certificates issued, renewed, or delivered on or after July 1, 2023, with an effective date of the same. The legislation aims to enhance transparency and fairness in dental billing practices, ensuring that dentists can adequately charge for their services without being restricted by insurers.

Statutes affected:
Introduced: 26-22-505