79R2278 PB-D

By:  Solis                                                        H.B. No. 2398



A BILL TO BE ENTITLED

AN ACT

relating to payment by health benefit plans for certain dental care 
services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subtitle F, Title 8, Insurance Code, as 
effective April 1, 2005, is amended by adding Chapter 1456 to read 
as follows:

CHAPTER 1456.  PROHIBITED PAYMENTS BY CERTAIN

HEALTH BENEFIT PLANS
	Sec. 1456.001.  DEFINITIONS.  In this chapter:                          
		(1)  "Dental care service" means a service provided to 
a person to prevent, alleviate, cure, or heal a human dental illness 
or injury.
		(2)  "Dentist" means a person licensed by the State 
Board of Dental Examiners to engage in the practice of dentistry 
under Subtitle D, Title 3, Occupations Code.
		(3)  "Enrollee"  means an individual enrolled in a 
health benefit plan.
	Sec. 1456.002.  APPLICABILITY OF CHAPTER.  This chapter 
applies only to a health benefit plan that provides benefits for  
expenses incurred by an enrollee in this state for dental care 
services, including an individual, group, blanket, or franchise 
insurance policy or insurance agreement, a group hospital service 
contract, or an individual or group evidence of coverage or similar 
coverage document that is offered by:
		(1)  an insurance company;                                             
		(2)  a group hospital service corporation operating 
under Chapter 842;
		(3)  a fraternal benefit society operating under 
Chapter 885;        
		(4)  a stipulated premium company operating under 
Chapter 884;       
		(5)  a reciprocal exchange operating under Chapter 942;                
		(6)  a health maintenance organization operating under 
Chapter 843;  
		(7)  a multiple employer welfare arrangement that holds 
a certificate of authority under Chapter 846;
		(8)  an approved nonprofit health corporation that 
holds a certificate of authority under Chapter 844;  or
		(9)  a small employer health benefit plan written under 
Chapter 1501.
	Sec. 1456.003.  PAYMENTS PROHIBITED.  A health benefit plan 
issuer may not pay for, or otherwise reimburse a person for the 
provision of, dental care services provided to an enrollee in this 
state if the person who provides the dental care services is not a 
dentist.
	SECTION 2.  This Act takes effect September 1, 2005.