BILL NUMBER: SB 1633 ENROLLED BILL TEXT PASSED THE SENATE AUGUST 28, 2008 PASSED THE ASSEMBLY AUGUST 20, 2008 AMENDED IN ASSEMBLY AUGUST 19, 2008 AMENDED IN ASSEMBLY AUGUST 15, 2008 AMENDED IN ASSEMBLY JUNE 18, 2008 AMENDED IN SENATE MAY 23, 2008 INTRODUCED BY Senator Kuehl (Coauthor: Senator Aanestad) FEBRUARY 22, 2008 An act to add Section 654.3 to the Business and Professions Code, relating to dental services. LEGISLATIVE COUNSEL'S DIGEST SB 1633, Kuehl. Dental services: credit. Existing law prohibits a healing arts licensee, including physicians and surgeons, psychologists, acupuncturists, optometrists, dentists, podiatrists, and chiropractic practitioners, from referring a person for certain health care services if the licensee has a financial interest, as defined, with the person or entity that receives the referral. Existing law provides specified exemptions from this prohibition. Under existing law, a violation of the provisions governing referrals is a crime. This bill would prohibit a dentist, or an employee or agent of that dentist, from charging, without the patient's written consent, as specified, fees or costs not yet incurred to an open-end credit extended by a 3rd party that is arranged for or established in the dental office. The bill would require a dentist to refund to the lender any payment received for treatment that has not been rendered or costs that have not been incurred, as specified, within 15 business days upon the patient's request. The bill would prohibit a dentist, or an employee or agent of that dentist, from arranging for or establishing credit extended by a 3rd party for a patient without first providing a written notice, as specified, and a written treatment plan, as specified, and would prohibit that arrangement or establishment of credit with regard to a patient who has been administered or is under the influence of general anesthesia, conscious sedation, or nitrous oxide. The bill would subject a person who willfully violates these provisions to specified civil liability. Because a violation of these provisions would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 654.3 is added to the Business and Professions Code, to read: 654.3. (a) A dentist, or an employee or agent of a dentist, shall not charge to an open-end credit that is extended by a third party and that is arranged for or established in a dental office, before the date upon which the treatment is rendered or costs are incurred, without providing the patient a list of treatment and services to be rendered, the estimated costs of the treatment and services, and which treatment and services are being charged in advance of rendering or incurring of costs, and ensuring that the patient has received the treatment plan required by subdivision (d). (b) A dentist shall, within 15 business days of a patient's request, refund to the lender any payment received for treatment that has not been rendered or costs that have not been incurred made through a credit extended by a third party that is arranged for or established in a dental office. (c) A dentist, or an employee or agent of that dentist, shall not arrange for or establish credit extended by a third party for a patient without first providing the following written notice on one page in at least 14-point type and obtaining a signature from the patient: "Credit for Dental Services The attached application and information is for a credit card/line of credit or loan to help you finance your dental treatment. You should know that: You are applying for a ____ credit card/line of credit or a ____ loan for $____. You do not have to apply for the credit card/line of credit or loan. You may pay your dentist for dental treatment in another manner. This credit card/line of credit or loan is not a payment plan with the dental office; it is credit with (name of company issuing the credit card/line of credit or loan). Your dentist does not work for this company. Before applying for this credit card/line of credit or loan, you have the right to a written treatment plan from your dentist that includes the anticipated treatment to be provided and the estimated costs of each service. If you are approved for a credit card/line of credit, your dentist can only charge treatment and lab costs to that credit card/line of credit when you get the treatment or the dentist incurs costs unless your dentist has given you a list of treatments that you are paying for in advance and the cost for each treatment or service. You have the right to receive a credit to your credit card/line of credit or loan account refunded for any costs charged to the credit card/line of credit or loan for treatment that has not been rendered or costs that your dentist has not incurred. Your dentist must refund the amount of the charges to the lender within 15 business days of your request, after which the lender will credit your account. Please read carefully the terms and conditions of this credit card/line of credit or loan, including any promotional offers. You may be required to pay interest on the amount charged to the credit card/line of credit or the amount of the loan. If you miss a payment or do not pay on time, you may have to pay a penalty and/or a higher interest rate. If you do not pay the money that you owe the company that provides you with a credit card/line of credit or loan, your missed payments can appear on your credit report and could hurt your credit rating. You could also be sued. (Patient's Signature)" (d) A dentist shall give a patient a written treatment plan prior to arranging for or establishing credit extended by a third party. The treatment plan shall include each anticipated service to be provided and the estimated cost of each service. If a patient is covered by a private or government dental benefit plan or dental insurance, from which the dentist takes assignment of benefits, the treatment plan shall indicate the patient's private or government estimated share of cost for each service. If the dentist does not take assignment of benefits from a patient's dental benefit plan or insurance, the treatment plan shall indicate that the treatment may or may not be covered by a patient's dental benefit or insurance plan, and that the patient has the right to confirm dental benefit or insurance information from the patient's plan, insurer, or employer before beginning treatment. (e) A dentist, or an employee or agent of that dentist, shall not arrange for or establish credit extended by a third party for a patient with whom the dentist, or an employee or agent of that dentist, communicates primarily in a language other than English that is one of the Medi-Cal threshold languages, unless the written notice information required by subdivision (c) is also provided in that language. (f) A dentist, or an employee or agent of that dentist, shall not arrange for or establish credit that is extended by a third party for a patient who has been administered or is under the influence of general anesthesia, conscious sedation, or nitrous oxide. (g) A patient who suffers any damage as a result of the use or employment by any person of a method, act, or practice that willfully violates this section may seek the relief provided by Chapter 4 (commencing with Section 1780) of Title 1.5 of Part 4 of Division 3 of the Civil Code. (h) The rights, remedies, and penalties established by this article are cumulative, and shall not supersede the rights, remedies, or penalties established under other laws. (i) For purposes of this section, the following definitions shall apply: (1) "Dentist" includes, but is not limited to, a dental corporation, as defined in Section 1800. (2) "Open-end credit" means credit extended by a creditor under a plan in which the creditor reasonably contemplates repeated transactions, the creditor may impose a finance charge from time to time on an outstanding unpaid balance, and the amount of credit that may be extended to the debtor during the term of the plan (up to any limit set by the creditor) is generally made available to the extent that any outstanding balance is repaid. (3) "Patient" includes, but is not limited to, the patient's parent or other legal representative. SEC. 2. 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.