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A BILL TO BE ENTITLED
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AN ACT
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relating to the payments and reimbursements for noncontracting and |
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contracting provider dentists under certain health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1451.206(a), Insurance Code, is amended |
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to read as follows: |
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(a) The employee benefit plan or health insurance policy |
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shall: |
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(1) provide: |
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(A) [that payment or reimbursement for a |
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noncontracting provider dentist shall be the same as payment or |
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reimbursement for a contracting provider dentist; |
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[(B)] that the party to or beneficiary of the |
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plan or policy may assign the right to payment or reimbursement to |
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the dentist who provides the dental care services; and |
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(B) [(C)] one or more methods of payment or |
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reimbursement that provide the dentist 100 percent of the |
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contracted amount of the payment or reimbursement and that do not |
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require the dentist to incur a fee to access the payment or |
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reimbursement; and |
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(2) disclose on the Internet website required under |
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Section 1451.205 and on request of a dentist or a party to or |
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beneficiary of the plan or policy the fees, if any, associated with |
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the methods of payment or reimbursement available under the plan or |
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policy. |
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SECTION 2. Section 1451.206, Insurance Code, as amended by |
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this Act, applies only to a health benefit plan delivered, issued |
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for delivery, or renewed on or after January 1, 2026. A plan |
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delivered, issued for delivery, or renewed before January 1, 2026, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 3. This Act takes effect September 1, 2025. |