Bills › 91st General Assembly
Relating to prior authorization for dental care services
Topics:Health careInsurance
Same legislation: HF 636
Where it is now
- Done: IntroducedFebruary 17, 2025
- Done: SubcommitteeFebruary 17, 2025
- Done: House committeeFebruary 25, 2025
- Skipped: Passes the HouseContinued as HF 636
- Next: Senate committee
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Became HF 636 → Its progress continues under the new number. Go to HF 636 What’s a funnel?
What’s in it
AI summary Insurance companies cannot refuse to pay dentists for dental work that they already approved in advance. If a dentist gets permission for a service, the insurance company must pay them the agreed-upon amount. This rule applies to all dental insurance plans and cannot be changed by private contracts.1
Read the official explanation
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. _____ bill.
House subcommittee
Named February 17, 2025. On February 24, 2025 it recommended passage.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
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91st General Assembly