Bill Text: MN SF2888 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Dental service providers participation requirements in public health care programs modifications
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2014-03-24 - Referred to Health, Human Services and Housing [SF2888 Detail]
Download: Minnesota-2013-SF2888-Introduced.html
1.2relating to human services; modifying participation requirements in certain
1.3public health care programs for dental service providers;amending Minnesota
1.4Statutes 2012, section 256B.0644.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 256B.0644, is amended to read:
1.7256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
1.8PROGRAMS.
1.9 (a) A vendor of medical care, as defined in section256B.02, subdivision 7 , and a
1.10health maintenance organization, as defined in chapter 62D, must participate as a provider
1.11or contractor in the medical assistance program and MinnesotaCare as a condition of
1.12participating as a provider in health insurance plans and programs or contractor for state
1.13employees established under section43A.18 , the public employees insurance program
1.14under section43A.316 , for health insurance plans offered to local statutory or home
1.15rule charter city, county, and school district employees, the workers' compensation
1.16system under section176.135 , and insurance plans provided through the Minnesota
1.17Comprehensive Health Association under sections62E.01 to
62E.19 . The limitations
1.18on insurance plans offered to local government employees shall not be applicable in
1.19geographic areas where provider participation is limited by managed care contracts
1.20with the Department of Human Services. This section does not apply to dental service
1.21providers providing dental services outside the seven-county metropolitan area.
1.22 (b) For providers other than health maintenance organizations, participation in the
1.23medical assistance program means that:
1.24 (1) the provider accepts new medical assistance and MinnesotaCare patients;
2.1 (2) for providers other than dental service providers, at least 20 percent of the
2.2provider's patients are covered by medical assistance and MinnesotaCare as their primary
2.3source of coverage; or
2.4 (3) for dental service providers providing dental services in the seven-county
2.5metropolitan area, at least ten percent of the provider's patients are covered by medical
2.6assistance and MinnesotaCare as their primary source of coverage, or the provider accepts
2.7new medical assistance and MinnesotaCare patients who are children with special health
2.8care needs. For purposes of this section, "children with special health care needs" means
2.9children up to age 18 who: (i) require health and related services beyond that required
2.10by children generally; and (ii) have or are at risk for a chronic physical, developmental,
2.11behavioral, or emotional condition, including: bleeding and coagulation disorders;
2.12immunodeficiency disorders; cancer; endocrinopathy; developmental disabilities;
2.13epilepsy, cerebral palsy, and other neurological diseases; visual impairment or deafness;
2.14Down syndrome and other genetic disorders; autism; fetal alcohol syndrome; and other
2.15conditions designated by the commissioner after consultation with representatives of
2.16pediatric dental providers and consumers.
2.17 (c) Patients seen on a volunteer basis by the provider at a location other than
2.18the provider's usual place of practice may be considered in meeting the participation
2.19requirement in this section. The commissioner shall establish participation requirements
2.20for health maintenance organizations. The commissioner shall provide lists of participating
2.21medical assistance providers on a quarterly basis to the commissioner of management and
2.22budget, the commissioner of labor and industry, and the commissioner of commerce. Each
2.23of the commissioners shall develop and implement procedures to exclude as participating
2.24providers in the program or programs under their jurisdiction those providers who do
2.25not participate in the medical assistance program. The commissioner of management
2.26and budget shall implement this section through contracts with participating health and
2.27dental carriers.
2.28(d) A volunteer dentist who has signed a volunteer agreement under section
2.29256B.0625, subdivision 9a
, shall not be considered to be participating in medical
2.30assistance or MinnesotaCare for the purpose of this section.
2.31EFFECTIVE DATE.This section is effective upon receipt of any necessary federal
2.32waiver or approval. The commissioner of human services shall notify the revisor of
2.33statutes if a federal waiver or approval is sought and, if sought, when a federal waiver
2.34or approval is obtained.
2.35 Sec. 2. FEDERAL WAIVER OR APPROVAL.
3.1The commissioner of human services shall seek any federal waiver or approval
3.2necessary to implement section 1.
1.3public health care programs for dental service providers;amending Minnesota
1.4Statutes 2012, section 256B.0644.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 256B.0644, is amended to read:
1.7256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
1.8PROGRAMS.
1.9 (a) A vendor of medical care, as defined in section
1.10health maintenance organization, as defined in chapter 62D, must participate as a provider
1.11or contractor in the medical assistance program and MinnesotaCare as a condition of
1.12participating as a provider in health insurance plans and programs or contractor for state
1.13employees established under section
1.14under section
1.15rule charter city, county, and school district employees, the workers' compensation
1.16system under section
1.17Comprehensive Health Association under sections
1.18on insurance plans offered to local government employees shall not be applicable in
1.19geographic areas where provider participation is limited by managed care contracts
1.20with the Department of Human Services. This section does not apply to dental service
1.21providers providing dental services outside the seven-county metropolitan area.
1.22 (b) For providers other than health maintenance organizations, participation in the
1.23medical assistance program means that:
1.24 (1) the provider accepts new medical assistance and MinnesotaCare patients;
2.1 (2) for providers other than dental service providers, at least 20 percent of the
2.2provider's patients are covered by medical assistance and MinnesotaCare as their primary
2.3source of coverage; or
2.4 (3) for dental service providers providing dental services in the seven-county
2.5metropolitan area, at least ten percent of the provider's patients are covered by medical
2.6assistance and MinnesotaCare as their primary source of coverage, or the provider accepts
2.7new medical assistance and MinnesotaCare patients who are children with special health
2.8care needs. For purposes of this section, "children with special health care needs" means
2.9children up to age 18 who: (i) require health and related services beyond that required
2.10by children generally; and (ii) have or are at risk for a chronic physical, developmental,
2.11behavioral, or emotional condition, including: bleeding and coagulation disorders;
2.12immunodeficiency disorders; cancer; endocrinopathy; developmental disabilities;
2.13epilepsy, cerebral palsy, and other neurological diseases; visual impairment or deafness;
2.14Down syndrome and other genetic disorders; autism; fetal alcohol syndrome; and other
2.15conditions designated by the commissioner after consultation with representatives of
2.16pediatric dental providers and consumers.
2.17 (c) Patients seen on a volunteer basis by the provider at a location other than
2.18the provider's usual place of practice may be considered in meeting the participation
2.19requirement in this section. The commissioner shall establish participation requirements
2.20for health maintenance organizations. The commissioner shall provide lists of participating
2.21medical assistance providers on a quarterly basis to the commissioner of management and
2.22budget, the commissioner of labor and industry, and the commissioner of commerce. Each
2.23of the commissioners shall develop and implement procedures to exclude as participating
2.24providers in the program or programs under their jurisdiction those providers who do
2.25not participate in the medical assistance program. The commissioner of management
2.26and budget shall implement this section through contracts with participating health and
2.27dental carriers.
2.28(d) A volunteer dentist who has signed a volunteer agreement under section
2.30assistance or MinnesotaCare for the purpose of this section.
2.31EFFECTIVE DATE.This section is effective upon receipt of any necessary federal
2.32waiver or approval. The commissioner of human services shall notify the revisor of
2.33statutes if a federal waiver or approval is sought and, if sought, when a federal waiver
2.34or approval is obtained.
2.35 Sec. 2. FEDERAL WAIVER OR APPROVAL.
3.1The commissioner of human services shall seek any federal waiver or approval
3.2necessary to implement section 1.
