After Minnesota’s Medicaid dental benefits for adults were reduced due to budget cuts in 2009, the state successfully expanded its set of Medicaid benefits for adults, effective in the new year.
About one in four Minnesota residents receive public dental insurance and non-traumatic emergency room dental care is estimated to it costs $22 million a year. The Minnesota Dental Association (MDA) successfully advocated for the expansion of dental benefits in 2020 and 2022.
this year, House File 898 and Senate File 782Sponsored by Representative Robert Bierman (D-Apple Valley) and Senator Liz Boldon (D-Rochester), bills that would restore full Medicaid benefits for adults were signed into law through the General health and human services bill.
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“The bill had bipartisan support in committee. HF 898 restores medically necessary dental care services for MA [Medical Assistance] patients removed during [previous] tight financial years. The rollback will result in long-term savings for the state when we treat conditions early rather than allowing them to become chronic. Better oral health for many Minnesotans is the immediate and most important outcome.”
— Bierman in the State of Reformation
The 2009 budget cuts resulted in Minnesota having two different sets of dental benefits for Medicaid enrollees, which apply to pregnant adults and pregnant children and to non-pregnant adults. Pregnant adults and pregnant children under the age of 21 had extended benefits, while many Minnesotans enrolled in Medicaid lacked coverage for essential dental services.
Services that are not covered by the state’s adult dental benefits package, but will be in the new year, include:
- More than one periodical examination each year
- Detailed and thorough oral assessment
- A comprehensive periodontal evaluation
- A second annual appointment for prophylaxis or cleaning
- A second annual topical fluoride treatment
- Crowns
- Additional endodontic treatment, periodontal scaling and root planing
- Complete prosthetic treatment, including dentures
HF 1176 and SF 1265 were other third-party payer dental bills included in the larger Commerce Omnibus Bill, both of which took effect on August 1. State of Reform spoke with Dan Murphy, director of government affairs for MDA, about the impact of this legislation.
Murphy told State of Reform that these bills address three critical aspects of the relationship between dentists and dental plans, including requiring dental plans to provide a fee schedule before providers sign contracts. When dentists consider new contracts with dental plans, dental plans were not previously required to share the fee schedule before the dentist signed the contract.
These accounts also require at least one reimbursement method provided to non-fee dental providers. In the past, insurance carriers were able to require dentists to accept claim payments exclusively using a virtual credit card instead of a paper check or direct deposit, with the virtual credit card payment method consisting of a fee per transaction of up to five percent hundred, which was paid by dentists. The legislation improves transparency and requires dental plans to offer at least one non-fee reimbursement method.
The latter aspect allows disclosure of network lease agreements to dental providers, giving providers the opportunity to opt out without penalty. Some dental plan contracts have forced dentists to join other payer or managed care networks without receiving full disclosure of fees, processing policies and written consent from the provider, which can often lead to confusion between patients and providers. The legislation provides an opportunity for dentists to accept or decline these contracts and opt out of any network leasing practices without penalty.
“Overall, the bill will bring fairness and transparency to dental contracts,” Murphy said.
