514C.3B Dental coverage — fee schedules. 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 coveredindividuals at a fee set by the dental plan unless such services are covered services under thedental 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 arenot 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 ofmedical 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. lity 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.2010 Acts, ch 1179, §1 Sat Dec 23 00:44:59 2023 Iowa Code 2024, Section 514C.3B (17, 0)
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