HB397 Alabama 2015 Session

Summary

Primary Sponsor

Anthony DanielsRepresentative

Democrat

Session

Regular Session 2015

Title

Dental services, certain health insurance policies and health maintenance organizations plans, setting fees for services not covered by the plan, prohibited

Summary

HB397 would stop health plans from forcing dentists to charge a plan-set fee for dental services that aren’t covered by the plan.

What This Bill Does

If passed, the bill would prohibit a dental provider from being required to render services to a covered person at a fee set by the policy or plan unless the service is covered. It would not apply to health care service plans. The bill also keeps existing insurer rights like balance billing, waiting periods, frequency limits, deductibles, and maximum annual benefits intact, and it takes effect for plans issued after January 1 following the act’s effective date.

Who It Affects

• Covered persons (patients) enrolled in a plan: plan-set fees for non-covered dental services cannot be required by the plan.
• Dental care providers (licensed dentists): they would not be required to accept a plan-set fee for non-covered services and may set their own fees for those services.

Key Provisions

• Prohibits an insurance policy, plan, or contract that provides third-party payment or prepayment of health expenses from requiring a dental care provider to bill at a fee set by the plan for non-covered services; exception for services that are covered.
• Plans issued after January 1 following the act’s effective date shall comply with the fee prohibition; the act preserves insurer rights such as balance billing, waiting periods, frequency limitations, deductibles, and maximum benefits; and the act becomes effective on the first day of the third month after legislative passage.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health