| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to human services; modifying dental service coverage to include pediatric |
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| 3 | 3 | | 1.3 zirconia crowns; amending Minnesota Statutes 2024, section 256B.0625, |
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| 4 | 4 | | 1.4 subdivision 9. |
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| 5 | 5 | | 1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 6 | 6 | | 1.6 Section 1. Minnesota Statutes 2024, section 256B.0625, subdivision 9, is amended to read: |
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| 7 | 7 | | 1.7 Subd. 9.Dental services.(a) Medical assistance covers medically necessary dental |
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| 8 | 8 | | 1.8services. |
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| 9 | 9 | | 1.9 (b) The following guidelines apply to dental services: |
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| 10 | 10 | | 1.10 (1) posterior fillings are paid at the amalgam rate; |
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| 11 | 11 | | 1.11 (2) application of sealants are covered once every five years per permanent molar; and |
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| 12 | 12 | | 1.12 (3) application of fluoride varnish is covered once every six months. |
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| 13 | 13 | | 1.13 (c) In addition to the services specified in paragraph (a), medical assistance covers the |
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| 14 | 14 | | 1.14following services: |
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| 15 | 15 | | 1.15 (1) house calls or extended care facility calls for on-site delivery of covered services; |
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| 16 | 16 | | 1.16 (2) behavioral management when additional staff time is required to accommodate |
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| 17 | 17 | | 1.17behavioral challenges and sedation is not used; |
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| 18 | 18 | | 1.18 (3) oral or IV sedation, if the covered dental service cannot be performed safely without |
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| 19 | 19 | | 1.19it or would otherwise require the service to be performed under general anesthesia in a |
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| 20 | 20 | | 1.20hospital or surgical center; and |
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| 21 | 21 | | 1Section 1. |
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| 22 | 22 | | 25-01518 as introduced12/19/24 REVISOR AGW/AD |
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| 23 | 23 | | SENATE |
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| 24 | 24 | | STATE OF MINNESOTA |
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| 25 | 25 | | S.F. No. 274NINETY-FOURTH SESSION |
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| 26 | 26 | | (SENATE AUTHORS: BOLDON, Mann and Kupec) |
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| 27 | 27 | | OFFICIAL STATUSD-PGDATE |
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| 28 | 28 | | Introduction and first reading01/21/2025 |
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| 29 | 29 | | Referred to Health and Human Services 2.1 (4) prophylaxis, in accordance with an appropriate individualized treatment plan, but |
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| 30 | 30 | | 2.2no more than four times per year; and |
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| 31 | 31 | | 2.3 (5) pediatric zirconia crowns for children. |
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| 32 | 32 | | 2.4 (d) The commissioner shall not require prior authorization for the services included in |
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| 33 | 33 | | 2.5paragraph (c), clauses (1) to (3), and shall prohibit managed care and county-based purchasing |
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| 34 | 34 | | 2.6plans from requiring prior authorization for the services included in paragraph (c), clauses |
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| 35 | 35 | | 2.7(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12. |
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| 36 | 36 | | 2Section 1. |
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| 37 | 37 | | 25-01518 as introduced12/19/24 REVISOR AGW/AD |
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