1.  An organization for dental care or an administrator who recovers overpayments under a plan for dental care shall provide written notice to a dentist of any attempt to recover an overpayment, other than a duplicate payment. The notice must include, without limitation:

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

(a) A description of the error that justifies the recovery; and

(b) The date on which the dental care for which the overpayment was made was provided and the name of the member to whom the dental care was provided.

2.  An organization for dental care or an administrator who recovers overpayments under a plan for dental care shall establish written procedures by which a dentist may challenge an attempt to recover an overpayment. Those procedures must include, without limitation, procedures for sharing information concerning a disputed claim with the dentist.

3.  Except as otherwise provided in this subsection, an organization for dental care or an administrator who recovers overpayments under a plan for dental care shall not attempt to recover an overpayment more than 12 months after the date of the overpayment. This subsection does not apply to an attempt to recover an overpayment that is:

(a) Based on a reasonable belief that the overpayment involved fraud, abuse or other intentional misconduct; or

(b) Initiated by or at the request of a self-insured employer.

4.  Any provision of a contract that conflicts with this section is against public policy, void and unenforceable.