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MA S504

Relative to dental benefit plan transparency and patients' Bill of Rights


summary

Introduced
01/23/2017
In Committee
01/23/2017
Crossed Over
Passed
Dead
12/31/2018

Introduced Session

190th General Court

Bill Summary

For legislation relative to dental benefit plan transparency and patients' Bill of Rights. Financial Services.

AI Summary

This bill aims to introduce greater transparency and patient protections in dental benefit plans. It establishes a new chapter in state law (Chapter 176V) that defines key terms, including "carrier" (insurers, non-profit medical service corporations, dental service corporations, etc.), and applies to most dental benefit plans issued or renewed after April 1, 2017. The bill requires the Division of Insurance to issue regulations defining dental service categories and coverage requirements, including 100% coverage for preventive and diagnostic services for individuals 18 and older, and 100% coverage for preventive, diagnostic, and basic restorative services for individuals under 18. It also prohibits annual maximum benefit limits below $1,000 after April 1, 2018, and bans waiting periods for preventive and diagnostic services. Additionally, the bill sets requirements for carrier reimbursement methodologies, including a minimum annual increase tied to the New England dental Consumer Price Index, and limits on geographic region-based rate adjustments. It also allows insured individuals to direct their dental benefits to be paid directly to non-contracted dentists who meet credentialing criteria.

Committee Categories

Business and Industry

Sponsors (8)

Last Action

Accompanied a study order, see S2496 (on 04/30/2018)

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