House File 2511 - Introduced HOUSE FILE 2511 BY ISENHART , FORBES , and WILSON A BILL FOR An Act relating to reimbursement for dental services under the 1 Medicaid program. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5759YH (6) 90 pf/ko

H.F. 2511 Section 1. MEDICAID REIMBURSEMENT RATES FOR DENTAL 1 SERVICES. The department of health and human services shall 2 establish reimbursement rates for dental services provided 3 under the Medicaid program as follows: 4 1. For adult Medicaid recipients through the Medicaid 5 dental wellness plan, reimbursement rates shall be equal to 6 the current mean or median, whichever is greater, of the rates 7 paid for the same services in Minnesota, Wisconsin, Illinois, 8 Missouri, Nebraska, and South Dakota, as calculated by the 9 department of health and human services in consultation with 10 the dental board, and adjusted annually to comply with the 11 methodology prescribed under this subsection. 12 2. For Medicaid recipients who are children under the 13 Medicaid dental wellness plan kids, reimbursement rates shall 14 be equal to the greater of the following: 15 a. The current mean or median, whichever is greater, of 16 the rates paid for the same services in Minnesota, Wisconsin, 17 Illinois, Missouri, Nebraska, and South Dakota, as calculated 18 by the department of health and human services in consultation 19 with the dental board, and adjusted annually to comply with the 20 methodology prescribed under this paragraph. 21 b. The reimbursement rates for the same services under the 22 healthy and well kids in Iowa (Hawki) program under chapter 23 514I. 24 EXPLANATION 25 The inclusion of this explanation does not constitute agreement with 26 the explanation’s substance by the members of the general assembly. 27 This bill requires the department of health and human 28 services (HHS) to establish reimbursement rates for dental 29 services provided under the Medicaid program based on certain 30 criteria. 31 For adult Medicaid recipients through the Medicaid dental 32 wellness plan, reimbursement rates shall be equal to the 33 current mean or median, whichever is greater, of the rates 34 paid for the same services in Minnesota, Wisconsin, Illinois, 35 -1- LSB 5759YH (6) 90 pf/ko 1/ 2

H.F. 2511 Missouri, Nebraska, and South Dakota, as calculated by HHS in 1 consultation with the dental board, and adjusted annually to 2 comply with the methodology prescribed in the bill. 3 For Medicaid recipients who are children under the Medicaid 4 dental wellness plan kids, reimbursement rates shall be equal 5 to the greater of the current mean or median, whichever is 6 greater, of the rates paid for the same services in Minnesota, 7 Wisconsin, Illinois, Missouri, Nebraska, and South Dakota, as 8 calculated by the department of health and human services in 9 consultation with the dental board, and adjusted annually to 10 comply with the methodology prescribed under the bill; or the 11 reimbursement rates for the same services under the healthy and 12 well kids in Iowa (Hawki) program under Code chapter 514I. 13 -2- LSB 5759YH (6) 90 pf/ko 2/ 2