Bill Text: MN HF3035 | 2013-2014 | 88th Legislature | Introduced
Bill Title: MinnesotaCare enrollees dental services and medical assistance provision; single administrator established.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-03-19 - Author added Laine [HF3035 Detail]
Download: Minnesota-2013-HF3035-Introduced.html
1.2relating to human services; establishing a single administrator to administer the
1.3provision of dental services to medical assistance and MinnesotaCare enrollees;
1.4proposing coding for new law in Minnesota Statutes, chapter 256B.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. [256B.54] PROVISION OF DENTAL SERVICES.
1.7 Subdivision 1. Single dental administrator. Effective for dental services rendered
1.8on or after January 1, 2016, the commissioner shall contract with a single dental plan or
1.9dental plan administrative entity to administer the delivery of dental services to medical
1.10assistance and MinnesotaCare enrollees. The contract for the single administrator shall be
1.11awarded through competitive bidding. The entity shall administer all state dental program
1.12services, including those provided through the current fee-for-service system and those
1.13provided through the prepaid medical assistance program.
1.14 Subd. 2. Contract provisions. The contract with the dental administrator shall:
1.15(1) include the provision of all dental services authorized under section 256B.0625;
1.16(2) ensure adequate numbers of dentists and dental clinics to provide accessible
1.17care to program enrollees;
1.18(3) establish a centralized dental referral system, including a toll-free telephone
1.19number, to identify available dentists and dental clinics and to schedule appointments for
1.20program enrollees who need assistance in locating dental care;
1.21(4) include nonprofit clinics, federally qualified health centers, the University of
1.22Minnesota School of Dentistry and its affiliated clinics, publicly owned and operated
1.23hospital-based dental clinics, dental clinics within state-operated services, and private
1.24practicing dentists in its dental provider network;
2.1(5) encourage private practicing dentists to participate and provide services to public
2.2program enrollees through flexible scheduling and coordination of referrals;
2.3(6) develop a program to reduce hospital emergency room visits for dental care
2.4treatment;
2.5(7) streamline information systems to provide information on patient eligibility and
2.6state program restrictions on dental benefits, including prior authorization requirements
2.7for dental care treatments;
2.8(8) clearly communicate authorization criteria and benefit changes to dental
2.9providers participating in the dental provider network; and
2.10(9) measure access to dental services for program enrollees and report access and
2.11encounter data annually to the commissioner.
2.12 Subd. 3. Advisory committee. The administrator shall establish an advisory
2.13committee of participating providers from community and public clinics and private
2.14practices to assist in the development and maintenance of the program.
2.15 Subd. 4. Appeals. All recipients of dental services provided under contract by the
2.16administrator shall have the right to appeal to the commissioner under section 256.045.
2.17 Subd. 5. Data privacy. The contract between the commissioner and the
2.18administrator must specify that the administrator is the agent of the state and shall have
2.19access to patient data on program enrollees to the extent necessary to carry out the
2.20administrator's responsibilities under the contract. The administrator shall comply with
2.21the relevant provisions of chapter 13.
2.22 Subd. 6. Prepaid medical assistance dental services. Effective January 1, 2016,
2.23all dental services must be removed from prepaid medical assistance program contracts
2.24with managed care organizations and county-based purchasing plans. All dental services
2.25must be included in the services provided under contract from the dental administrator.
2.26Each managed care organization and county-based purchasing plan providing dental care
2.27to program enrollees either directly or through contract with a dental plan administrator
2.28must provide the commissioner with dental encounter data and aggregate reimbursement
2.29data for dental care provided through the prepaid medical assistance program for calendar
2.30year 2014.
2.31 Subd. 7. Exclusions. The commissioner may exclude from this section dental
2.32programs administered through county-based purchasing plans if the commissioner
2.33determines that a single administrator already exists and that the dental services currently
2.34provided are adequate to meet the needs of public program enrollees within the area
2.35served by the county-based purchasing plan.
3.1EFFECTIVE DATE.This section is effective July 1, 2015, and is applicable to all
3.2Department of Human Services contracts providing dental services on or after that date.
1.3provision of dental services to medical assistance and MinnesotaCare enrollees;
1.4proposing coding for new law in Minnesota Statutes, chapter 256B.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. [256B.54] PROVISION OF DENTAL SERVICES.
1.7 Subdivision 1. Single dental administrator. Effective for dental services rendered
1.8on or after January 1, 2016, the commissioner shall contract with a single dental plan or
1.9dental plan administrative entity to administer the delivery of dental services to medical
1.10assistance and MinnesotaCare enrollees. The contract for the single administrator shall be
1.11awarded through competitive bidding. The entity shall administer all state dental program
1.12services, including those provided through the current fee-for-service system and those
1.13provided through the prepaid medical assistance program.
1.14 Subd. 2. Contract provisions. The contract with the dental administrator shall:
1.15(1) include the provision of all dental services authorized under section 256B.0625;
1.16(2) ensure adequate numbers of dentists and dental clinics to provide accessible
1.17care to program enrollees;
1.18(3) establish a centralized dental referral system, including a toll-free telephone
1.19number, to identify available dentists and dental clinics and to schedule appointments for
1.20program enrollees who need assistance in locating dental care;
1.21(4) include nonprofit clinics, federally qualified health centers, the University of
1.22Minnesota School of Dentistry and its affiliated clinics, publicly owned and operated
1.23hospital-based dental clinics, dental clinics within state-operated services, and private
1.24practicing dentists in its dental provider network;
2.1(5) encourage private practicing dentists to participate and provide services to public
2.2program enrollees through flexible scheduling and coordination of referrals;
2.3(6) develop a program to reduce hospital emergency room visits for dental care
2.4treatment;
2.5(7) streamline information systems to provide information on patient eligibility and
2.6state program restrictions on dental benefits, including prior authorization requirements
2.7for dental care treatments;
2.8(8) clearly communicate authorization criteria and benefit changes to dental
2.9providers participating in the dental provider network; and
2.10(9) measure access to dental services for program enrollees and report access and
2.11encounter data annually to the commissioner.
2.12 Subd. 3. Advisory committee. The administrator shall establish an advisory
2.13committee of participating providers from community and public clinics and private
2.14practices to assist in the development and maintenance of the program.
2.15 Subd. 4. Appeals. All recipients of dental services provided under contract by the
2.16administrator shall have the right to appeal to the commissioner under section 256.045.
2.17 Subd. 5. Data privacy. The contract between the commissioner and the
2.18administrator must specify that the administrator is the agent of the state and shall have
2.19access to patient data on program enrollees to the extent necessary to carry out the
2.20administrator's responsibilities under the contract. The administrator shall comply with
2.21the relevant provisions of chapter 13.
2.22 Subd. 6. Prepaid medical assistance dental services. Effective January 1, 2016,
2.23all dental services must be removed from prepaid medical assistance program contracts
2.24with managed care organizations and county-based purchasing plans. All dental services
2.25must be included in the services provided under contract from the dental administrator.
2.26Each managed care organization and county-based purchasing plan providing dental care
2.27to program enrollees either directly or through contract with a dental plan administrator
2.28must provide the commissioner with dental encounter data and aggregate reimbursement
2.29data for dental care provided through the prepaid medical assistance program for calendar
2.30year 2014.
2.31 Subd. 7. Exclusions. The commissioner may exclude from this section dental
2.32programs administered through county-based purchasing plans if the commissioner
2.33determines that a single administrator already exists and that the dental services currently
2.34provided are adequate to meet the needs of public program enrollees within the area
2.35served by the county-based purchasing plan.
3.1EFFECTIVE DATE.This section is effective July 1, 2015, and is applicable to all
3.2Department of Human Services contracts providing dental services on or after that date.
