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Oklahoma Legislature· HB 2056Second Reading referred to Rules

An act relating to dental insurance claims, the official text

Shown verbatim: the complete text as captured from the official PDF posted by the Oklahoma Legislature, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
1                    STATE OF OKLAHOMA

2   1st Session of the 60th Legislature (2025)

3 HOUSE BILL 2056                    By: Stinson

4

5

6                               AS INTRODUCED

7   An Act relating to dental insurance claims; amending

    36 O.S. 2021, Section 7301, which relates to dental

8   plans; modifying definition; and providing an

    effective date.

9

10

11 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

12  SECTION 1.      AMENDATORY       36 O.S. 2021, Section 7301, is

13 amended to read as follows:

14  Section 7301. A. No contract between a dental plan of a health

15 benefit plan and a dentist for the provision of services to patients

16 may require that a dentist provide services to its subscribers at a

17 fee set by the health benefit plan unless the services are covered

18 services under the applicable subscriber agreement.

19  B. As used in this section:

20  1. "Covered services" means services reimbursable reimbursed

21 under the applicable subscriber agreement, subject notwithstanding,

22 and without regard to the contractual limitations on subscriber

23 benefits as may apply, including, for example, deductibles, waiting

24 period or frequency limitations;

    Req. No. 11719                                                  Page 1
1   2. "Dental plan" means and shall include any policy of

2 insurance which is issued by a health benefit plan which provides

3 for coverage of dental services not in connection with a medical

4 plan; and

5   3. "Health benefit plan" means any plan or arrangement as

6 defined in subsection C of Section 6060.4 of this title or any

7 dental service corporation authorized pursuant to Section 2671 of

8 this title.

9   C. A health benefit plan or dental plan shall establish and

10 maintain appeal procedures for any claim by a dentist or a

11 subscriber that is denied based on lack of medical necessity. Any

12 such denial shall be based upon a determination by a dentist who

13 holds a nonrestricted license in the United States. Any written

14 communication to a dentist that includes or pertains to a denial of

15 benefits for all or part of a claim on the basis of a lack of

16 medical necessity shall include the identifier and license number

17 together with state of issuance, and a contact telephone number of

18 the licensed dentist making the adverse determination. The dentist

19 who reviewed the claim shall only be contacted at the telephone

20 number provided in the written communication about the denial during

21 business hours.

22  SECTION 2. This act shall become effective November 1, 2025.

23

24  60-1-11719      TJ  01/12/25was

    Req. No. 11719                                                  Page 2
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