Relating to prior authorization for dental care services

This bill relates to prior authorization for dental care services. Under the bill, a dental carrier (carrier) shall not deny a claim submitted by a dental care provider (provider) for dental care services (services) approved by prior authorization. A carrier shall reimburse a provider at the contracted reimbursement rate for a service provided by the provider to a covered person per a prior authorization. “Covered person”, “dental care provider”, “dental care services”, “dental carrier”, and “prior authorization” are defined in the bill. A carrier may deny a claim submitted by a provider for services approved by prior authorization if, for each service for which a provider is denied reimbursement, an exception as described in the bill is applicable. The requirements of the bill shall not be waived by contract, and any contract to the contrary shall be null and void. The commissioner of insurance may adopt rules to administer the bill.