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SF 3201

as introduced - 91st Legislature (2019 - 2020) Posted on 02/18/2020 08:34am

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

Current Version - as introduced

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A bill for an act
relating to health care; prohibiting managed care plans and county-based purchasing
plans from requiring completion of a treatment plan before payment for any service
performed as part of the treatment plan; amending Minnesota Statutes 2018, section
256B.69, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2018, section 256B.69, is amended by adding a subdivision
to read:


new text begin Subd. 6e. new text end

new text begin Dental services. new text end

new text begin (a) If a dental provider is providing services to an enrollee
of a managed care plan or county-based purchasing plan based on (1) a treatment plan that
requires more than one visit, (2) the managed care plan or county-based purchasing plan,
or (3) the plan's subcontractor if the plan subcontracts with a third party to administer dental
services to the plan's enrollees, the dental provider must not require the completion of the
treatment plan as a condition of payment to the dental provider for services performed as
part of the treatment plan. The health plan or subcontractor must reimburse the dental
provider for all services performed by the provider regardless of whether the treatment plan
is completed, as long as the enrollee was covered under the plan at the time the service was
performed.
new text end

new text begin (b) Nothing in paragraph (a) prevents a health plan from paying for services using a
bundled payment method. If a bundled payment method is used and the treatment plan
covered by the payment is not completed for any reason, the health plan or its subcontractor
must reimburse the dental provider for the services performed, as long as the enrollee was
covered under the plan at the time the service was performed.
new text end