Bill Text: MN SF2133 | 2013-2014 | 88th Legislature | Engrossed
Bill Title: Critical access dental provider requirements modifications
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-03-20 - Comm report: To pass as amended and re-refer to Finance [SF2133 Detail]
Download: Minnesota-2013-SF2133-Engrossed.html
1.2relating to human services; modifying the critical access dental provider
1.3requirements;amending Minnesota Statutes 2013 Supplement, section 256B.76,
1.4subdivision 4.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2013 Supplement, section 256B.76, subdivision 4, is
1.7amended to read:
1.8 Subd. 4. Critical access dental providers. (a) Effective for dental services
1.9rendered on or after January 1, 2002, the commissioner shall increase reimbursements
1.10to dentists and dental clinics deemed by the commissioner to be critical access dental
1.11providers. For dental services rendered on or after July 1, 2007, the commissioner shall
1.12increase reimbursement by 35 percent above the reimbursement rate that would otherwise
1.13be paid to the critical access dental provider. The commissioner shall pay the managed
1.14care plans and county-based purchasing plans in amounts sufficient to reflect increased
1.15reimbursements to critical access dental providers as approved by the commissioner.
1.16(b) The commissioner shall designate the following dentists and dental clinics as
1.17critical access dental providers:
1.18 (1) nonprofit community clinics that:
1.19(i) have nonprofit status in accordance with chapter 317A;
1.20(ii) have tax exempt status in accordance with the Internal Revenue Code, section
1.21501(c)(3);
1.22(iii) are established to provide oral health services to patients who are low income,
1.23uninsured, have special needs, and are underserved;
2.1(iv) have professional staff familiar with the cultural background of the clinic's
2.2patients;
2.3(v) charge for services on a sliding fee scale designed to provide assistance to
2.4low-income patients based on current poverty income guidelines and family size;
2.5(vi) do not restrict access or services because of a patient's financial limitations
2.6or public assistance status; and
2.7(vii) have free care available as needed;
2.8 (2) federally qualified health centers, rural health clinics, and public health clinics;
2.9 (3) city or county owned and operated hospital-based dental clinics;
2.10(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
2.11accordance with chapter 317A with more than 10,000 patient encounters per year with
2.12patients who are uninsured or covered by medical assistance or MinnesotaCare;
2.13(5) a dental clinic owned and operated by the University of Minnesota or the
2.14Minnesota State Colleges and Universities system; and
2.15(6) private practicing dentists if:
2.16(i) the dentist's office is located within a health professional shortage area as defined
2.17under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
2.18section 254E;
2.19(ii) more than 50 percent of the dentist's patient encounters per year are with patients
2.20who are uninsured or covered by medical assistance or MinnesotaCare;
2.21(iii) the dentist does not restrict access or services because of a patient's financial
2.22limitations or public assistance status; and
2.23(iv) (iii) the level of service provided by the dentist is critical to maintaining
2.24adequate levels of patient access within the service area in which the dentist operates.
2.25(c) A designated critical access clinic shall receive the reimbursement rate specified
2.26in paragraph (a) for dental services provided off site at a private dental office if the
2.27following requirements are met:
2.28(1) the designated critical access dental clinic is located within a health professional
2.29shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
2.30States Code, title 42, section 254E, and is located outside the seven-county metropolitan
2.31area;
2.32(2) the designated critical access dental clinic is not able to provide the service
2.33and refers the patient to the off-site dentist;
2.34(3) the designated critical access dental clinic and the dentist providing the service
2.35have entered into a contractual agreement that specifies that the critical access dental clinic
2.36is responsible for the services provided;
3.1(3) (4) the service, if provided at the critical access dental clinic, would be
3.2reimbursed at the critical access reimbursement rate;
3.3(4) (5) the dentist and allied dental professionals providing the services off site are
3.4licensed and in good standing under chapter 150A;
3.5(5) (6) the dentist providing the services is enrolled as a medical assistance provider;
3.6(6) (7) the critical access dental clinic submits the claim for services provided off
3.7site and receives the payment for the services; and
3.8(7) (8) the critical access dental clinic maintains dental records for each claim
3.9submitted under this paragraph, including the name of the dentist, the off-site location, and
3.10the license number of the dentist and allied dental professionals providing the services.
1.3requirements;amending Minnesota Statutes 2013 Supplement, section 256B.76,
1.4subdivision 4.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2013 Supplement, section 256B.76, subdivision 4, is
1.7amended to read:
1.8 Subd. 4. Critical access dental providers. (a) Effective for dental services
1.9rendered on or after January 1, 2002, the commissioner shall increase reimbursements
1.10to dentists and dental clinics deemed by the commissioner to be critical access dental
1.11providers. For dental services rendered on or after July 1, 2007, the commissioner shall
1.12increase reimbursement by 35 percent above the reimbursement rate that would otherwise
1.13be paid to the critical access dental provider. The commissioner shall pay the managed
1.14care plans and county-based purchasing plans in amounts sufficient to reflect increased
1.15reimbursements to critical access dental providers as approved by the commissioner.
1.16(b) The commissioner shall designate the following dentists and dental clinics as
1.17critical access dental providers:
1.18 (1) nonprofit community clinics that:
1.19(i) have nonprofit status in accordance with chapter 317A;
1.20(ii) have tax exempt status in accordance with the Internal Revenue Code, section
1.21501(c)(3);
1.22(iii) are established to provide oral health services to patients who are low income,
1.23uninsured, have special needs, and are underserved;
2.1(iv) have professional staff familiar with the cultural background of the clinic's
2.2patients;
2.3(v) charge for services on a sliding fee scale designed to provide assistance to
2.4low-income patients based on current poverty income guidelines and family size;
2.5(vi) do not restrict access or services because of a patient's financial limitations
2.6or public assistance status; and
2.7(vii) have free care available as needed;
2.8 (2) federally qualified health centers, rural health clinics, and public health clinics;
2.9 (3) city or county owned and operated hospital-based dental clinics;
2.10(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
2.11accordance with chapter 317A with more than 10,000 patient encounters per year with
2.12patients who are uninsured or covered by medical assistance or MinnesotaCare;
2.13(5) a dental clinic owned and operated by the University of Minnesota or the
2.14Minnesota State Colleges and Universities system; and
2.15(6) private practicing dentists if:
2.16(i) the dentist's office is located within a health professional shortage area as defined
2.17under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
2.18section 254E;
2.19(ii) more than 50 percent of the dentist's patient encounters per year are with patients
2.20who are uninsured or covered by medical assistance or MinnesotaCare;
2.21
2.22
2.23
2.24adequate levels of patient access within the service area in which the dentist operates.
2.25(c) A designated critical access clinic shall receive the reimbursement rate specified
2.26in paragraph (a) for dental services provided off site at a private dental office if the
2.27following requirements are met:
2.28(1) the designated critical access dental clinic is located within a health professional
2.29shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
2.30States Code, title 42, section 254E, and is located outside the seven-county metropolitan
2.31area;
2.32(2) the designated critical access dental clinic is not able to provide the service
2.33and refers the patient to the off-site dentist;
2.34(3) the designated critical access dental clinic and the dentist providing the service
2.35have entered into a contractual agreement that specifies that the critical access dental clinic
2.36is responsible for the services provided;
3.1
3.2reimbursed at the critical access reimbursement rate;
3.3
3.4licensed and in good standing under chapter 150A;
3.5
3.6
3.7site and receives the payment for the services; and
3.8
3.9submitted under this paragraph, including the name of the dentist, the off-site location, and
3.10the license number of the dentist and allied dental professionals providing the services.
