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IA SF327

A bill for an act relating to dental provider reimbursement under the dental wellness plan and the dental wellness plan kids.


summary

Introduced
02/17/2025
In Committee
02/17/2025
Crossed Over
Passed
Dead

Introduced Session

91st General Assembly

Bill Summary

This bill requires that a provider participating in the dental wellness plan or the dental wellness plan kids shall be reimbursed for services at the percentage of the usual, customary, and reasonable fee or at the percentage of the commercial dental insurance billed charges, whichever is higher, to align dental provider reimbursement rates under the dental wellness plan and the dental wellness plan kids with those under the healthy and well kids in Iowa (Hawki) program, in order to maximize dental provider participation in and member access under the dental wellness plan and the dental wellness plan kids.

AI Summary

This bill seeks to improve dental provider reimbursement rates for the dental wellness plan and the dental wellness plan kids by mandating that providers be paid at the higher of two rates: either the percentage of the usual, customary, and reasonable fee or the percentage of commercial dental insurance billed charges. The goal is to align these reimbursement rates with those of the Healthy and Well Kids in Iowa (Hawki) program, which is a state health insurance program for children. By establishing these more favorable reimbursement terms, the bill aims to increase dental provider participation and improve access to dental services for plan members. The legislation addresses potential financial barriers that might discourage healthcare providers from participating in these specific dental wellness plans by ensuring they receive competitive compensation for their services.

Committee Categories

Health and Social Services

Sponsors (4)

Last Action

Subcommittee: Klimesh, Costello, and Trone Garriott. S.J. 327. (on 02/20/2025)

bill text


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