HB 5317

Abstract

Amends the Uniform Electronic Transactions in Dental Care Billing Act. Provides that beginning January 1, 2027 (instead of 2025), no dental plan carrier is required to accept from a dental care provider eligibility for a dental plan transaction or dental care claims or equivalent encounter information transaction. Sets forth exemptions from the requirements of the Act, and requires a dental care provider who is exempt from the requirements of the Act to file a form with the Department of Insurance indicating the applicable exemption. Requires each dental plan carrier to establish a portal that provides certain benefit and billing information. Requires a dental plan carrier to establish an electronic portal that allows dental care providers to submit claims electronically and directly to the dental care provider; accept attachments in an electronic format with the initial electronic claim's submission; and provide remittance advice with the corresponding payment. Provides that nothing in the Act requires a dental care provider to only accept electronic payment from a dental plan carrier. Provides that dental plan carriers shall allow alternative forms of payment, without additional fees or charges, to a dental care provider, if requested. Effective immediately. House Committee Amendment No. 1 Deletes reference to: 215 ILCS 111/15 215 ILCS 111/25 215 ILCS 111/30 new 215 ILCS 111/35 new 215 ILCS 111/40 new 215 ILCS 111/45 new Adds reference to: 215 ILCS 111/20 Replaces everything after the enacting clause. Amends the Uniform Electronic Transactions in Dental Care Billing Act. Provides that beginning January 1, 2027 (instead of 2025), no dental plan carrier is required to accept from a dental care provider eligibility for a dental plan transaction or dental care claims or equivalent encounter information transaction. Effective immediately. House Floor Amendment No. 2 Replaces everything after the enacting clause. Reinserts the provisions of the bill, as amended by House Amendment No. 1, with the following change. Provides that beginning January 1, 2026 (rather than January 1, 2027), no dental plan carrier is required to accept from a dental care provider eligibility for a dental plan transaction or dental care claims or equivalent encounter information transaction. Effective immediately.