HF 2511 (LSB 5759YH (6) 90)

HOUSE FILE 2511

BY  ISENHART, FORBES, and WILSON

A BILL FOR

An Act relating to reimbursement for dental services under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAID REIMBURSEMENT RATES FOR DENTAL SERVICES.  The department of health and human services shall establish reimbursement rates for dental services provided under the Medicaid program as follows:
   1.  For adult Medicaid recipients through the Medicaid dental wellness plan, reimbursement rates shall be equal to the current mean or median, whichever is greater, of the rates paid for the same services in Minnesota, Wisconsin, Illinois, Missouri, Nebraska, and South Dakota, as calculated by the department of health and human services in consultation with the dental board, and adjusted annually to comply with the methodology prescribed under this subsection.
   2.  For Medicaid recipients who are children under the Medicaid dental wellness plan kids, reimbursement rates shall be equal to the greater of the following:
   a.  The current mean or median, whichever is greater, of the rates paid for the same services in Minnesota, Wisconsin, Illinois, Missouri, Nebraska, and South Dakota, as calculated by the department of health and human services in consultation with the dental board, and adjusted annually to comply with the methodology prescribed under this paragraph.
   b.  The reimbursement rates for the same services under the healthy and well kids in Iowa (Hawki) program under chapter 514I. 
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill requires the department of health and human services (HHS) to establish reimbursement rates for dental services provided under the Medicaid program based on certain criteria. 
   For adult Medicaid recipients through the Medicaid dental wellness plan, reimbursement rates shall be equal to the current mean or median, whichever is greater, of the rates paid for the same services in Minnesota, Wisconsin, Illinois, Missouri, Nebraska, and South Dakota, as calculated by HHS in consultation with the dental board, and adjusted annually to comply with the methodology prescribed in the bill.
   For Medicaid recipients who are children under the Medicaid dental wellness plan kids, reimbursement rates shall be equal to the greater of the current mean or median, whichever is greater, of the rates paid for the same services in Minnesota, Wisconsin, Illinois, Missouri, Nebraska, and South Dakota, as calculated by the department of health and human services in consultation with the dental board, and adjusted annually to comply with the methodology prescribed under the bill; or the reimbursement rates for the same services under the healthy and well kids in Iowa (Hawki) program under Code chapter 514I.