Report Title:

Oral Health and Hygiene Procedures; Mandated Covered Health Benefit

Description:

Requires insurers, hospital and medical services plans, and health maintenance organizations to provide oral health and hygiene procedures to their policyholders, members, and enrollees.

THE SENATE

S.B. NO.

2603

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to health insurance.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that, based upon the 1999 findings of the department of health, dental health division, among public elementary school children statewide, children in Hawaii have tooth decay (dental caries) rates that far exceed those documented on the United States mainland. At an average of 3.9 decayed teeth per child, the rate of dental caries among children ages five through nine in Hawaii is 2.1 times the last published United States national average of 1.9. Hawaii's dental caries prevalence rate is among the highest in the nation. The rates among Hawaii's native Hawaiians (4.2) and Filipinos (5.5) exceed the national average by 2.2 and 2.9 times, respectively.

Poor oral health among children and vulnerable adult populations is among the most widespread and pressing public health problems identified in Hawaii. Dental disease, including tooth decay, is Hawaii's silent epidemic. Affecting most Hawaii residents at one time or another, tooth decay causes pain, loss of productivity at school and work, expensive treatment, and the risk of severe, even life-threatening infection.

The purpose of this Act is to require insurers, hospital and medical services plans, and health maintenance organizations to provide oral health and hygiene procedures to their policyholders, members, and enrollees.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A-   Oral health and hygiene procedures; notice. (a) Any other law to the contrary notwithstanding, each employer group health policy, contract, plan, or agreement issued or renewed in this State after December 31, 2004, shall provide, not as an employer option, oral health and hygiene procedures for policyholders and individuals covered under the policy, contract, plan, or agreement. The oral health and hygiene procedures shall be jointly certified by the board of medical examiners and the board of dental examiners as health benefits.

(b) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2004 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2004."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432-   Oral health and hygiene procedures; notice. (a) Any other law to the contrary notwithstanding, each individual and group hospital or medical service plan, policy, contract, or agreement issued or renewed in this State after December 31, 2004, shall provide, not as an employer option, oral health and hygiene procedures for members and individuals covered under the service plan, policy, contract, or agreement. The oral health and hygiene procedures shall be jointly certified by the board of medical examiners and the board of dental examiners as health benefits.

(b) Every mutual benefit society shall provide notice to its members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2004 when annual information is made available to policyholders, or in any other mailing to members, but in no case later than December 31, 2004."

SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, [and] 431:10A-121, and 431:10A-   , and chapter 431M."

SECTION 5. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under section 431:10A-   , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2004.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.

INTRODUCED BY:

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