00HOUSE BILL NO. 476                                                                                                      
01 "An Act relating to insurance for services performed by a dentist; and providing                                        
02 for an effective date."                                                                                                 
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1.  AS 21.42 is amended by adding a new section to read:                                                   
05  Sec. 21.42.390.  DENTAL INSURANCE POLICY PROVISIONS.  (a)  An                                                         
06 insurer authorized under AS 21.09 to offer, issue for delivery, deliver, or renew an                                    
07 individual or group disability insurance policy for medical coverage on an expense                                      
08 incurred basis in the state                                                                                             
09   (1)  may not                                                                                                         
10   (A)  prohibit the policyholder from selecting the dentist of the                                                    
11 policyholder's choice if the dentist is licensed under AS 08.36 to perform the                                          
12 dental service;                                                                                                         
13   (B)  deny a dentist the right to participate as a contract provider                                                 
14 if the dentist is licensed under AS 08.36 to perform the covered dental service;                                        

01   (C)  authorize a person to regulate, interfere, or intervene in a                                                   
02 dentist's diagnosis or treatment of a patient's dental illness or injury if the                                         
03 dentist is licensed to perform the diagnosis or treatment under AS 08.36;                                               
04   (D)  require that in treating a dental illness or injury the dentist                                                
05 make or obtain dental x-rays or other diagnostic aids; this paragraph does not                                          
06 prohibit a request for existing dental x-rays or other existing diagnostic aids for                                     
07 the purpose of determining if benefits are payable under the applicable policy;                                         
08   (2)  shall                                                                                                           
09   (A)  if applicable, disclose to each policyholder that the coverage                                                 
10 is limited to the least costly treatment;                                                                               
11   (B)  define and explain the standard on which coverage or                                                           
12 reimbursement for the cost of dental services is based; and                                                             
13   (C)  provide that coverage or reimbursement for a noncontracting                                                    
14 provider dentist shall be equal to the coverage or reimbursement for a                                                  
15 contracting provider dentist; this paragraph does not require coverage or                                               
16 reimbursement in an amount greater than allowed under the policy or contract                                            
17 or greater than charged by the dentist providing the dental care services.                                              
18  (b)  This section does not require that particular dental care benefits be                                            
19 provided under an insurance policy.                                                                                     
20  (c)  Notwithstanding the other provisions of this section,                                                            
21   (1)  a dentist licensed under AS 08.36 may contract directly with a                                                  
22 person to provide dental care services that the dentist is licensed to perform; and                                     
23   (2)  an insurer authorized under AS 21.09 to offer, issue for delivery,                                              
24 deliver, or renew an individual or group disability insurance policy for medical                                        
25 coverage on an expense incurred basis in the state may                                                                  
26   (A)  make information relating to dental care services, fees,                                                       
27 location, or hours of service available to a policyholder or covered person if the                                      
28 information is provided after a request by a dentist licensed under AS 08.36;                                           
29   (B)  establish an administrative procedure to facilitate payment                                                    
30 for dental care services by an insured or covered person to the dentist of the                                          
31 insured or covered person's choice; and                                                                                 

01   (C)  pay or reimburse, on a nondiscriminatory basis, an insured                                                     
02 or covered person for the cost of dental care services by the dentist of the                                            
03 insured or covered person's choice.                                                                                     
04  (d)  An individual or group disability insurance policy offered, issued for                                           
05 delivery, or delivered in violation of this section may not be enforced.                                                
06  (e)  In this section, "dental care services" means services performed for the                                         
07 purpose of preventing, alleviating, curing, or healing an illness or injury relating to a                               
08 person's teeth and includes the practices described under AS 08.36.360.                                                 
09    * Sec. 2.  APPLICABILITY.  This Act applies to a policy of insurance entered into or                                 
10 renewed on or after the effective date of this Act.                                                                     
11    * Sec. 3.  This Act takes effect July 1, 1994.