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HF2690 (Legislative Session 94 (2025-2026))

Medical assistance dental provisions modified.

AI Generated Summary

Purpose of the Bill

The purpose of this bill is to modify regulations surrounding dental services under Minnesota's medical assistance and MinnesotaCare programs to improve access, administration, and quality of dental care for recipients.

Main Provisions

  • Dental Administrator Contract: If current plans do not meet set performance benchmarks for dental care coverage by 2024, the state will engage a new dental administrator by 2026. This administrator will oversee services for all medical assistance and MinnesotaCare recipients.

  • Administrative Responsibilities: The dental administrator will handle tasks such as provider recruitment, recipient outreach, utilization management, dental claims processing, fraud monitoring, and quality evaluation.

  • Provider Choice and Payment: Recipients can choose from any dental provider who meets the plan’s requirements. Payment rates to providers must be at least equal to the average rates for 2024.

  • Performance Benchmarks: Contracts include a clause requiring termination if the administrator fails to meet benchmarks indicating that at least 55% of enrolled individuals had a dental visit by 2029.

  • Health Services Advisory Council: The council will include a Dental Subcouncil to advise on dental program policies and improvements for medical assistance and MinnesotaCare.

Significant Changes to Existing Law

  • Centralization of Dental Services: Transitioning from a dispersed model with multiple managed care plans to a centralized dental administrator, should current benchmarks not be met.

  • Role of Advisory Councils: Expanding the role of the Health Services Advisory Council and establishing a new Dental Subcouncil to focus specifically on dental care issues, policy development, and recipient access improvement.

  • Directing Funds: Ensuring that funds from medical assistance and MinnesotaCare capitation rates are directly applied to the rates payments by the dental administrator, emphasizing financial accountability and transparency.

Relevant Terms

medical assistance, MinnesotaCare, dental services, dental administrator, managed care, county-based purchasing plans, Health Services Advisory Council, Dental Subcouncil, performance benchmarks, provider recruitment, fraud monitoring, capitation rate

Bill text versions

Actions

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

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new provision for engaging a dental administrator if benchmarks are not met."
      ],
      "removed": [],
      "summary": "This bill modifies the procedure for contracting a dental administrator in medical assistance under section 256B.0371.",
      "modified": [
        "Clarifies the roles of the dental administrator and establishes performance benchmarks."
      ]
    },
    "citation": "256B.0371",
    "subdivision": "subdivision 3"
  },
  {
    "analysis": {
      "added": [
        "Establishes a dental subcouncil under the Health Services Advisory Council."
      ],
      "removed": [],
      "summary": "This legislation modifies the structure and responsibilities of the Health Services Advisory Council under section 256B.0625.",
      "modified": [
        "Revises the scope of advice provided by the Health Services Advisory Council."
      ]
    },
    "citation": "256B.0625",
    "subdivision": "subdivision 3c"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "This bill ensures compliance with network adequacy requirements for dental services under section 62K.14.",
      "modified": [
        "Applies network adequacy and geographic access requirements to the dental administrator."
      ]
    },
    "citation": "62K.14",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "This bill engages with payment rates for dental services under section 256B.76.",
      "modified": [
        "Clarifies that dental administrator payments to providers must meet established rates."
      ]
    },
    "citation": "256B.76",
    "subdivision": ""
  }
]

Sponsors