Louisiana Revised Statutes 37:771.1 – Dentist fees; discount to an uninsured individual; effect on a dentist’s contracted reimbursement amount
Terms Used In Louisiana Revised Statutes 37:771.1
- Board: means the Louisiana State Board of Dentistry. See Louisiana Revised Statutes 37:751
- Contract: A legal written agreement that becomes binding when signed.
- Dentistry: means the evaluation, diagnosis, prevention, or treatment, including nonsurgical, surgical, or related procedures, of diseases, disorders, or conditions of the oral cavity, maxillofacial areas or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of his education, training, and experience, in accordance with the ethics of the profession and applicable law. See Louisiana Revised Statutes 37:751
A. Notwithstanding any state or federal provisions to the contrary, a contracted dentist licensed to practice dentistry by the board may offer a discount for dental care services rendered to an uninsured individual. Any such discount granted by a contracted dentist to an uninsured individual shall not reduce the contracted reimbursement amount between a dentist and a health or dental insurance issuer for dental care services rendered to the issuer’s enrollees, insureds, and subscribers.
B. For the purposes of this Section:
(1) “Contracted dentist” means a dentist licensed to practice dentistry by the board who has executed a direct, specific contract with a health insurance issuer.
(2) “Contracted reimbursement amount” means the quantity of remuneration a health or dental insurance issuer has agreed to pay a dentist for rendering dental care services in a direct, specific agreement between a dentist and a health or dental insurance issuer.
(3) “Enrollee”, “insured”, or “subscriber” means an individual who is enrolled or insured by a health or dental insurance issuer or who is subscribed to a dental service contractor for dental insurance coverage or prepaid dental services.
(4) “Health or dental insurance issuer” means any entity that offers health or dental insurance coverage through a policy, contract, dental benefit plan, or certificate of insurance subject to state law that regulates the business of insurance. For purposes of this Section, a “health or dental insurance issuer” shall include but not be limited to a dental service contractor as defined and certified pursuant to Subpart G of Part III of Chapter 4 of Title 22 of the Louisiana Revised Statutes of 1950.
Acts 2006, No. 744, §1, eff. June 29, 2006; Acts 2008, No. 415, §2, eff. Jan. 1, 2009; Acts 2022, No. 271, §2.