BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
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
- 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;
- may not limit a fee set by a dentist for a service unless the service is covered under the insurer's plan or contract;
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,
the health care insurer may not
- take an action against the dentist based on the dentist's refusal to enter into a contract with an insurer;
- fail to list a dentist who does not enter into a contract with an insurer in the insurer's marketing materials; or
- take action against the dentist during the management or administration of a contract based on the dentist's choice of contract;
the terms or provisions of the contract
- may not violate AS 45.50.562 - 45.50.566; and
- may authorize the insurer to provide information to the insured describing the dentist's choice of contract and fee schedules;
- "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.