By Reyna of Bexar H.B. No. 94
76R640 PB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to insurance coverage for certain dental procedures.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 2, Article 21.53, Insurance Code, is
1-5 amended to read as follows:
1-6 Sec. 2. PROHIBITED PROVISIONS. (a) A [No] health insurance
1-7 policy or employee benefit plan that [which] is delivered, renewed,
1-8 issued for delivery, or otherwise contracted for in this state may
1-9 not [shall]:
1-10 (1) [(a)] prevent any person who is a party to or
1-11 beneficiary of the [any such] health insurance policy or employee
1-12 benefit plan from selecting the dentist of the person's [his]
1-13 choice to furnish the dental care services offered by the [said]
1-14 policy or plan or interfere with that [said] selection if
1-15 [provided] the dentist is licensed to furnish those [such] dental
1-16 care services in this state;
1-17 (2) [(b)] deny any dentist the right to participate as
1-18 a contracting provider for the [such] policy or plan if [provided]
1-19 the dentist is licensed to furnish the dental care services offered
1-20 by the [said] policy or plan;
1-21 (3) [(c)] authorize any person to regulate, interfere,
1-22 or intervene in any manner in the diagnosis or treatment rendered
1-23 by a dentist to the dentist's [his] patient for the purpose of
1-24 preventing, alleviating, curing, or healing dental illness or
2-1 injury if the [provided said] dentist practices within the scope of
2-2 the dentist's [his] license; [or]
2-3 (4) [(d)] require that a [any] dentist furnishing
2-4 dental care services must make or obtain dental x-rays or any other
2-5 diagnostic aids for the purpose of preventing, alleviating, curing,
2-6 or healing dental illness or injury; or
2-7 (5) limit benefits for dental care services relating
2-8 to the diagnosis, preparation, and fitting of a dental crown on a
2-9 particular tooth to one dental crown for that tooth in a specified
2-10 period [provided, however, that nothing herein shall prohibit
2-11 requests for existing dental x-rays or any other existing
2-12 diagnostic aids for the purpose of determining benefits payable
2-13 under a health insurance policy or employee benefit plan].
2-14 (b) Subsection (a)(4) of this section does not prohibit a
2-15 request for existing dental x-rays or any other existing diagnostic
2-16 aids to determine benefits payable under a health insurance policy
2-17 or employee benefit plan.
2-18 (c) This section does not [Nothing herein shall] prohibit
2-19 the predetermination of benefits for dental care expenses prior to
2-20 treatment by the attending dentist.
2-21 SECTION 2. Article 21.53, Insurance Code, as amended by this
2-22 Act, applies only to a health insurance policy or employee benefit
2-23 plan that is delivered, issued for delivery, or renewed on or after
2-24 January 1, 2000. A policy or plan delivered, issued for delivery,
2-25 or renewed before January 1, 2000, is governed by the law as it
2-26 existed immediately before the effective date of this Act, and that
2-27 law is continued in effect for that purpose.
3-1 SECTION 3. This Act takes effect September 1, 1999.
3-2 SECTION 4. The importance of this legislation and the
3-3 crowded condition of the calendars in both houses create an
3-4 emergency and an imperative public necessity that the
3-5 constitutional rule requiring bills to be read on three several
3-6 days in each house be suspended, and this rule is hereby suspended.