APPROVED 04/29/2010

If you would like more information on how to implement these laws within your state, join today or login to view.

AN ACT prohibiting the imposition by a dental plan of fee schedules for the provision of dental services that are not covered by the plan.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. NEW SECTION. 514C.3B Dental coverage—fee schedules.

  1. A contract between a dental plan and a dentist for the provision of services to covered individuals under the plan shall not require that a dentist provide services to those covered individuals at a fee set by the dental plan unless such services are covered services under the dental plan.
  2. A person or entity providing third-party administrator services shall not make available any dentists in its dentist network to a dental plan that sets fees for dental services that are not covered
  3. For the purpose of this section:

a. “Covered services” means services reimbursed under the dental plan.

b. “Dental plan” means any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.

  1. Nothing in this section shall be construed as limiting the ability of an insurer or a third-party administrator to restrict any of the following as they relate to covered services:

a. Balance billing.

b. Waiting periods.

c. Frequency limitations.

d. Deductibles

e. Maximum annual benefits

Our Dental Community Sponsors

Resolv logoPatient News logoEdra logoBerman logoPPO logoBasebone logoThe New Dentist logoDental Slang logo