Minnesota 2025-2026 Regular Session

Minnesota House Bill HF2690 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to health care; modifying medical assistance dental provisions; amending
3	3	1.3 Minnesota Statutes 2024, sections 256B.0371, subdivision 3; 256B.0625,
4	4	1.4 subdivision 3c.
5	5	1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
6	6	1.6 Section 1. Minnesota Statutes 2024, section 256B.0371, subdivision 3, is amended to read:
7	7	1.7 Subd. 3.Contingent contract with dental administrator.(a) The commissioner shall
8	8	1.8determine the extent to which managed care and county-based purchasing plans in the
9	9	1.9aggregate meet the performance benchmark specified in subdivision 1 for coverage year
10	10	1.102024. If managed care and county-based purchasing plans in the aggregate fail to meet the
11	11	1.11performance benchmark, the commissioner, after issuing a request for information followed
12	12	1.12by a request for proposals, shall contract with a dental administrator to administer dental
13	13	1.13services beginning January 1, 2026, for all recipients of medical assistance and
14	14	1.14MinnesotaCare, including persons served under fee-for-service and persons receiving
15	15	1.15services through managed care and county-based purchasing plans.
16	16	1.16 (b) The dental administrator must provide administrative services, including but not
17	17	1.17limited to:
18	18	1.18 (1) provider recruitment, contracting, and assistance;
19	19	1.19 (2) recipient outreach and assistance;
20	20	1.20 (3) utilization management and reviews of medical necessity for dental services;
21	21	1.21 (4) dental claims processing;
22	22	1.22 (5) coordination of dental care with other services;
23	23	1Section 1.
24	24	REVISOR AGW/NS 25-0468703/12/25
25	25	State of Minnesota
26	26	This Document can be made available
27	27	in alternative formats upon request
28	28	HOUSE OF REPRESENTATIVES
29	29	H. F. No. 2690
30	30	NINETY-FOURTH SESSION
31	31	Authored by Liebling, Bierman, Huot, Carroll, Mahamoud and others03/24/2025
32	32	The bill was read for the first time and referred to the Committee on Health Finance and Policy 2.1 (6) management of fraud and abuse;
33	33	2.2 (7) monitoring access to dental services;
34	34	2.3 (8) performance measurement;
35	35	2.4 (9) quality improvement and evaluation; and
36	36	2.5 (10) management of third-party liability requirements.
37	37	2.6 (c) Dental administrator payments to contracted dental providers must be at the rates
38	38	2.7established under sections 256B.76 and 256L.11 at least equal to the average rates paid by
39	39	2.8managed care plans and county-based purchasing plans for coverage year 2024.
40	40	2.9 (d) Recipients must be given a choice of dental provider, including any provider who
41	41	2.10agrees to provider participation requirements and payment rates established by the
42	42	2.11commissioner and dental administrator. The dental administrator must comply with the
43	43	2.12network adequacy and geographic access requirements that apply to managed care and
44	44	2.13county-based purchasing plans for dental services under section 62K.14.
45	45	2.14 (e) The contract with the dental administrator must include a provision that states that
46	46	2.15if the dental administrator fails to meet, by calendar year 2029, a performance benchmark
47	47	2.16under which at least 55 percent of children and adults who were continuously enrolled for
48	48	2.17at least 11 months in either medical assistance or MinnesotaCare received at least one dental
49	49	2.18visit during the calendar year, the contract must be terminated and the commissioner must
50	50	2.19enter into a contract with a new dental administrator as soon as practicable.
51	51	2.20 (f) The commissioner shall implement this subdivision in consultation with representatives
52	52	2.21of providers who provide dental services to patients enrolled in medical assistance or
53	53	2.22MinnesotaCare, including but not limited to providers serving primarily low-income and
54	54	2.23socioeconomically complex populations, and with representatives of managed care plans
55	55	2.24and county-based purchasing plans.
56	56	2.25 Sec. 2. Minnesota Statutes 2024, section 256B.0625, subdivision 3c, is amended to read:
57	57	2.26 Subd. 3c.Health Services Advisory Council.(a) The commissioner, after receiving
58	58	2.27recommendations from professional physician associations, professional associations
59	59	2.28representing licensed nonphysician health care professionals, and consumer groups, shall
60	60	2.29establish a 14-member Health Services Advisory Council, which consists of 13 voting
61	61	2.30members and one nonvoting member. The Health Services Advisory Council shall advise
62	62	2.31the commissioner regarding (1) health services pertaining to the administration of health
63	63	2.32care benefits covered under Minnesota health care programs (MHCP); and (2) evidence-based
64	64	2Sec. 2.
65	65	REVISOR AGW/NS 25-0468703/12/25 3.1decision-making and health care benefit and coverage policies for MHCP. The Health
66	66	3.2Services Advisory Council shall consider available evidence regarding quality, safety, and
67	67	3.3cost-effectiveness when advising the commissioner. The Health Services Advisory Council
68	68	3.4shall meet at least quarterly. The Health Services Advisory Council shall annually select a
69	69	3.5chair from among its members who shall work directly with the commissioner's medical
70	70	3.6director to establish the agenda for each meeting. The Health Services Advisory Council
71	71	3.7may recommend criteria for verifying centers of excellence for specific aspects of medical
72	72	3.8care where a specific set of combined services, a volume of patients necessary to maintain
73	73	3.9a high level of competency, or a specific level of technical capacity is associated with
74	74	3.10improved health outcomes.
75	75	3.11 (b) The commissioner shall establish a dental subcouncil to operate under the Health
76	76	3.12Services Advisory Council. The dental subcouncil consists of general dentists, dental
77	77	3.13specialists, safety net providers, dental hygienists, health plan company and county and
78	78	3.14public health representatives, health researchers, consumers, and a designee of the
79	79	3.15commissioner of health. The dental subcouncil shall advise the commissioner regarding:
80	80	3.16 (1) the critical access dental program under section 256B.76, subdivision 4, including
81	81	3.17but not limited to criteria for designating and terminating critical access dental providers;
82	82	3.18 (2) any changes to the critical access dental provider program necessary to comply with
83	83	3.19program expenditure limits;
84	84	3.20 (3) dental coverage policy based on evidence, quality, continuity of care, and best
85	85	3.21practices;
86	86	3.22 (4) the development of dental delivery models; and
87	87	3.23 (5) dental services to be added or eliminated from subdivision 9.; and
88	88	3.24 (6) the availability of dental services under MHCP and policies to improve MHCP
89	89	3.25recipients' access to the services.
90	90	3.26 (c) The Health Services Advisory Council may monitor and track the practice patterns
91	91	3.27of health care providers who serve MHCP recipients under fee-for-service, managed care,
92	92	3.28and county-based purchasing. The monitoring and tracking shall focus on services or
93	93	3.29specialties for which there is a high variation in utilization or quality across providers, or
94	94	3.30which are associated with high medical costs. The commissioner, based upon the findings
95	95	3.31of the Health Services Advisory Council, may notify providers whose practice patterns
96	96	3.32indicate below average quality or higher than average utilization or costs. Managed care
97	97	3.33and county-based purchasing plans shall provide the commissioner with utilization and cost
98	98	3Sec. 2.
99	99	REVISOR AGW/NS 25-0468703/12/25 4.1data necessary to implement this paragraph, and the commissioner shall make these data
100	100	4.2available to the Health Services Advisory Council.
101	101	4.3 Sec. 3. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; PAYMENTS
102	102	4.4FOR DENTAL SERVICES.
103	103	4.5 Upon implementation of a dental administrator administering dental services for all
104	104	4.6recipients of medical assistance and MinnesotaCare, the commissioner of human services
105	105	4.7must ensure the portion of the capitation rate paid to managed care organizations and
106	106	4.8county-based purchasing plans under medical assistance and MinnesotaCare attributable to
107	107	4.9the provision of dental services is directed toward the rates the dental administrator must
108	108	4.10pay dental providers under Minnesota Statutes, section 256B.0371, subdivision 3, paragraph
109	109	4.11(c).
110	110	4Sec. 3.
111	111	REVISOR AGW/NS 25-0468703/12/25