(a) In this section:
(1) “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:
(A) a deductible;
(B) a copayment;
(C) coinsurance;
(D) a waiting period;
(E) an annual or lifetime maximum limit;
(F) a frequency limitation;
(G) an alternative benefit payment; or
(H) any other limitation.
(2) “Insurer” means a provider or issuer of an employee benefit plan or health insurance policy.
(b) A contract between an insurer and a dentist may not:
(1) limit the fee the dentist may charge for a service that is not a covered service; or
(2) include a provision that both:
(A) allows the insurer to disallow a service, resulting in denial of payment to the dentist for a service that ordinarily would have been covered; and
(B) prohibits the dentist from billing for and collecting the amount owed from the patient for that service if there is a dental necessity, as defined by § 32.054, Human Resources Code, for that service.