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FL S0834
Bill
AI Summary
- Prohibits health insurers, HMOs, and prepaid limited health service organizations from restricting dentist payment methods to credit card only, and requires notification of fees and available alternatives when initiating or changing to electronic funds transfers or virtual credit card payments.
- Bars insurers and their vendors from charging dentists fees solely to transmit Automated Clearing House (ACH) Network payments without the dentist's consent, though a dentist's agent may charge reasonable fees for value-added services beyond basic transmittal.
- Prohibits insurers from denying dental claims for procedures that received prior authorization, except under seven specified circumstances including benefit limits reached after authorization, patient ineligibility, fraud, duplicate payment, or changed medical necessity.
- Narrows the definition of "covered services" in dentist provider contracts so that insurers may only set fees for services for which reimbursement is actually available, removing language that previously extended fee-setting to services subject to deductibles, maximums, and other contractual limitations.
- All new payment and claims protections cannot be waived by contract, with any conflicting contractual clauses rendered void, and enforcement is assigned to the Financial Services Commission, effective July 1, 2023.
Legislative Description
Dental Payments under Health Insurance Plans
Last Action
Died in Banking and Insurance
5/5/2023
Full Bill Text
No bill text available