HB 1028 Summary

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

• Prohibits dentists and optometrists from charging patients for non-covered health care services an amount exceeding the provider's usual and customary charges for those services.

• Requires reimbursement for covered services to be reasonable and not so minimal that services cannot reasonably be considered covered under the policy.

• Specifies that discounts may not result in charges below what reimbursement would be without contractual limitations like deductibles, copayments, or coinsurance.

• Applies to agreements entered into, renewed, or amended after June 30, 2017, with an effective date of July 1, 2017, and covers both traditional insurers and limited service health maintenance organizations.