An Act To Further Expand Access to Oral Health Care by Requiring Insurance Coverage for Services Performed by Denturists
Maine Legislature, Session 125, LD 1239
Committee: Insurance and Financial Services
Sponsors: SHAW, SNOWE-MELLO, CLARK, GILBERT, SAVIELLO
Amends: 24 MRSA §2317-B, 24-A MRSA §2765, 24-A MRSA §2847-Q, 24-A MRSA §4257

Legislative Document 
No. 1239 
H.P. 930 
House of Representatives, March 22, 2011 
An Act To Further Expand Access to Oral Health Care by 
Requiring Insurance Coverage for Services Performed by 
Denturists 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative SHAW of Standish. 
Cosponsored by Senator SNOWE-MELLO of Androscoggin and 
Representatives: CLARK of Millinocket, GILBERT of Jay, Senator: SAVIELLO of Franklin. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24 MRSA §2317-B, sub-§12-E, as enacted by PL 2009, c. 307, §1 and 
affected by §6, is amended to read: 
12-E.  Title 24-A, sections 2765 and 2847-Q.  Coverage for  services provided by 
independent practice dental hygienists or denturists, Title 24-A, sections 2765 and 
2847-Q; 
Sec. 2.  24-A MRSA §2765, as enacted by PL 2009, c. 307, §2 and affected by §6, 
is amended to read: 
§2765.  Coverage for services provided by independent practice dental hygienist; 
denturist 
1.  Services provided by independent practice dental hygienist or denturist.  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 
or a denturist licensed under Title 32, chapter 16, subchapter 6 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 or denturist. 
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 MRSA §2847-Q, as enacted by PL 2009, c. 307, §3 and affected by 
§6, is amended to read: 
§2847-Q.  Coverage for services provided by independent practice dental hygienist; 
denturist 
1.  Services provided by independent practice dental hygienist or denturist.  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 or a denturist 
licensed under Title 32, chapter 16, subchapter 6 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 or denturist. 
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 
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, as enacted by PL 2009, c. 307, §4 and affected by §6, 
is amended to read: 
§4257.  Coverage for services provided by independent practice dental hygienist; 
denturist 
1.  Services provided by independent practice dental hygienist or denturist.  All 
individual and group health maintenance organization contracts that include 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 or a denturist 
licensed under Title 32, chapter 16, subchapter 6 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 or denturist. 
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, 2012.  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 policies and contracts to 
provide coverage for dental services performed by a denturist if those services would be 
covered under the policy or contract and those services are within the lawful scope of 
practice of the denturist.  The bill applies to all individual and group policies and 
contracts issued or renewed on or after January 1, 2012.