HF2690

Purpose of the Bill

This bill aims to improve the administration and quality of dental services for recipients of medical assistance and MinnesotaCare. It introduces a system where an independent dental administrator is contracted to manage these services if existing managed care and county-based purchasing plans do not meet established performance benchmarks.

Main Provisions

• Contract with Dental Administrator: The commissioner will contract with a dental administrator if existing plans fail to meet performance targets, starting January 1, 2026. The administrator will provide a host of services including provider recruitment, recipient outreach, dental claims processing, and fraud management.

• Dental Administrator Responsibilities: The administrator is tasked with ensuring adequate provider networks, monitoring dental service access, implementing quality improvements, and managing third-party liabilities.

• Payment and Provider Options: Payments to dental providers must match or exceed 2024 rates, with recipients having the freedom to choose from network providers who agree to participation requirements.

• Performance Benchmark for Dental Visits: By 2029, if the contracted dental administrator fails to ensure that at least 55% of continuously enrolled children and adults receive at least one dental visit per year, the contract will be terminated.

• Consultation with Providers: Implementation involves consulting with dental service providers, especially those serving low-income and socioeconomically complex populations.

Significant Changes

• Health Services Advisory Council: The bill amends the leadership structure of this council, creating a dental subcouncil specifically to advise on critical access dental programs, coverage policies, and service availability. This includes the development of new dental delivery models and service impact assessments.

• Financial Oversight: Specifies that funds allotted for dental services in capitation payments must be properly allocated to ensure fair payments to dental providers.

Relevant Terms

• Medical Assistance
• MinnesotaCare
• Dental Administrator
• Managed Care Plans
• County-Based Purchasing Plans
• Capitation Payments
• Performance Benchmark
• Health Services Advisory Council
• Dental Subcouncil