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A BILL TO BE ENTITLED
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AN ACT
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relating to contracts between dentists and health maintenance |
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organizations or insurers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter I, Chapter 843, Insurance Code, is |
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amended by adding Section 843.3115 to read as follows: |
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Sec. 843.3115. CONTRACTS WITH DENTISTS. A contract between |
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a health maintenance organization and a dentist may not limit the |
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fee the dentist may charge for a service for which an enrollee's |
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health care plan does not provide a benefit or reimbursement, |
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including a service that exceeds the annual or lifetime maximum |
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plan limit or that is provided during a waiting period. |
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SECTION 2. Subchapter E, Chapter 1451, Insurance Code, is |
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amended by adding Section 1451.2065 to read as follows: |
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Sec. 1451.2065. CONTRACTS WITH DENTISTS. A contract |
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between an insurer and a dentist may not limit the fee the dentist |
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may charge for a service for which a patient's employee benefit plan |
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or health insurance policy does not provide a benefit or |
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reimbursement, including a service that exceeds the annual or |
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lifetime maximum limit of the plan or policy or that is provided |
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during a waiting period. |
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SECTION 3. Sections 843.3115 and 1451.2065, Insurance Code, |
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as added by this Act, apply only to a contract entered into or |
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renewed on or after the effective date of this Act. A contract |
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entered into or renewed before the effective date of this Act is |
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governed by the law in effect immediately before the effective date |
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of this Act, and that law is continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2011. |