An Act To Assist Dental Hygienists
Maine Legislature, Session 122, LD 0161
Committee: Insurance and Financial Services
Sponsors: PERRY, PINGREE, MARTIN, SULLIVAN, WEBSTER
Amends: 24-A MRSA §2761, 24-A MRSA §2847-L

Legislative Document 
No. 161 
S.P.67 
In Senate, January 13,2005 
An Act To Assist Dental Hygienists 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Senator PERRY of Penobscot. 
Cosponsored by Representative PINGREE of North Haven and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: MARTIN of Aroostook, SULLIVAN of York, Representative: WEBSTER of 
Freeport. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24 MRS A §2317-B, sub-§12-B is enacted to read: 
12-B. Title 24-A. sections 2161 and 2841-L. Coverage for 
services provided by dental hygienists, Title 24-A, sections 2761 
and 2847-L: 
Sec. 2. 24-A MRSA §2761 is enacted to read: 
§2161. 
Coverage for services provided by dental hygienist 
1. 
Services provided by dental hygienist. 
An insurer that 
issues 
individual 
health 
insurance 
contracts 
shall 
provide 
coverage 
for dental 
services provided by 
a 
dental hygienist 
within the scope of that dental hygienist's license regardless of 
the facility or setting in which the services are rendered if 
those same dental services would be covered when provided by a 
dental hygienist in a dental office. 
2. 
Limits; 
coinsurance; 
deductibles. 
A 
contract 
that 
provides coverage for the services reguired by this section may 
contain provisions 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the reguirements 
of this section. 
3. Coordination of benefits with dental insurance. If an 
enrollee 
eligible 
for 
coverage 
under 
this 
section 
is 
also 
eligible 
for 
coverage 
for 
general 
anesthesia 
and 
associated 
faciiity charges under a dental insurance policy or contract, the 
nonprofit health care service organization or insurer providing 
dental 
insurance is the primary payer 
responsible 
for 
those 
charges and the insurer providing individual health insurance is 
the secondary payer. 
4. Application. 
The reguirements of this section apply to 
All policies, 
contracts 
and certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec.3. 24-A MRSA §2847-L is enacted to read: 
§2841-L. 
Coverage for services provided by dental hygienist 
1. 
Services provided by dental hygienist. 
An insurer that 
issues group health insurance contracts shall provide coverage 
for dental services provided by a dental hygienist within the 
scope 
of 
that dental hygienist's 
license 
regardless 
of 
the 
Page I-LR0324(1) 
facility or setting in which the services are rendered if those 
same dental services would be covered when provided by a dental 
hygienist in a dental office. 
2. 
Limits: 
coinsurance: 
deductibles. 
A 
contract 
that 
provides coverage for the services required by this section may 
contain provisions 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements 
of this section. 
3. Coordination of benefits with dental insurance. If an 
enrollee 
eligible 
for 
coverage 
under 
this 
section 
is 
also 
eligible 
for 
coverage 
for 
general 
anesthesia 
and 
associated 
facility charges under a dental insurance policy or contract, the 
nonprofit health care service organization or insurer providing 
dental 
insurance is 
the primary payer 
responsible 
for 
those 
charges and the insurer providing individual health insurance is 
the secondary payer. 
4. Application. 
The requirements of this section apply to 
all policies, 
contracts 
and certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this State. 
For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. 4. 24·A MRS A §4252 is enacted to read: 
§4252. 
Coverage for services provided by dental hygienist 
1. 
Services provided by dental hygienist. 
All individual 
and group health maintenance organization contracts must provide 
coverage 
for 
dental 
services provided 
by 
a 
dental hygienist 
within the scope of that dental hygienist's license regardless of 
the facility or setting in which the services are rendered if 
those same dental services would be covered when provided by a 
dental hygienist in a dental office. 
2. 
Limits: 
coinsurance: 
deductibles. 
A 
contract 
that 
provides coverage for the services required by this section may 
contain provisions 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements 
of this section. 
3. Coordination of benefits with dental insurance. If an 
enrollee 
eligible 
for 
coverage 
under 
this 
section 
is 
also 
eligible 
for 
coverage 
for 
general 
anesthesia 
and 
associated 
facility charges under a dental insurance policy or contract, the 
nonprofi t 
health care service organization or insurer providing 
dental 
insurance is 
the primary payer 
responsible 
for 
those 
charges and the insurer providing individual health insurance is 
the secondary payer. 
4. Application. 
The reguirements of this section apply to 
all policies, 
contracts 
and certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. 5. Applicability. 
This 
Act 
applies 
to all policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State on or after January 
1, 2006. For purposes of this Act, all contracts are deemed to be 
renewed no later than the next yearly anniversary of the contract 
date. 
SUMMARY 
This bill requires health insurers and health maintenance 
organizations to provide coverage 
for 
services provided by 
a 
dental hygienist regardless of the setting in which the services 
are delivered if those services would be covered if delivered in 
a dental office. 
The bill applies to all policies, contracts and certificates 
issued or renewed on or after January 1, 2006.