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S.F. No. 801 - Dental Services (First Engrossment)
Author: Senator Julie A. Rosen
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
Date: April 9, 2015


SF 801 makes a number of changes to the dental services covered under medical assistance, the payment rates for these dental services, and to the delivery of these services.

Section 1 (256B.0625, subd. 9) modifies the adult dental services covered under medical assistance by covering a comprehensive exam once every three years; covering a full-mouth series of x-rays if panoramic x-rays cannot be taken; covering nonsurgical treatment for periodontal disease limited to once a year; and covering a comprehensive oral exam and full-mouth series of x-rays as part of outpatient dental surgery.

Section 2 (256B.0625, subd. 9b) authorizes a dentist who is not a medical assistance provider, and who is either a faculty or adjunct member at the University of Minnesota Dental School or a dental resident to be enrolled as a medical assistance provider for purposes of providing dental services at the University of Minnesota Dental School clinic if the provider submits an agreement form to the commissioner.

Section 2 (256B.0625, subd. 14) specifies that medical assistance covers as a part of screening services oral health screenings that are performed by a dental hygienist, dental therapist, or advanced dental therapist in a collaborative practice  to determine an enrollee’s need to be seen by a dentist for diagnosis, assessment, or referral for treatment.  The oral screenings are limited to once a year and the provider performing the screening must have an agreement in place that refers to those needing follow-up care to a licensed dentist.

Section 3 (256B.76, subd. 2) increases dental rates to the lower of the submitted charges or 50 percent of the 90th percentile of the 2012 charges submitted for the applicable CDT code.

Section 4 (subd. 1) establishes a grant to be awarded to a public higher education institution dental school by the Commissioner of Human Services to develop a new payment reimbursement system for oral health and dental services for medical assistance and MinnesotaCare.

Subd. 2 requires the grantee to consult with a stakeholder oversight committee.

Subd. 3 requires the grantee, as part of the development of the new reimbursement system, to create a simulation model to test the system and to provide a sufficient assessment of statewide implementation in terms of populations served, types of providers, practice settings, and geographic locations.

Subd. 4 requires the grantee to submit a report to the legislature describing the new reimbursement system, reviewing the findings and conclusions of the research and analysis conducted by the grantee; summarizing the results of the modeling and testing that were undertaken, and including a process, timeline, and budget for implementation of the new reimbursement system.

Section 5 appropriates money to the Commissioner of Human Services for the grant to develop and test a new reimbursement system.



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