Senate Bill 115 Summary

• Prohibits dental and vision insurers from requiring dentists and optometrists to accept limited or set payment amounts unless the services are covered services under the policy.

• Prohibits dentists and optometrists from charging for noncovered services an amount exceeding their usual and customary charges for those services.

• Requires that discounts offered by insurers cannot result in charges below the reimbursement amount that would be available if not eliminated by contractual limitations such as deductibles, copayments, or coinsurance.

• Requires that reimbursement for covered services must be reasonable and cannot be so small that the services cannot reasonably be considered covered services.

• Applies to agreements entered into, renewed, or modified after June 30, 2014, with an effective date of July 1, 2014.