HF 4205

as introduced - 90th Legislature (2017 - 2018) Posted on 03/22/2018 02:24pm

A bill for an act
relating to human services; applying the dental services withhold to the medical
assistance fee-for-service program; proposing coding for new law in Minnesota
Statutes, chapter 256B.

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

Section 1.

new text begin [256B.7611] MEDICAL ASSISTANCE FEE-FOR-SERVICE DENTAL
WITHHOLD.
new text end

new text begin Subdivision 1. new text end

new text begin Return of withhold based on performance. new text end

new text begin The commissioner of
management and budget shall withhold from the medical assistance funding made available
to the commissioner of human services for each calendar year an amount equal to ten percent
of medical assistance fee-for-service expenditures on dental services for the fiscal year
ending the previous June 30. This amount, or a portion as calculated under this section,
shall be returned no sooner than July 1 and no later than July 31 of the subsequent fiscal
year, only if, in the judgment of the commissioner, the performance targets in subdivisions
3 and 4 are achieved.
new text end

new text begin Subd. 2. new text end

new text begin Withhold return scoring. new text end

new text begin (a) The withheld funds shall be returned to the
commissioner for performance during calendar year 2019 based on the following point
assignment:
new text end

new text begin (1) service utilization:
new text end

new text begin (i) age stratification one through 20 years, 65 points; or
new text end

new text begin (ii) age stratification 21 through 64 years, 35 points; and
new text end

new text begin (2) provider network service mix, restorative versus preventive, zero points.
new text end

new text begin (b) The percentage of withheld funds to be returned shall be calculated by summing all
earned points, dividing the sum by 100, and converting to a percentage. This percentage is
referred to as the withhold score.
new text end

new text begin Subd. 3. new text end

new text begin Performance target; service utilization. new text end

new text begin (a) The commissioner must
demonstrate an annual increase in its rate of providing at least one annual dental visit. The
age stratification one through 20 years and the age stratification 21 through 64 years must
be equal to or greater than an absolute ten percent increase over the baseline of calendar
year 2017. For calendar year 2019, if the measurement rate is equal to or greater than the
absolute ten percent first annual growth target rate, all assigned points shall be awarded.
Partial points will be awarded if at least a five percent or greater improvement is achieved
on a sliding scale.
new text end

new text begin (b) Points shall be based on the commissioner demonstrating an annual increase in visits
according to this schedule:
new text end

new text begin (1) first annual growth target is ten percent;
new text end

new text begin (2) second annual growth target is five percent; and
new text end

new text begin (3) third annual growth target is three percent.
new text end

new text begin (c) If the ten percent increase is not achieved in the first year, then the deficit will be
added to the second year goal.
new text end

new text begin Subd. 4. new text end

new text begin Performance target; provider network service mix. new text end

new text begin The commissioner of
human services shall work with dental providers that serve enrollees with both preventative
and restorative dental services. For calendar year 2019, no points shall be awarded. The
commissioner of human services shall develop a measure specification for this performance
target to be used for calendar year 2020.
new text end

new text begin Subd. 5. new text end

new text begin Implementation methodology. new text end

new text begin The commissioner of management and budget
shall implement this section using the procedures specified in and developed under the
Department of Human Services model contract for prepaid medical assistance and
MinnesotaCare, January 1, 2018. The performance targets under this section for calendar
year 2020 and subsequent calendar years shall be those established for the dental withhold
in the prepaid medical assistance and MinnesotaCare contract for the respective calendar
year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2019.
new text end