Public Chapter 363

SENATE BILL NO. 878

By Jordan

Substituted for: House Bill No. 785

By McMillan, West, Stamps, Hood

AN ACT To amend Tennessee Code Annotated, Title 56, relative to insurance coverage of certain costs associated with dental procedures.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:

SECTION 1. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by adding the following as a new section to be appropriately designated:

Section __. Any accident or sickness insurance or hospital, medical service contract or policy under Chapters 7, 26, 27, 28, 29 or 32 of this title, which takes effect on or after July 1, 1997, shall provide for reimbursement of anesthesia expenses, hospital expenses and physician expenses associated with any inpatient/outpatient hospital dental procedure where:

(1) such expense is covered under such contract or policy; and

(2) the procedure is performed on a minor eight (8) years of age or younger and cannot be safely performed in a dental office setting.

The benefit provided for by this section shall be subject to the same annual deductibles or co-insurance established for all other covered benefits within a given plan, policy or contract. Private third party payors may not reduce or eliminate coverage due to the requirements of this section. Nothing contained herein shall be construed as applying to medical assistance programs funded with state and federal funds, if such programs require provision of services as medically necessary.

SECTION 2. This act shall take effect July 1, 1997, the public welfare requiring it.