Bill > HB2056

This bill modifies Oklahoma's existing dental insurance law by making several key changes to how dental plans and health benefit plans operate. The bill revises the definition of "covered services" to remove specific references to contractual limitations like deductibles and waiting periods, and changes the language from "reimbursable" to "reimbursed" when describing services under subscriber agreements. It maintains existing provisions that prevent dental plans from requiring dentists to provide services at fees set by the health plan unless those services are covered. The bill also strengthens appeal procedures for claim denials, mandating that any denial based on medical necessity must be reviewed and determined by a licensed dentist, and requires that written communications about such denials include the reviewing dentist's identifier, license number, state of license, and contact information. The communication rules stipulate that the reviewing dentist can only be contacted during business hours at the provided telephone number. The bill is set to take effect on November 1, 2025, and aims to provide more transparency and fairness in dental insurance claims processes.

http://www.oklegislature.gov/BillInfo.aspx?Bill=hb2056&Session=2600