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HF1934 (Legislative Session 94 (2025-2026))

Requirements for dental administrator rates modified in the medical assistance and MinnesotaCare programs, dental administrator contract dates changed, critical access dental provider task force established, and report required.

Related bill: SF1896

AI Generated Summary

This bill modifies requirements for dental administrator rates in the Medical Assistance and MinnesotaCare programs in Minnesota. Key elements include:

  1. Changes to Dental Administrator Contract:

    • If managed care and county-based purchasing plans do not meet performance benchmarks, the state will contract with a dental administrator to manage dental services starting in 2030 instead of 2026.
    • The contract stipulates that if by 2032 less than 55% of eligible children and adults have at least one dental visit per year, the contract will be terminated, and a new provider will be selected.
    • The dental administrator must manage provider recruitment, patient outreach, utilization reviews, claims processing, fraud management, monitoring service access, and other administrative tasks.
    • Payments to contracted dental providers must follow the reimbursement rates established in the Minnesota statutes.

  2. Creation of the Critical Access Dental Provider Task Force:

    • The task force will assess the impact of contracting a single dental administrator on critical access providers (dentists who primarily serve low-income and complex populations).
    • Areas of evaluation include financial impacts, effects on patient access, funding disruptions, and potential harm to coordinated care.

  3. Task Force Membership and Responsibilities:

    • The task force will consist of state officials, legislators, representatives from the Minnesota Dental Association, critical access providers, nonprofit clinics, private dental clinics, and the Minnesota Rural Health Association.
    • A report with recommendations on patient access, financial sustainability, and ways to prevent funding disruptions must be submitted to the legislature by January 15, 2027.

The bill aims to improve accountability in dental care for low-income individuals while ensuring critical access providers remain financially viable.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 04, 2025HouseFloorActionIntroduction and first reading, referred toHealth Finance and Policy
March 04, 2025HouseFloorActionIntroduction and first reading, referred toHealth Finance and Policy
March 19, 2025HouseFloorActionAuthor added
March 19, 2025HouseFloorActionAuthor added
March 25, 2025HouseFloorActionAuthor added
March 25, 2025HouseFloorActionAuthor added
March 31, 2025HouseFloorActionAuthor added
March 31, 2025HouseFloorActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "Provisions related to performance benchmarks and administration for dental services."
      ],
      "removed": [
        ""
      ],
      "summary": "The bill modifies existing requirements for a contingent contract with a dental administrator under section 256B.0371, subdivision 3.",
      "modified": [
        "Changes to deadlines and performance measurement criteria."
      ]
    },
    "citation": "256B.0371",
    "subdivision": "subdivision 3"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "This bill references existing rate establishment requirements for dental administrator payments under sections 256B.76.",
      "modified": [
        "Provides context for payment rates in dental services."
      ]
    },
    "citation": "256B.76",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "In conjunction with section 256B.76, section 256L.11 is referenced for rate establishment in dental administrator agreements.",
      "modified": [
        "Specifies consolidated rate structures from prior legislations."
      ]
    },
    "citation": "256L.11",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "Defines critical access dental providers as described in section 256B.76, subdivision 4.",
      "modified": [
        "Updates the definitions used in eligibility categories for dental providers."
      ]
    },
    "citation": "256B.76",
    "subdivision": "subdivision 4"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "References network adequacy and geographic access requirements for dental administrators.",
      "modified": [
        "Aligns the statutory framework for managed care plans to encompass dental services."
      ]
    },
    "citation": "62K.14",
    "subdivision": ""
  }
]

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