Bill > LD1800

This bill addresses how dental insurance providers can set fees for dental services by establishing new regulations for insurers and health maintenance organizations (HMOs) in Maine. The bill defines "covered dental services" as dental procedures for which insurance reimbursement is available, including services subject to contractual limitations like deductibles or copayments. It prohibits insurers issuing individual or group dental and health insurance plans from requiring dental providers (licensed dental professionals) to charge fees set by the insurer for services that are not covered by the insurance plan. Additionally, the bill mandates that fees for covered dental services must be set by the insurer in good faith and cannot be considered nominal or unreasonably low. This legislation applies to individual and group dental insurance plans, as well as health insurance plans that include dental coverage, and aims to protect dental providers from being forced to provide services at unfairly low rates or for free. The bill creates consistent regulations across different types of dental insurance providers, including traditional insurers and health maintenance organizations.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1800&snum=132