Today's Law As Amended


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AB-2643 Dentistry: general anesthesia: health care coverage.(2017-2018)



As Amends the Law Today


SECTION 1.

 Section 1682 of the Business and Professions Code is amended to read:

1682.
 In addition to other acts constituting unprofessional conduct under this chapter, it is unprofessional conduct for:
(a) Any dentist performing dental procedures to have more than one patient undergoing moderate sedation, deep sedation,  conscious sedation  or general anesthesia on an outpatient basis at any given time unless each patient is being continuously monitored on a one-to-one ratio while sedated by either the dentist or another licensed health professional authorized by law to administer moderate sedation, deep sedation,  conscious sedation  or general anesthesia.
(b) Any dentist with patients recovering from moderate sedation, deep sedation,  conscious sedation  or general anesthesia to fail to have the patients closely monitored by licensed health professionals experienced in the care and resuscitation of patients recovering from moderate sedation, deep sedation,  conscious sedation  or general anesthesia. If one licensed professional is responsible for the recovery care of more than one patient at a time, all of the patients shall be physically in the same room to allow continuous visual contact with all patients and the patient to recovery staff ratio should not exceed three to one.
(c) Any dentist with patients who are undergoing deep sedation, general anesthesia, or moderate  conscious  sedation to fail to have these patients continuously monitored during the dental procedure with a pulse oximeter or similar or superior monitoring equipment and ventilation continuously monitored using at least two of the three following methods: required by the board. 
(1) Auscultation of breath sounds using a precordial stethoscope.
(2) Monitoring for the presence of exhaled carbon dioxide with capnography.
(3) Verbal communication with a patient under moderate sedation. This method shall not be used for a patient under deep sedation or general anesthesia.
(d) Any dentist with patients who are undergoing moderate conscious  sedation to have dental office personnel directly involved with the care of those patients who are not certified in basic cardiac life support (CPR) and recertified biennially.
(e) (1) Any dentist to fail to obtain the written informed consent of a patient prior to administering moderate sedation, deep sedation, or general anesthesia. general anesthesia or conscious sedation.  In the case of a minor, the consent shall be obtained from the child’s parent or guardian.
(2) The written informed consent for general anesthesia, in the case of a minor, shall include, but not be limited to, the following information:
“The administration and monitoring of deep sedation or  general anesthesia may vary depending on the type of procedure, the type of practitioner, the age and health of the patient, and the setting in which anesthesia is provided. Risks may vary with each specific situation. You are encouraged to explore all the options available for your child’s anesthesia for their dental treatment, his or her dental treatment  and consult with your dentist, family physician,  dentist  or pediatrician as needed.” needed. You are further encouraged to consult with your dentist on all of the nonsurgical dental treatment options available that may reduce, delay, or eliminate the need for anesthesia for surgical dental treatment prior to granting this consent.” 
(3) Nothing in this subdivision shall be construed to establish the reasonable standard of care for administering or monitoring adult  oral conscious sedation, pediatric minimal sedation, moderate sedation, deep sedation,  conscious sedation,  or general anesthesia.

SEC. 2.

 Section 1367.71 of the Health and Safety Code is amended to read:

1367.71.
 (a) Every health care service plan contract, other than a specialized health care service plan contract, that is issued, amended, renewed, or delivered on or after January 1, 2000, 2019,  shall be deemed to cover general anesthesia and associated facility charges for dental procedures rendered in a hospital or surgery center setting,  when the clinical status or underlying medical condition of the patient requires dental procedures that ordinarily would not require general anesthesia to be rendered in a hospital or surgery center setting.  anesthesia.  The health care service plan may require prior authorization of general anesthesia and associated charges required for dental care procedures in the same manner that prior authorization is required for other covered diseases or conditions.
(b) This section shall apply only to general anesthesia and associated facility charges for only the following enrollees, and only if the enrollees meet the criteria in subdivision (a):
(1) Enrollees who are under seven years of age.
(2) Enrollees who are developmentally disabled, regardless of age.
(3) Enrollees whose health is compromised and for whom general anesthesia is medically necessary, regardless of age.
(c) Nothing in this section shall require the health care service plan to cover any charges for the dental procedure itself, including, but not limited to, the professional fee of the dentist. Coverage for anesthesia and associated facility charges pursuant to this section shall be subject to all other terms and conditions of the plan that apply generally to other benefits.
(d) Nothing in this section shall be construed to allow a health care service plan to deny coverage for basic health care services, as defined in Section 1345.
(e) A health care service plan may include coverage specified in subdivision (a) at any time prior to January 1, 2000.  2019. 

SEC. 3.

 Section 10119.9 of the Insurance Code is amended to read:

10119.9.
 (a) A disability insurance policy or certificate covering hospital, surgical, or medical expenses, that meets the definition of “health benefit plan” in subdivision (a) of Section 10198.6, that is issued, amended, renewed, or delivered on or after January 1, 2000, 2019,  shall be deemed to cover general anesthesia and associated facility charges for dental procedures rendered in a hospital or surgery center setting,  when the clinical status or underlying medical condition of the insured requires dental procedures that ordinarily would not require general anesthesia to be rendered in a hospital or surgery center setting.  anesthesia.  The disability insurance policy or certificate may require prior authorization of general anesthesia and associated charges required for dental care procedures in the same manner that prior authorization is required for other covered diseases or conditions.
(b) This section shall apply only to general anesthesia and associated facility charges for only the following insureds, and only if the insureds meet the criteria in subdivision (a):
(1) Insureds who are under seven years of age.
(2) Insureds who are developmentally disabled, regardless of age.
(3) Insureds whose health is compromised and for whom general anesthesia is medically necessary, regardless of age.
(c) Nothing in this section shall require insurers to cover any charges for the dental procedure itself, including the professional fee of the dentist. Coverage for anesthesia and associated facility charges pursuant to this section shall be subject to all other terms and conditions of the policy or certificate that apply generally to other benefits.
(d) Nothing in this section shall require insurers to cover anesthesia or related facility charges for dental procedures that ordinarily would require general anesthesia and that do not meet the requirements of subdivision (a), (b), or (c).
(e) A disability insurance policy may include coverage specified in subdivision (a) at any time prior to January 1, 2000. 2019. 
SEC. 4.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.