Senate Bill sb0992e1

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    CS for SB 992                                  First Engrossed



  1                      A bill to be entitled

  2         An act relating to dental service claim

  3         denials; amending s. 627.419, F.S.; providing

  4         for appeals from certain adverse

  5         determinations; amending s. 456.031, F.S.;

  6         providing an alternative by which licensees may

  7         comply with a general requirement that they

  8         take domestic-violence education courses;

  9         amending s. 456.033, F.S.; providing an

10         alternative by which licensees may comply with

11         a general requirement that they take AIDS/HIV

12         education courses; providing an effective date.

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14  Be It Enacted by the Legislature of the State of Florida:

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16         Section 1.  Subsection (9) is added to section 627.419,

17  Florida Statutes, to read:

18         627.419  Construction of policies.--

19         (9)  With respect to any group or individual insurer

20  covering dental services, each claimant, or dentist acting for

21  a claimant, who has had a claim denied as not medically or

22  dentally necessary or who has had a claim payment based on an

23  alternate dental service in accordance with accepted dental

24  standards for adequate and appropriate care must be provided

25  an opportunity for an appeal to the insurer's licensed dentist

26  who is responsible for the medical necessity reviews under the

27  plan or is a member of the plan's peer review group. The

28  appeal may be by telephone, and the insurer's dentist must

29  respond within a reasonable time, not to exceed 15 business

30  days.

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    CS for SB 992                                  First Engrossed



  1         Section 2.  Subsection (3) of section 456.031, Florida

  2  Statutes, is amended to read:

  3         456.031  Requirement for instruction on domestic

  4  violence.--

  5         (3)(a)  In lieu of completing a course as required in

  6  subsection (1), a licensee or certificateholder may complete a

  7  course in end-of-life care and palliative health care, if the

  8  licensee or certificateholder has completed an approved

  9  domestic violence course in the immediately preceding

10  biennium.

11         (b)  In lieu of completing a course as required by

12  subsection (1), a person licensed under chapter 466, who has

13  completed an approved domestic-violence education course in

14  the immediately preceding 2 years may complete a course

15  approved by the Board of Dentistry.

16         Section 3.  Subsection (9) of section 456.033, Florida

17  Statutes, is amended to read:

18         456.033  Requirement for instruction for certain

19  licensees on human immunodeficiency virus and acquired immune

20  deficiency syndrome.--

21         (9)(a)  In lieu of completing a course as required in

22  subsection (1), the licensee may complete a course in

23  end-of-life care and palliative health care, so long as the

24  licensee completed an approved AIDS/HIV course in the

25  immediately preceding biennium.

26         (b)  In lieu of completing a course as required by

27  subsection (1), a person licensed under chapter 466 who has

28  completed an approved AIDS/HIV course in the immediately

29  preceding 2 years may complete a course approved by the Board

30  of Dentistry.

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    CS for SB 992                                  First Engrossed



  1         Section 4.  This act shall take effect July 1, 2001,

  2  and shall apply to policies issued or renewed after that date.

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CODING: Words stricken are deletions; words underlined are additions.