Single dental administrator implementation delayed for the medical assistance program.

A bill for an act

relating to human services; delaying implementation of the single dental

administrator for the medical assistance program; amending Minnesota Statutes

2024, section 256B.0371, subdivision 4; Minnesota Statutes 2025 Supplement,

section 256B.0371, subdivision 3.

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

Section 1.

Minnesota Statutes 2025 Supplement, section 256B.0371, subdivision 3, is

amended to read:

Subd. 3.

Contingent contract with dental administrator.

(a) The commissioner shall

determine the extent to which managed care and county-based purchasing plans in the

aggregate meet the performance benchmark specified in subdivision 1 for coverage year

2024. If managed care and county-based purchasing plans in the aggregate fail to meet the

performance benchmark, the commissioner, after issuing a request for information followed

by a request for proposals, shall contract with a dental administrator to administer dental

services beginning January 1,
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2028
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2030
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, for recipients of medical assistance and

MinnesotaCare who are served under fee-for-service and persons receiving services through

managed care plans.

(b) The dental administrator must provide administrative services, including but not

limited to:

(1) provider recruitment, contracting, and assistance;

(2) recipient outreach and assistance;

(3) utilization management and reviews of medical necessity for dental services;

(4) dental claims processing;

(5) coordination of dental care with other services;

(6) management of fraud and abuse;

(7) monitoring access to dental services statewide;

(8) performance measurement;

(9) quality improvement and evaluation;

(10) management of third-party liability requirements; and

(11) establishment of grievance and appeals processes for providers and enrollees that

the commissioner can monitor.

(c) Dental administrator payments to contracted dental providers must be based on rates

recommended by the dental access working group. If the recommended rates are not

established in law prior to July 1,
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2027
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2029
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, dental administrator payments to contracted

dental providers must be at the rates established under sections
256B.76
and
256L.11
.

(d) Recipients must be given a choice of dental provider, including any provider who

agrees to provider participation requirements and payment rates established by the

commissioner and dental administrator. The dental administrator must comply with the

network adequacy and geographic access requirements that apply to managed care plans

for dental services under section
62K.14
.

(e) The contract with the dental administrator must include performance benchmarks,

accountability measures, and progress rewards based on the recommendations from the

dental access working group.

(f) Notwithstanding the contract term limits under section
16C.06, subdivision 3b
, the

commissioner may extend the implementation contract for the single dental administrator

under paragraph (a) up to three years from the date of execution and may contract with the

same contractor as the single dental administrator for up to five years, beginning in
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2028
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new text begin

2030
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.

Sec. 2.

Minnesota Statutes 2024, section 256B.0371, subdivision 4, is amended to read:

Subd. 4.

Dental utilization report.

(a) The commissioner shall submit an annual report

beginning March 15, 2022, and ending March 15,
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2026
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2028
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, to the chairs and ranking

minority members of the legislative committees with jurisdiction over health and human

services policy and finance that includes the percentage for adults and children one through

20 years of age for the most recent complete calendar year receiving at least one dental visit

for both fee-for-service and the prepaid medical assistance program. The report must include:

(1) statewide utilization for both fee-for-service and for the prepaid medical assistance

program;

(2) utilization by county;

(3) utilization by children receiving dental services through fee-for-service and through

a managed care plan or county-based purchasing plan; and

(4) utilization by adults receiving dental services through fee-for-service and through a

managed care plan or county-based purchasing plan.

(b) The report must also include a description of any corrective action plans required to

be submitted under subdivision 2.

(c) The initial report due on March 15, 2022, must include the utilization metrics described

in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.

(d) In the annual report due on March 15, 2023, and in each report due thereafter, the

commissioner shall include the following:

(1) the number of dentists enrolled with the commissioner as a medical assistance dental

provider and the congressional district or districts in which the dentist provides services;

(2) the number of enrolled dentists who provided fee-for-service dental services to

medical assistance or MinnesotaCare patients within the previous calendar year in the

following increments: one to nine patients, ten to 100 patients, and over 100 patients;

(3) the number of enrolled dentists who provided dental services to medical assistance

or MinnesotaCare patients through a managed care plan or county-based purchasing plan

within the previous calendar year in the following increments: one to nine patients, ten to

100 patients, and over 100 patients; and

(4) the number of dentists who provided dental services to a new patient who was enrolled

in medical assistance or MinnesotaCare within the previous calendar year.

(e) The report due on March 15, 2023, must include the metrics described in paragraph

(d) for each of the following years: 2017, 2018, 2019, 2020, and 2021.