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Rhode Island General Laws 27-18.8-4. Contracts with providers for dental services

     

No contract between a dental plan of a healthcare entity and a dentist for the provision of services to beneficiaries may require that a dentist provide services to its patients at a fee set by the healthcare entity unless said services are covered services under the applicable subscriber agreement. “Covered services,” as used herein, means services reimbursable under the applicable beneficiary agreement, subject to such contractual limitations on beneficiary benefits as may apply, including, for example, deductibles, waiting period, or frequency limitations.

History of Section.
P.L. 2017, ch. 302, art. 5, § 4.

Terms Used In Rhode Island General Laws 27-18.8-4

  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Beneficiary: means a policy holder subscriber, enrollee, or other individual participating in a health benefit plan. See Rhode Island General Laws 27-18.8-2
  • Contract: A legal written agreement that becomes binding when signed.
  • Healthcare entity: means an insurance company licensed, or required to be licensed, by the state of Rhode Island or other entity subject to the jurisdiction of the commissioner or the jurisdiction of the department of business regulation that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including, without limitation: a for-profit or nonprofit hospital, medical or dental service corporation or plan, a health maintenance organization, a health insurance company, or any other entity providing health insurance, accident and sickness insurance, health benefits, or healthcare services. See Rhode Island General Laws 27-18.8-2

Rhode Island General Laws 27-18-8.4. Rules as to filing

     

The commissioner may make any reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this chapter as are necessary, proper, or advisable to the administration of this chapter. This provision shall not abridge any other authority granted the commissioner by law.

History of Section.
P.L. 1988, ch. 564, § 2.