Senate Bill 2566

AN ACT TO AMEND SECTION 83-51-5, MISSISSIPPI CODE OF 1972, TO DELETE THE PROVISION WHICH REQUIRES HEALTH INSURANCE POLICIES OR EMPLOYEE BENEFIT PLANS TO REIMBURSE A NONCONTRACTING PROVIDER DENTIST THE SAME AS A CONTRACTING PROVIDER DENTIST; TO AMEND SECTION 83-51-11, MISSISSIPPI CODE OF 1972, IN CONFORMITY THERETO; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 83-51-5, Mississippi Code of 1972, is amended as follows:

83-51-5. Any health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery or otherwise contracted for in this state shall, to the extent that it provides benefits for dental care expenses:

(a) Disclose, if applicable, that the benefit offered is limited to the least costly treatment;

(b) Define and explain the standard upon which the payment of benefits or reimbursement for the cost of dental care services is based, such as "usual and customary," "reasonable and customary," "usual, customary and reasonable," or fees or words of similar import, or it shall specify in dollars and cents the amount of the payment or reimbursement for dental care services to be provided. * * *

SECTION 2. Section 83-51-11, Mississippi Code of 1972, is amended as follows:

83-51-11. Notwithstanding any other provision of this chapter:

(a) A dentist may contract directly with a patient for the furnishing of dental care services to such patient as may be otherwise authorized by law;

(b) Any person providing a health insurance policy or employee benefit plan, or an employer, or an employee organization may:

(i) Make available to its insureds, beneficiaries, participants, employees or members information relating to dental care services by distributing factually accurate information regarding dental care services, rates, fees, location and hours of service, provided such distribution is made upon the request of any dentist licensed by the state; or

(ii) Establish an administrative mechanism which facilitates payment for dental care services by insureds, beneficiaries, participants, employees or members to the dentist of their choice; or

(iii) Pay or reimburse * * * its insureds, beneficiaries, participants, employees or members for the cost of dental care services rendered by the dentist of their choice.

SECTION 3. This act shall take effect and be in force from and after July 1, 2005.