HF 90

as introduced - 94th Legislature (2025 - 2026) Posted on 02/10/2025 03:07pm

A bill for an act
relating to human services; modifying dental service coverage to include pediatric
zirconia crowns; amending Minnesota Statutes 2024, section 256B.0625,
subdivision 9.

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

Section 1.

Minnesota Statutes 2024, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

(a) Medical assistance covers medically necessary dental
services.

(b) The following guidelines apply to dental services:

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

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

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

(c) In addition to the services specified in paragraph (a), medical assistance covers the
following services:

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

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

(3) oral or IV 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; deleted text begin and
deleted text end

(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year new text begin ; and
new text end

new text begin (5) pediatric zirconia crowns for children new text end .

(d) The commissioner shall not require prior authorization for the services included in
paragraph (c), clauses (1) to (3), and shall prohibit managed care and county-based purchasing
plans from requiring prior authorization for the services included in paragraph (c), clauses
(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.