SB 493

Abstract

Creates the Uniform Electronic Transactions in Dental Care Billing Act. Requires all dental plan carriers and dental care providers to exchange claims and eligibility information electronically using the standard electronic data interchange transactions for claims submissions, payments, and verification of benefits required under the Health Insurance Portability and Accountability Act in order to be compensable by the dental plan carrier. Provides that no dental plan carrier or dental care provider may add to or modify the uniform electronic claims and eligibility requirements adopted by the Department. Provides that the Act applies to all dental plan carriers. Grants the Director of Insurance the right to investigate complaints filed under the Act. Sets forth criteria for complaints filed under the Act. Requires the Department of Insurance to adopt rules, and allows the Department to establish exemptions to the Act by rule. Defines terms. Effective immediately. Senate Floor Amendment No. 1 Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Removes language that provides that "dental plan carrier" includes employee or employer self-insured benefit plans under the federal Employee Retirement Income Security Act of 1974. Removes language that provides that the Director of Insurance has the right to investigate complaints filed under the Uniform Electronic Transactions in Dental Care Billing Act and that provides criteria for complaints filed under the Act. Effective immediately.