An Act To Expand Access to Oral Health Care
Maine Legislature, Session 124, LD 0234
Committee: Insurance and Financial Services
Sponsors: JONES, SULLIVAN, BEAUDOIN, BECK, BUTTERFIELD, PERRY, THOMAS, BRANNIGAN
Amends: 24 MRSA §2317-B, 24-A MRSA §2765, 24-A MRSA §4257

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Legislative Document 
No. 234 
H.P.188 
House of Representatives, January 23,2009 
An Act To Expand Access to Oral Health Care 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative JONES of Mount Vernon. 
Cosponsored by Senator SULLIVAN of York and 
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111· mll£:~{ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BEAUDOIN of Biddeford, BECK of Waterville, BUTTERFIELD of Bangor, 
PERRY of Calais, SMITH ofMomnouth, THOMAS of Ripley, Senator: BRANNIGAN of 
Cumberland. 
Printct.l on r~cyclt:t.l puper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24 MRSA §2317-B, sub-§12-E is enacted to read: 
12-E. Title 24-A, sections 2765 ami' 2847-Q. Coverage for services provided by 
independent practice dental hygienists, Title 24-A, sections 2765 and 2847-0; 
Sec. 2. 24-A MRSA §2765 is enacted to read: 
§2765. Coverage for services provided by independent practice dental hygienist 
1. Services provided by independent practice dental hygienist. An insurer that 
issues individual dental insurance or health insurance that includes coverage for dental 
services shall provide coverage for dental services performed by an independent practice 
dental hygienist licensed under Title 32, chapter 16, subchapter 3-B when those services 
are covered services under the contract and when they are within the lawful scope of 
practice of the independent practice dental hygienist. 
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 eligible for coverage under a dental insurance policy or 
contract and a health insurance policy or contract, the insurer providing dental insurance 
is the primary payer responsible for charges under subsection 1 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. 3. 24-A MRS A §2847-Q is enacted to read: 
§2847-Q. Coverage for services provided by independent practice dental hygienist 
1. Services provided by independent practice dental hygienist. An insurer that 
issues group dental insurance or health insurance that includes coverage for dental 
services shall provide coverage for dental services performed by an independent practice 
dental hygienist licensed under Title 32, chapter 16, subchapter 3-B when those services 
are covered services under the contract and when they are within the lawful scope of 
practice of the independent practice dental hygienist. 
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. 
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3. Coordination of benefits with dental insurance. 
If an enrollee eligible for 
coverage under this section is eligible for coverage under a dental insurance policy or 
contract and a health insurance policy or contract, the insurer providing dental insurance 
is the primary payer responsible for charges under subsection 1 and the insurer providing 
group 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 MRSA §4257 is enacted to read: 
§4257. Coverage for services provided by independent practice dental hygienist 
1. Services provided by independent practice dental hygienist. All individual and 
group health maintenance organization contracts that include coverage for dental services 
shall provide coverage for dental services perfonned by an independent practice dental 
hygienist licensed under Title 32, chapter 16, subchapter 3-B when those services are 
covered services under the contract and when they are within the lawful scope of practice 
of the independent practice dental hygienist. 
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 eligible for coverage under a dental insurance policy or 
contract and a health maintenance organization policy or contract, the insurer providing 
dental insurance is the primary payer responsible for charges under subsection 1 and the 
health maintenance organization providing health coverage 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. 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, 2010. 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 dental insurers and health insurers and health maintenance 
organizations that include coverage for dental services in their policie~ and contracts to 
provide coverage for dental services perfonned by an independent practice dental 
hygienist if those services would be covered under the policy or contract and those 
services are within the lawful scope of practice of the independent practice dental 
hygienist. The bill applies to all individual and group policies and contracts issued or 
renewed on or after January 1, 2010. 
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