Section 1374.195 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1374.195
. (a) With respect to a contract between a health care
service plan or specialized health care service plan and a dentist to
provide covered dental services to enrollees of the plan, the
contract shall not require a dentist to accept an amount set by the
plan as payment for dental care services provided to an enrollee that
are not covered services under the enrollee's plan contract. This
subdivision shall only apply to provider contracts issued, amended,
or renewed on or after January 1, 2011.
(b) A provider shall not charge more for dental services that are
not covered services under a plan contract than his or her usual and
customary rate for those services. The department shall not be
required to enforce this subdivision.
(c) The evidence of coverage and disclosure form, or combined
evidence of coverage and disclosure form, for every health care
service plan contract covering dental services, or specialized health
care service plan contract covering dental services, that is issued,
amended, or renewed on or after July 1, 2011, shall include the
following statement: