HF 2571

as introduced - 87th Legislature (2011 - 2012) Posted on 02/29/2012 01:34pm

A bill for an act
relating to human services; expanding dental services for the disabled; amending
Minnesota Statutes 2010, section 256B.0625, subdivision 9.

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

Section 1.

Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to
read:

Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the
following services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically
necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
or (2) once every two years for patients who cannot cooperate for intraoral film due to
a developmental disability or medical condition that does not allow for intraoral film
placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, each dental arch limited to one every six years;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
abscesses;

(14) palliative treatment and sedative fillings for relief of pain; and

(15) full-mouth debridement, limited to one every five years.

(c) In addition to the services specified in paragraph (b), medical assistance
covers the following services for adults, if provided in an outpatient hospital setting or
freestanding ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two
years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for
children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

new text begin (e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for disabled adults who are served by residential services
licensed on January 1, 2012, under section 256B.097:
new text end

new text begin (1) house calls or extended care facility calls for on-site delivery of covered services;
new text end

new text begin (2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;
new text end

new text begin (3) oral or IV conscious sedation, if the covered dental service cannot be performed
safely without it or would otherwise require the service to be performed under general
anesthesia in a hospital or surgical center; and
new text end

new text begin (4) prophylaxis, in accordance with an appropriate individualized treatment plan
formulated by a licensed dentist, but no more than four times per year.
new text end