§ 26.1-47-02.1 — Fees for dental services - Prohibition

North Dakota § 26.1-47-02.1

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-47: Preferred Provider Organizations

Text

1. As used in this section, "covered services" means dental care services for which a
reimbursement is available under an enrollee's plan or for which a reimbursement
would be available but for the application of a deductible, copayment, coinsurance,
waiting period, annual or lifetime maximum, or frequency limitation.
2. Except for fees for covered services, a preferred provider arrangement for a dental
plan may not directly or indirectly set or otherwise regulate the fees charged by the
preferred provider for dental care services.

3. A preferred provider arrangement may not restrict a covered person from receiving or
paying for additional dental care services that were denied by the covered person's
dental plan.
4. Unless disclosed to the covered person before receiving dental care, a covered person
receiving or paying for additional dental care services described in subsection 3 may
not be charged a rate in excess of the preferred provider arrangement's contracted
rate for covered services.