HF 1102

as introduced - 87th Legislature (2011 - 2012) Posted on 03/14/2011 10:52am

A bill for an act
relating to human services; modifying dental reimbursement for the medical
assistance program; amending Minnesota Statutes 2010, section 256B.76,
subdivision 2.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:

Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after
October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on December
31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for
diagnostic examinations and dental x-rays provided to children under age 21 shall be the
lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.

(e) new text begin Effective for services provided on or after January 1, 2012, payment rates for
dental services shall be the lower of:
new text end

new text begin (1) 70 percent of the statewide average dental fee based on a statewide dental fee
schedule set at the 80th percentile of the Ingenix table of dental fees for Minnesota in
2010; or
new text end

new text begin (2) the submitted charge.
new text end

new text begin (f) new text end The deleted text begin increases deleted text end new text begin increase new text end listed in deleted text begin paragraphs (b) and (c) deleted text end new text begin paragraph (e) new text end shall be
implemented January 1, deleted text begin 2000 deleted text end new text begin 2012 new text end , for managed care.

deleted text begin (f) deleted text end new text begin (g) new text end Effective for dental services rendered on or after October 1, 2010, by a
state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
on the Medicare principles of reimbursement. This payment shall be effective for services
rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
county-based purchasing plans.

deleted text begin (g) deleted text end new text begin (h) new text end Beginning in fiscal year 2011, if the payments to state-operated dental clinics
in paragraph deleted text begin (f) deleted text end new text begin (g) new text end , including state and federal shares, are less than $1,850,000 per fiscal
year, a supplemental state payment equal to the difference between the total payments
in paragraph deleted text begin (f) deleted text end new text begin (g) new text end and $1,850,000 shall be paid from the general fund to state-operated
services for the operation of the dental clinics.

deleted text begin (h) deleted text end new text begin (i) new text end If the cost-based payment system for state-operated dental clinics described
in paragraph deleted text begin (f) deleted text end new text begin (g) new text end does not receive federal approval, then state-operated dental clinics
shall be designated as critical access dental providers under subdivision 4, paragraph
(b), and shall receive the critical access dental reimbursement rate as described under
subdivision 4, paragraph (a).