Enrolled Bill Summary

House Bill 2486	House Author:  Goldman et al.
Effective:  9-1-19	Senate Sponsor:  Schwertner et al.

House Bill 2486 amends the Insurance Code to set out provisions applicable to an employee benefit plan or health insurance policy that provides dental care benefits. The bill provides for the establishment of a website for certain of those plans and policies and for the required disclosure of certain dental care benefit information on the website. The bill requires an applicable plan or policy to provide one or more methods of payment or reimbursement that provide the dentist 100 percent of the contracted amount of the payment or reimbursement and that do not require the dentist to incur a fee to access the payment or reimbursement.

House Bill 2486 prohibits an applicable plan or policy from deducting the amount of an overpayment of a claim from a payment or reimbursement for a service provided by a dentist who did not receive the overpayment. The bill sets out provisions regarding the prior authorization of dental care services, including provisions limiting the conditions under which a provider or issuer may deny a claim for a preauthorized service or reduce payment or reimbursement for the service.