NRS 695D.227 Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members.
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NRS 695D.227 Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members.
1. No plan for dental care and no contract between an organization for dental care and a dentist may require, directly or indirectly, that the dentist provide dental care to a member at a fee set by or subject to the approval of the organization for dental care unless the dental care is a covered service.
2. An organization for dental care or any other person providing services as a third-party administrator shall not make available any dentists in its network of dentists to a plan for dental care that sets fees for any dental care except covered services.
3. As used in this section, “covered service” means dental care for which reimbursement is available under a member’s policy, or for which reimbursement would be available but for the application of a contractual limitation, including, without limitation, any deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment or any other limitation.