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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:

AN ACT

Prohibiting health care insurers that provide dental care coverage from setting fees that a dentist may charge under a preferred provider contract for dental services not covered under the insurer's policy and relating to preferred provider contracts between insurers and dentists.

Section 1. AS 21.42.392(c) is amended to read:

A health care insurer that provides coverage for dental care
1. may reimburse a covered person at a different rate because of the person's choice of a dentist if the dentist is not a part of the covered person's dental network or preferred provider organization agreement; the [THE] covered expense for non-network providers may not be less than that allowed to a network provider, although the covered expense may be reimbursed at a lower percentage or with higher deductibles than if the service had been provided within the network;
2. may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
3. and may offer a dentist the option of entering into a preferred provider contract with the insurer that provides a fee schedule for covered services only or a fee schedule for both covered and uncovered services; under this paragraph,
  1. the health care insurer may not
    1. take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
    2. fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
    3. take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
  2. the terms or provisions of the contract
    1. may not violate AS 45.50.562 - 45.50.566; and
    2. may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
  3. "covered service" means a health care service for which a health care insurer pays a benefit for all or part of the service, including a benefit that is available but limited by deductible, coinsurance, or frequency terms under the contract between the insurer and the insured.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:

AN ACT

Prohibiting health care insurers that provide dental care coverage from setting fees that a dentist may charge under a preferred provider contract for dental services not covered under the insurer's policy and relating to preferred provider contracts between insurers and dentists.

Section 1. AS 21.42.392(c) is amended to read:

A health care insurer that provides coverage for dental care
1. may reimburse a covered person at a different rate because of the person's choice of a dentist if the dentist is not a part of the covered person's dental network or preferred provider organization agreement; the [THE] covered expense for non-network providers may not be less than that allowed to a network provider, although the covered expense may be reimbursed at a lower percentage or with higher deductibles than if the service had been provided within the network;
2. may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
3. and may offer a dentist the option of entering into a preferred provider contract with the insurer that provides a fee schedule for covered services only or a fee schedule for both covered and uncovered services; under this paragraph,
  1. the health care insurer may not
    1. take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
    2. fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
    3. take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
  2. the terms or provisions of the contract
    1. may not violate AS 45.50.562 - 45.50.566; and
    2. may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
  3. "covered service" means a health care service for which a health care insurer pays a benefit for all or part of the service, including a benefit that is available but limited by deductible, coinsurance, or frequency terms under the contract between the insurer and the insured.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:

AN ACT

Prohibiting health care insurers that provide dental care coverage from setting fees that a dentist may charge under a preferred provider contract for dental services not covered under the insurer's policy and relating to preferred provider contracts between insurers and dentists.

Section 1. AS 21.42.392(c) is amended to read:

A health care insurer that provides coverage for dental care
1. may reimburse a covered person at a different rate because of the person's choice of a dentist if the dentist is not a part of the covered person's dental network or preferred provider organization agreement; the [THE] covered expense for non-network providers may not be less than that allowed to a network provider, although the covered expense may be reimbursed at a lower percentage or with higher deductibles than if the service had been provided within the network;
2. may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
3. and may offer a dentist the option of entering into a preferred provider contract with the insurer that provides a fee schedule for covered services only or a fee schedule for both covered and uncovered services; under this paragraph,
  1. the health care insurer may not
    1. take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
    2. fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
    3. take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
  2. the terms or provisions of the contract
    1. may not violate AS 45.50.562 - 45.50.566; and
    2. may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
  3. "covered service" means a health care service for which a health care insurer pays a benefit for all or part of the service, including a benefit that is available but limited by deductible, coinsurance, or frequency terms under the contract between the insurer and the insured.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:

AN ACT

Prohibiting health care insurers that provide dental care coverage from setting fees that a dentist may charge under a preferred provider contract for dental services not covered under the insurer's policy and relating to preferred provider contracts between insurers and dentists.

Section 1. AS 21.42.392(c) is amended to read:

A health care insurer that provides coverage for dental care
1. may reimburse a covered person at a different rate because of the person's choice of a dentist if the dentist is not a part of the covered person's dental network or preferred provider organization agreement; the [THE] covered expense for non-network providers may not be less than that allowed to a network provider, although the covered expense may be reimbursed at a lower percentage or with higher deductibles than if the service had been provided within the network;
2. may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
3. and may offer a dentist the option of entering into a preferred provider contract with the insurer that provides a fee schedule for covered services only or a fee schedule for both covered and uncovered services; under this paragraph,
  1. the health care insurer may not
    1. take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
    2. fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
    3. take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
  2. the terms or provisions of the contract
    1. may not violate AS 45.50.562 - 45.50.566; and
    2. may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
  3. "covered service" means a health care service for which a health care insurer pays a benefit for all or part of the service, including a benefit that is available but limited by deductible, coinsurance, or frequency terms under the contract between the insurer and the insured.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:

AN ACT

Prohibiting health care insurers that provide dental care coverage from setting fees that a dentist may charge under a preferred provider contract for dental services not covered under the insurer's policy and relating to preferred provider contracts between insurers and dentists.

Section 1. AS 21.42.392(c) is amended to read:

A health care insurer that provides coverage for dental care
1. may reimburse a covered person at a different rate because of the person's choice of a dentist if the dentist is not a part of the covered person's dental network or preferred provider organization agreement; the [THE] covered expense for non-network providers may not be less than that allowed to a network provider, although the covered expense may be reimbursed at a lower percentage or with higher deductibles than if the service had been provided within the network;
2. may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
3. and may offer a dentist the option of entering into a preferred provider contract with the insurer that provides a fee schedule for covered services only or a fee schedule for both covered and uncovered services; under this paragraph,
  1. the health care insurer may not
    1. take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
    2. fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
    3. take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
  2. the terms or provisions of the contract
    1. may not violate AS 45.50.562 - 45.50.566; and
    2. may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
  3. "covered service" means a health care service for which a health care insurer pays a benefit for all or part of the service, including a benefit that is available but limited by deductible, coinsurance, or frequency terms under the contract between the insurer and the insured.

ALASKA

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