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Current as of January 01, 2024 | Updated by Findlaw Staff
1. A contract between a dental plan and a dentist for the provision of services to covered individuals under the plan shall not require that a dentist provide services to those covered individuals at a fee set by the dental plan unless such services are covered services under the dental plan.
2. A person or entity providing third-party administrator services shall not make available any dentists in its dentist network to a dental plan that sets fees for dental services that are not covered services.
3. For the purposes of this section:
a. “Covered services” means services reimbursed under the dental plan.
b. “Dental plan” means any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.
4. Nothing in this section shall be construed as limiting the ability of an insurer or a third-party administrator to restrict any of the following as they relate to covered services:
a. Balance billing.
b. Waiting periods.
c. Frequency limitations.
d. Deductibles.
e. Maximum annual benefits.
Cite this article: FindLaw.com - Iowa Code Title XIII. Commerce [Chs. 505-554D] § 514C.3B. Dental coverage--fee schedules - last updated January 01, 2024 | https://codes.findlaw.com/ia/title-xiii-commerce-chs-505-554d/ia-code-sect-514c-3b/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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