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SF 2110

as introduced - 87th Legislature (2011 - 2012) Posted on 04/02/2012 02:57pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to human services; modifying critical access dental provider payments;
amending Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4.


Section 1.

Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is
amended to read:

Subd. 4.

Critical access dental providers.

(a) Effective for dental services
rendered on or after January 1, 2002, the commissioner shall increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. For dental services rendered on or after July 1, 2007, the commissioner shall
increase reimbursement by 30 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider. The commissioner shall pay the managed
care plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.

(b) The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section

(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's

(v) charge for services on a sliding fee scale designed to provide assistance to
low-income patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations
or public assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) county owned and operated hospital-based dental clinics;

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance, general assistance medical
care, or MinnesotaCare; and

(5) a dental clinic owned and operated by the University of Minnesota or the
Minnesota State Colleges and Universities system.

(c) The commissioner may designate a dentist or dental clinic as a critical access
dental provider if the dentist or dental clinic is willing to provide care to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare at a level which
significantly increases access to dental care in the service area.

(d) deleted text beginNotwithstanding paragraph (a), critical access payments must not be made for
dental services provided from April 1, 2010, through June 30, 2010.
deleted text endnew text begin A designated critical
access clinic shall receive the reimbursement rate specified in paragraph (a) for dental
services provided off-site at a private dental office if the following requirements are met:
new text end

new text begin (1) the designated critical access dental clinic is not able to provide the service
and refers the patient to the off-site dentist;
new text end

new text begin (2) the service, if provided at the critical access dental clinic, would be reimbursed
at the critical access reimbursement rate;
new text end

new text begin (3) the dentist allied dental professionals providing the service off-site are licensed
and in good standing under chapter 150A;
new text end

new text begin (4) the critical access dental clinic submits the claim for services provided off-site
and receives the payment for the services; and
new text end

new text begin (5) the critical access dental clinic maintains dental records for each claim submitted
under this paragraph, including the name of the dentist, the off-site location, and the
license number of the dentist providing the service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012.
new text end