GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1999

H	1 

HOUSE BILL 1119

Short Title:  Children/Disable Anesth. Dental Care.	(Public)

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Sponsors: Representatives Wright, Edwards, Baddour, Cansler (Primary Sponsors), Horn; Bowie, Hardaway, Luebke, McMahan, Miner, Sherrill, and Smith.

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Referred to:  Insurance.

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April 15, 1999

A BILL TO BE ENTITLED
AN ACT TO ENSURE THAT HEALTH BENEFIT PLANS IN NORTH CAROLINA PROVIDE COVERAGE FOR ANESTHESIA AND HOSPITAL CHARGES IN CERTAIN CASES INVOLVING YOUNG CHILDREN, PERSONS WITH SERIOUS MENTAL OR PHYSICAL CONDITIONS, AND PERSONS WITH SIGNIFICANT BEHAVIORAL PROBLEMS, WHERE THE AGE OR CONDITION OR PROBLEM REQUIRES HOSPITALIZATION OR GENERAL ANESTHESIA IN ORDER TO SAFELY AND EFFECTIVELY PERFORM DENTAL PROCEDURES ON THE PATIENT INVOLVED.
The General Assembly of North Carolina enacts:
Section 1. Effective January 1, 2000, Article 3 of Chapter 58 of the General Statutes is amended by adding the following new section to read:
"§ 58-3-167.5. Anesthesia and hospital charges necessary for safe and effective administration of dental procedures for young children, persons with serious mental or physical conditions, and persons with significant behavioral problems; coverage in health benefit plans.
(a)	All health benefit plans shall provide coverage for payment of anesthesia and hospital charges for services in connection with dental procedures for children below the age of nine years, persons with serious mental or physical conditions, and persons with significant behavioral problems, where the provider treating the patient involved certifies that, because of the patient's age or condition or problem, hospitalization or general anesthesia is required in order to safely and effectively perform the procedures. The same deductibles, coinsurance, and other limitations as apply to physical illness benefits under the health benefit plan shall apply to coverage for anesthesia and hospital charges required to be covered under this section.
(b)	As used in this section, the term: