KS HB2556

Reviews, audits, or investigations by nonprofit dental service corporations that result in recoupment of funds must be completed within 6 months of initial claim payment, with exceptions for fraud, inappropriate billing patterns, coordination of benefits, and federal requirements.

Dental benefit plans cannot deny claims for procedures specifically included in a prior authorization, unless benefit limits were reached after authorization, documentation fails to support the claim, or the patient's condition changed making the procedure no longer medically necessary.

Insurers are prohibited from setting or limiting fees for dental services that are not covered under the health benefit plan.

Contracts cannot both allow insurers to disallow a service (denying payment) and prohibit the dentist from billing the patient directly when there is a dental necessity for that service.

Amends K.S.A. 40-2,185 and takes effect upon publication in the statute book.