Bill Text: MN SF863 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Medical assistance (MA) program dental reimbursement modification
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-03-17 - Referred to Health and Human Services [SF863 Detail]
Download: Minnesota-2011-SF863-Introduced.html
1.2relating to human services; modifying dental reimbursement for the medical
1.3assistance program; amending Minnesota Statutes 2010, section 256B.76,
1.4subdivision 2.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:
1.7 Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
1.8October 1, 1992, the commissioner shall make payments for dental services as follows:
1.9 (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
1.10percent above the rate in effect on June 30, 1992; and
1.11 (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
1.12percentile of 1989, less the percent in aggregate necessary to equal the above increases.
1.13 (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
1.14shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
1.15 (c) Effective for services rendered on or after January 1, 2000, payment rates for
1.16dental services shall be increased by three percent over the rates in effect on December
1.1731, 1999.
1.18 (d) Effective for services provided on or after January 1, 2002, payment for
1.19diagnostic examinations and dental x-rays provided to children under age 21 shall be the
1.20lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
1.21 (e) Effective for services provided on or after January 1, 2012, payment rates for
1.22dental services shall be the lower of:
2.1(1) 70 percent of the statewide average dental fee based on a statewide dental fee
2.2schedule set at the 80th percentile of the Ingenix table of dental fees for Minnesota in
2.32010; or
2.4(2) the submitted charge.
2.5(f) Theincreases increase listed in paragraphs (b) and (c) paragraph (e) shall be
2.6implemented January 1,2000 2012, for managed care.
2.7(f) (g) Effective for dental services rendered on or after October 1, 2010, by a
2.8state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
2.9on the Medicare principles of reimbursement. This payment shall be effective for services
2.10rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
2.11county-based purchasing plans.
2.12(g) (h) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
2.13in paragraph(f) (g), including state and federal shares, are less than $1,850,000 per fiscal
2.14year, a supplemental state payment equal to the difference between the total payments
2.15in paragraph(f) (g) and $1,850,000 shall be paid from the general fund to state-operated
2.16services for the operation of the dental clinics.
2.17(h) (i) If the cost-based payment system for state-operated dental clinics described
2.18in paragraph(f) (g) does not receive federal approval, then state-operated dental clinics
2.19shall be designated as critical access dental providers under subdivision 4, paragraph
2.20(b), and shall receive the critical access dental reimbursement rate as described under
2.21subdivision 4, paragraph (a).
1.3assistance program; amending Minnesota Statutes 2010, section 256B.76,
1.4subdivision 2.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:
1.7 Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
1.8October 1, 1992, the commissioner shall make payments for dental services as follows:
1.9 (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
1.10percent above the rate in effect on June 30, 1992; and
1.11 (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
1.12percentile of 1989, less the percent in aggregate necessary to equal the above increases.
1.13 (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
1.14shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
1.15 (c) Effective for services rendered on or after January 1, 2000, payment rates for
1.16dental services shall be increased by three percent over the rates in effect on December
1.1731, 1999.
1.18 (d) Effective for services provided on or after January 1, 2002, payment for
1.19diagnostic examinations and dental x-rays provided to children under age 21 shall be the
1.20lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
1.21 (e) Effective for services provided on or after January 1, 2012, payment rates for
1.22dental services shall be the lower of:
2.1(1) 70 percent of the statewide average dental fee based on a statewide dental fee
2.2schedule set at the 80th percentile of the Ingenix table of dental fees for Minnesota in
2.32010; or
2.4(2) the submitted charge.
2.5(f) The
2.6implemented January 1,
2.7
2.8state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
2.9on the Medicare principles of reimbursement. This payment shall be effective for services
2.10rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
2.11county-based purchasing plans.
2.12
2.13in paragraph
2.14year, a supplemental state payment equal to the difference between the total payments
2.15in paragraph
2.16services for the operation of the dental clinics.
2.17
2.18in paragraph
2.19shall be designated as critical access dental providers under subdivision 4, paragraph
2.20(b), and shall receive the critical access dental reimbursement rate as described under
2.21subdivision 4, paragraph (a).
