HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 1 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to dental care services; amending s. 2
409.906, F.S.; authorizing Medicaid to reimburse for 3
dental services provided in a mobile dental unit owned 4
by, operated by, or having a contractual agreement 5
with a certain health access setting or similar 6
setting or program under certain circumstances; 7
authorizing the Agency for Health Care Administration 8
to reimburse a licensed dental hygienist for certain 9
remediable tasks; amending s. 466.007, F.S.; deleting 10
a requirement that an applicant for dental hygienist 11
licensure demonstrate specified skills on a live 12
patient; amending s. 466.023, F.S.; deleting a 13
remediable task only a licensed dental hygienist may 14
be delegated; making technical changes; amending s. 15
466.024, F.S.; authorizing a licensed dental hygienist 16
to apply interim therapeutic restorations; deleting 17
requirements that certain licensed dentists or 18
physicians perform certain actions before and after a 19
licensed dental hygienist performs certain remediable 20
tasks and a prohibition on a licensed dental hygienist 21
performing certain remediable tasks without specified 22
supervision; providing an effective date. 23
24
Be It Enacted by the Legislature of the Stat e of Florida: 25
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 2 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
26
Section 1. Paragraph (c) of subsection (1) and subsection 27
(6) of section 409.906, Florida Statutes, are amended to read: 28
409.906 Optional Medicaid services. —Subject to specific 29
appropriations, the agency may make payments for services which 30
are optional to the state under Title XIX of the Social Security 31
Act and are furnished by Medicaid providers to recipients who 32
are determined to be eligible on the dates on which the services 33
were provided. Any optional service that is provided shall be 34
provided only when medically necessary and in accordance with 35
state and federal law. Optional services rendered by providers 36
in mobile units to Medicaid recipients may be restricted or 37
prohibited by the agency. Nothing in this section shall be 38
construed to prevent or limit the agency from adjusting fees, 39
reimbursement rates, lengths of stay, number of visits, or 40
number of services, or making any other adjustments necessary to 41
comply with the availability of moneys and any limitations or 42
directions provided for in the General Appropriations Act or 43
chapter 216. If necessary to safeguard the state's systems of 44
providing services to elderly and disabled persons and subject 45
to the notice and review provisions of s. 216.177, the Governor 46
may direct the Agency for Health Care Administration to amend 47
the Medicaid state plan to delete the optional Medicaid service 48
known as "Intermediate Care Facilities for the Developmentally 49
Disabled." Optional services may include: 50
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 3 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(1) ADULT DENTAL SERVICES. — 51
(c) However, Medicaid will not provide reimbursement for 52
dental services provided in a mobile dental unit, except for a 53
mobile dental unit: 54
1. Owned by, operated by, or having a contractual 55
agreement with the Department of Health and complying with 56
Medicaid's county he alth department clinic services program 57
specifications as a county health department clinic services 58
provider. 59
2. Owned by, operated by, or having a contractual 60
arrangement with a federally qualified health center and 61
complying with Medicaid's federally qualified health center 62
specifications as a federally qualified health center provider. 63
3. Rendering dental services to Medicaid recipients, 21 64
years of age and older, at nursing facilities. 65
4. Owned by, operated by, or having a contractual 66
agreement with a state-approved dental educational institution. 67
5. Owned by, operated by, or having a contractual 68
agreement with a health access setting as defined in s. 69
466.003(14) or a similar setting or program that serves 70
underserved or vulnerable populations t hat face barriers to 71
accessing dental services including, but not limited to, 72
homeless shelters or group homes for adults with disabilities. 73
(6) CHILDREN'S DENTAL SERVICES. —The agency may pay for 74
diagnostic, preventive, or corrective procedures, includin g 75
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 4 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
orthodontia in severe cases, provided to a recipient under age 76
21, by or under the supervision of a licensed dentist. The 77
agency may also reimburse a health access setting as defined in 78
s. 466.003(14) or a licensed dental hygienist s. 466.003 for the 79
remediable tasks that a licensed dental hygienist is authorized 80
to perform under s. 466.024(2). Services provided under this 81
program include treatment of the teeth and associated structures 82
of the oral cavity, as well as treatment of disease, injury, or 83
impairment that may affect the oral or general health of the 84
individual. However, Medicaid will not provide reimbursement for 85
dental services provided in a mobile dental unit, except for a 86
mobile dental unit: 87
(a) Owned by, operated by, or having a contractual 88
agreement with the Department of Health and complying with 89
Medicaid's county health department clinic services program 90
specifications as a county health department clinic services 91
provider. 92
(b) Owned by, operated by, or having a contractual 93
arrangement with a federally qualified health center and 94
complying with Medicaid's federally qualified health center 95
specifications as a federally qualified health center provider. 96
(c) Rendering dental services to Medicaid recipients, 21 97
years of age and older, at nursing facilities. 98
(d) Owned by, operated by, or having a contractual 99
agreement with a state -approved dental educational institution. 100
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 5 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(e) Owned by, operated by, or having a contractual 101
agreement with a health access setting as defined in s. 102
466.003(14) or a similar setting or program that serves 103
underserved or vulnerable populations that face barriers to 104
accessing dental services including, but not limited to, 105
homeless shelters, schools, Early Head Start programs, and the 106
Special Supplemental Nutrition Program for Women, Infants, and 107
Children. 108
Section 2. Paragraph (b) of subsection (4) of section 109
466.007, Florida Statutes, is amended to read: 110
466.007 Examination of dental hygienists. — 111
(4) Effective July 1, 2012, to be licensed as a dental 112
hygienist in this state, an applicant must successfully complete 113
the following: 114
(b) A practical or clinical examination approved by the 115
board. The examination shall be the Dental Hygiene Examination 116
produced by the American Board of Dental Examiners, Inc., (AD EX) 117
or its successor entity, if any, if the board finds that the 118
successor entity's clinical examination meets or exceeds the 119
provisions of this section. The board shall approve the ADEX 120
Dental Hygiene Examination if the board has attained and 121
continues to maintain representation on the ADEX House of 122
Representatives, the ADEX Dental Hygiene Examination Development 123
Committee, and such other ADEX Dental Hygiene committees as the 124
board deems appropriate through rulemaking to ensure that the 125
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 6 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
standards established in this section are maintained 126
organizationally. The ADEX Dental Hygiene Examination or the 127
examination produced by its successor entity is a comprehensive 128
examination in which an applicant must demonstrate skills within 129
the dental hygiene scope of prac tice on a live patient and any 130
other components that the board deems necessary for the 131
applicant to successfully demonstrate competency for the purpose 132
of licensure. 133
Section 3. Subsection (1) of section 466.023, Florida 134
Statutes, is amended to read: 135
466.023 Dental hygienists; scope and area of practice. — 136
(1) Except as otherwise provided in s. 466.024, only 137
dental hygienists may be delegated the task of removing calculus 138
deposits and, accretions, and stains from exposed surfaces of 139
the teeth and from tooth surfaces within the gingival sulcus and 140
the task of performing root planing and gingival curettage. In 141
addition, dental hygienists may expose dental X -ray films, apply 142
topical preventive or prophylactic agents, and perform all tasks 143
delegable by the dentist in accordance with s. 466.024. The 144
board by rule shall determine whether such functions shall be 145
performed under the direct, indirect, or general supervision of 146
the dentist. 147
Section 4. Paragraph (f) of subsection (2) of section 148
466.024, Florida Statutes, is redesignated as paragraph (g) and 149
amended, and a new paragraph (f) is added to that subsection, to 150
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 7 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
read: 151
466.024 Delegation of duties; expanded functions. — 152
(2) A dental hygienist licensed in this state may perform 153
the following remediabl e tasks in a health access setting as 154
defined in s. 466.003 without the physical presence, prior 155
examination, or authorization of a dentist: 156
(f) Apply interim therapeutic restorations. 157
(g)(f) Remove calculus deposits and, accretions, and 158
stains from exposed surfaces of the teeth and from tooth 159
surfaces within the gingival sulcus. 160
1. A dentist licensed under this chapter or a physician 161
licensed under chapter 458 or chapter 459 must give medical 162
clearance before a dental hygienist removes calculus depos its, 163
accretions, and stains from exposed surfaces of the teeth or 164
from tooth surfaces within the gingival sulcus. 165
2. A dentist shall conduct a dental examination on a 166
patient within 13 months after a dental hygienist removes the 167
patient's calculus deposi ts, accretions, and stains from exposed 168
surfaces of the teeth or from tooth surfaces within the gingival 169
sulcus. Additional oral hygiene services may not be performed 170
under this paragraph without a clinical examination by a dentist 171
who is licensed under th is chapter. 172
173
This subsection does not authorize a dental hygienist to perform 174
root planing or gingival curettage without supervision by a 175
HB 997 2022
CODING: Words stricken are deletions; words underlined are additions.
hb0997-00
Page 8 of 8
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
dentist. 176
Section 5. This act shall take effect July 1, 2022. 177