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HF2690 (Legislative Session 94 (2025-2026))

Medical assistance dental provisions modified.

AI Generated Summary

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

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 23, 2025HouseFloorActionIntroduction and first reading, referred toHealth Finance and Policy
March 23, 2025HouseFloorActionIntroduction and first reading, referred toHealth Finance and Policy
March 25, 2025HouseFloorActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new contingent contract requirement with a dental administrator."
      ],
      "removed": [
        ""
      ],
      "summary": "The bill outlines changes to the administration of dental services under medical assistance by modifying section 256B.0371, subdivision 3.",
      "modified": [
        "Adjustment to the administration guidelines for dental services."
      ]
    },
    "citation": "256B.0371",
    "subdivision": "subdivision 3"
  },
  {
    "analysis": {
      "added": [
        "A dental subcouncil to advise on dental services."
      ],
      "removed": [
        ""
      ],
      "summary": "Adjustments are made to the Health Services Advisory Council's role and structure in section 256B.0625, subdivision 3c.",
      "modified": [
        "Refinement of advisory responsibilities and composition."
      ]
    },
    "citation": "256B.0625",
    "subdivision": "subdivision 3c"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "Discussion on critical access dental program adjustments relevant to section 256B.76, subdivision 4.",
      "modified": [
        "Criteria for critical access dental providers."
      ]
    },
    "citation": "256B.76",
    "subdivision": "subdivision 4"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "Reference to network adequacy requirements for dental services as specified in section 62K.14.",
      "modified": [
        "Application of network adequacy standards to dental administrators."
      ]
    },
    "citation": "62K.14",
    "subdivision": ""
  }
]

Sponsors