Contracts With Dentists

Sec. 843.3115. CONTRACTS WITH DENTISTS. (a) In this section, "covered service" means a dental care service for which reimbursement is available under an enrollee's health care plan contract, 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 a health maintenance organization 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. 1, eff. September 1, 2011.