Office of the Revisor of Statutes
SF 1896
Introduction - 94th Legislature (2025 - 2026)
Posted on 07/09/2025 09:09 a.m.
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A bill for an act
relating to health care; modifying requirements for dental administrator rates in
the medical assistance and MinnesotaCare programs; changing dates relating to a
dental administrator contract; establishing the critical access dental provider task
force; requiring a report; amending Minnesota Statutes 2024, section 256B.0371,
subdivision 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 256B.0371, subdivision 3, is amended to read:
Subd. 3.
Contingent contract with dental administrator.
(a) The commissioner shall
determine the extent to which managed care and county-based purchasing plans in the
aggregate meet the performance benchmark specified in subdivision 1 for coverage year
2024. If managed care and county-based purchasing plans in the aggregate fail to meet the
performance benchmark, the commissioner, after issuing a request for information followed
by a request for proposals, shall contract with a dental administrator to administer dental
services beginning January 1, deleted text begin 2026deleted text end new text begin 2030new text end , for all recipients of medical assistance and
MinnesotaCare, including persons served under fee-for-service and persons receiving
services through managed care and county-based purchasing plans.
(b) The dental administrator must provide administrative services, including but not
limited to:
(1) provider recruitment, contracting, and assistance;
(2) recipient outreach and assistance;
(3) utilization management and reviews of medical necessity for dental services;
(4) dental claims processing;
(5) coordination of dental care with other services;
(6) management of fraud and abuse;
(7) monitoring access to dental services;
(8) performance measurement;
(9) quality improvement and evaluation; and
(10) management of third-party liability requirements.
deleted text begin
(c) Dental administrator payments to contracted dental providers must be at the rates
established under sections 256B.76 and 256L.11.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end Recipients must be given a choice of dental provider, including any provider who
agrees to provider participation requirements and payment rates established by the
commissioner and dental administrator. The dental administrator must comply with the
network adequacy and geographic access requirements that apply to managed care and
county-based purchasing plans for dental services under section 62K.14.
deleted text begin (e)deleted text end new text begin (d)new text end The contract with the dental administrator must include a provision that states
that if the dental administrator fails to meet, by calendar year deleted text begin 2029deleted text end new text begin 2032new text end , a performance
benchmark under which at least 55 percent of children and adults who were continuously
enrolled for at least 11 months in either medical assistance or MinnesotaCare received at
least one dental visit during the calendar year, the contract must be terminated and the
commissioner must enter into a contract with a new dental administrator as soon as
practicable.
deleted text begin (f)deleted text end new text begin (e)new text end The commissioner shall implement this subdivision deleted text begin in consultation with
representatives of providers who provide dental services to patients enrolled in medical
assistance or MinnesotaCare, including but not limited to providers serving primarily
low-income and socioeconomically complex populations, and with representatives of
managed care plans and county-based purchasing plansdeleted text end new text begin based on the recommendations of
the critical access dental provider task force established by the commissioner to identify
the impacts of a contract with a single dental administrator, as allowed within existing
appropriationsnew text end .
Sec. 2. new text begin CRITICAL ACCESS DENTAL PROVIDER TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For the purpose of this subdivision, "critical access dental
providers" means critical access dental providers as described in Minnesota Statutes, section
256B.76, subdivision 4.
new text end
new text begin Subd. 2. new text end
new text begin Task force established. new text end
new text begin
The commissioner must establish a task force to identify
the impacts of a contract with a single dental administrator under Minnesota Statutes, section
256B.0371, subdivision 3, on:
new text end
new text begin
(1) financial viability of critical access dental providers; and
new text end
new text begin
(2) access to care for medical assistance and MinnesotaCare enrollees served by critical
access dental providers.
new text end
new text begin Subd. 3. new text end
new text begin Required assessments. new text end
new text begin
In the performance of its responsibilities under
subdivision 2, the task force must consider the following:
new text end
new text begin
(1) the financial impact on reimbursement for critical access dental providers, including
fee-based revenue, between payments by managed care and county-based purchasing plans
and the rates established under Minnesota Statutes, sections 256B.76 and 256L.11;
new text end
new text begin
(2) the potential impact on supplemental funding opportunities, both public and private,
used by critical access dental providers to cover current operating costs;
new text end
new text begin
(3) the potential impact on supplemental funding opportunities, both public and private,
used by critical access dental providers for capital and service expansion costs, including
physical plant development and equipment acquisition, and workforce development and
training; and
new text end
new text begin
(4) the potential harmful impacts on patients of critical access dental providers resulting
from disruption of current integrated care coordination between medical, behavioral, dental,
and other service providers.
new text end
new text begin Subd. 4. new text end
new text begin Application of other law. new text end
new text begin
The provisions of Minnesota Statutes, section 15.059
relating to member terms, compensation, and removal govern the task force.
new text end
new text begin Subd. 5. new text end
new text begin Membership. new text end
new text begin
The task force consists of the following members:
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(1) the commissioner of human services or a designee appointed by the commissioner;
new text end
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(2) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the house minority leader;
new text end
new text begin
(3) two members of the senate, one appointed by the president of the senate and one
appointed by the senate minority leader;
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(4) a representative of the Minnesota Dental Association, appointed by the Minnesota
Dental Association;
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(5) a representative of the Association of Critical Access Dental Providers of Minnesota,
appointed by the Association of Critical Access Dental Providers of Minnesota;
new text end
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(6) a representative of nonprofit dental clinics providing services within the seven-county
metropolitan area, appointed by the governor;
new text end
new text begin
(7) a representative of nonprofit dental clinics providing services outside of the
seven-county metropolitan area, appointed by the governor;
new text end
new text begin
(8) a representative of private dental clinics for which medical assistance and
MinnesotaCare enrollees comprise more than 25 percent of the clinic's patient load, appointed
by the governor; and
new text end
new text begin
(9) a representative of the Minnesota Rural Health Association, appointed by the
Minnesota Rural Health Association.
new text end
new text begin Subd. 6. new text end
new text begin Reporting. new text end
new text begin
The task force must submit a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance by January 15, 2027. The report must include:
new text end
new text begin
(1) an evaluation of patient access to dental care and any proposed measures to prevent
service gaps;
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new text begin
(2) a detailed financial impact analysis on reimbursements for critical access dental
providers;
new text end
new text begin
(3) recommendations to mitigate funding disruptions for operational and capital expenses;
new text end
new text begin
(4) potential impacts of a contract with a single dental administrator under subdivision
3; and
new text end
new text begin
(5) recommendations to the legislature to prevent harm to the financial viability of critical
access dental providers and to maintain or increase access to care for enrollees in the medical
assistance and MinnesotaCare programs.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
The task force expires on ......
new text end