Sec. 1451.2065. CONTRACTS WITH DENTISTS. (a) In this section, "covered service" means a dental care service for which reimbursement is available under a patient's employee benefit plan or health insurance policy, or for which reimbursement is available subject to a contractual limitation, including:
(1) a deductible;
(2) a copayment;
(3) coinsurance;
(4) a waiting period;
(5) an annual or lifetime maximum limit;
(6) a frequency limitation; or
(7) an alternative benefit payment.
(b) A contract between an insurer and a dentist may not limit the fee the dentist may charge for a service that is not a covered service.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1061 (S.B. 554), Sec. 2, eff. September 1, 2011.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle F - Physicians and Health Care Providers
Chapter 1451 - Access to Certain Practitioners and Facilities
Subchapter E. Dental Care Benefits in Health Insurance Policies or Employee Benefit Plans
Section 1451.202. Applicability and Construction of Subchapter
Section 1451.203. Conflicting Provisions
Section 1451.204. Certain Conduct Permitted
Section 1451.205. Disclosure of Benefit Terms
Section 1451.206. Payment or Reimbursement of Dentist
Section 1451.2065. Contracts With Dentists
Section 1451.207. Prohibited Conduct
Section 1451.208. Prior Authorization of Dental Care Services