Bill Introduced to Force DMOs to Pay Individual Dentists Rather Than Group Practices

Austin Texas CapitolHB 2558, am act relating to capitation payments under a contract with a health maintenance organization for the provision of dental care services, has been introduced into this legislative session this week by State Rep. Dr. Tom Oliverson out of District 130 in the Houston area.  Per his legislative profile, Dr. Oliverson is a practicing anesthesiologist and a partner in US Anesthesia Partners, the largest anesthesiology group in Texas with over 1,100 anesthesia providers.

Disrupt group practices

HB 2558, as currently written, would change the insurance code to read “If a contract between a health maintenance organization and a dentist or an entity that provides dental care services uses capitation as a method of compensation, the contract must provide that the health maintenance organization pay the capitated amount for an enrollee to an individual dentist licensed under Chapter 256, Occupations Code, that is selected by or assigned to the enrollee as the enrollee ’s primary care dentist.”

If passed and signed into law by the governor, a long road still to go down, for those with group practices, the bill would disrupt their business model.

The bill and its history can be found online.


One Response

  • Why Medicaid HMO do not pay dentist capitation ???. instead kept the capitation coming from the HHS.
    something wrong with this picture.

    Plus recoup moneys from services already provided and paid to providers.

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