Read the full stored bill text
Florida Senate
-
2026
SB 1640
By
Senator Smith
17-01369A-26 20261640__
1 A bill to be entitled
2 An act relating to the Medicaid dental pilot program
3 for persons with disabilities; creating s. 409.9079,
4 F.S.; defining the term “persons with disabilities”;
5 requiring the Agency for Health Care Administration to
6 establish and operate a Medicaid dental pilot program
7 in a specified region to provide enhanced dental
8 services to persons with disabilities; specifying
9 eligibility for participation in the pilot program;
10 specifying dental services covered by the pilot
11 program; providing construction; requiring the agency
12 to reimburse dental providers under the pilot program
13 at a specified rate; providing for the delivery of
14 services under the pilot program through at least two
15 licensed dental managed care organizations meeting
16 certain criteria; requiring the agency to submit any
17 necessary state plan amendments or federal waiver
18 applications for federal approval; requiring the
19 agency to collect certain data on the pilot program;
20 requiring the agency to submit a report on the pilot
21 program to the Governor and the Legislature by a
22 specified date; providing for expiration of the pilot
23 program; providing an effective date.
24
25 Be It Enacted by the Legislature of the State of Florida:
26
27 Section 1. Section 409.9079, Florida Statutes, is created
28 to read:
29
409.9079 Medicaid dental pilot program for persons with
30
disabilities in Region
E
.—
31
(1) DEFINITION.—As used in this section, the term “persons
32
with disabilities” means Medicaid-eligible individuals who:
33
(a) Receive Supplemental Security Income (SSI) on the basis
34
of disability;
35
(b) Are enrolled in a home and community-based services
36
(HCBS) waiver program under s. 1915(c) of the Social Security
37
Act; or
38
(c) Meet federal disability criteria under 42 U.S.C. s.
39
1382c(a)(3), as determined by the Social Security Administration
40
or the state Medicaid program.
41
(2) PILOT PROGRAM ESTABLISHED.—The
agency
shall establish
42
and operate a 3-year Medicaid dental pilot program in Region
E
43
of the Statewide Medicaid Managed Care program to provide
44
enhanced dental services to persons with disabilities.
45
(3) ELIGIBILITY.—Participation in the pilot program is
46
limited to persons with disabilities who reside in Region
E
and
47
are enrolled in the Medicaid program.
48
(4) COVERED SERVICES.—
49
(a)
Dental services provided under the pilot program must
50
include
all of the following
:
51
1.
Routine diagnostic and preventive care, including
52
examinations, cleanings, and radiographs
.
53
2.
Basic dental services, including fillings and
54
extractions
.
55
3.
Major dental services, including root canals, crowns,
56
dentures, and other dental prostheses
.
57
4.
Emergency dental services
.
58
5.
Any additional dental services the agency determines are
59
necessary to promote oral health and prevent disease.
60
(b)
Services provided under this subsection supplement, and
61
do not replace, dental benefits available under ss. 409.906 and
62
409.973.
63
(5) REIMBURSEMENT.—The agency shall reimburse providers of
64
dental services under the pilot program at a rate equivalent to
65
80 percent of the 50th percentile of the 2024 Usual, Customary,
66
and Reasonable fees, as determined by the American Dental
67
Association or a comparable benchmark approved by the agency.
68
(6) MANAGED CARE PARTICIPATION.—The pilot program must be
69
delivered through at least two licensed dental managed care
70
organizations that meet agency standards and have demonstrated
71
experience in providing dental services to persons with
72
disabilities.
73
(7) FEDERAL APPROVAL.—The agency shall submit
for federal
74
approval
any Medicaid state plan amendments or federal waiver
75
applications necessary to implement the pilot program.
76
(8) EVALUATION
;
REPORT.—
77
(a)
The agency shall collect
pilot program
data on
all of
78
the following
:
79
1.
Access to dental care
.
80
2.
Utilization of services
.
81
3.
Reimbursement expenditures
.
82
4.
Oral health outcomes for participants.
83
(b)
By January 1, 202
9
, the agency shall submit a report to
84
the Governor, the President of the Senate, and the Speaker of
85
the House of Representatives evaluating the effectiveness of the
86
pilot program and recommending whether it should be expanded
87
statewide.
88
(9) EXPIRATION.—This section expires June 30, 202
9
.
89 Section 2. This act shall take effect July 1, 2026.