80R5331 UM-F

By: Martinez H.B. No. 2707

A BILL TO BE ENTITLED

AN ACT

relating to the development and implementation of a plan to increase Medicaid reimbursement rates for dental services.

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

SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.0541 to read as follows:

Sec. 32.0541. TASK FORCE ON REIMBURSEMENT RATES FOR DENTAL SERVICES. (a) In this section:

(1) "Dental provider" means a dentist who provides services eligible for reimbursement under the medical assistance program and who is in good standing in the dental profession.

(2) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

(3) "Task force" means the task force on medical assistance reimbursement rates for dental services appointed by the executive commissioner under this section.

(b) The executive commissioner shall appoint 15 representatives to a task force to develop a plan to increase medical assistance reimbursement rates for dental services in order to:

(1) improve basic dental health care for eligible individuals;

(2) improve the quality of dental health care provided under the medical assistance program;

(3) encourage more dentists to practice in rural areas with a high need for dental health care; and

(4) encourage dentists who recently graduated to remain in this state and provide dental services under the medical assistance program by making reimbursement rates in this state competitive with the reimbursement rates in other states.

(c) The representatives must include:

(1) seven general dental providers;

(2) six specialty dental providers, including:

(A) three pedodontists;

(B) one oral surgeon;

(C) one periodontist; and

(D) one orthodontist;

(3) one additional general or specialty dental provider, as determined by the executive commissioner; and

(4) an individual appointed by the executive commissioner to represent the Health and Human Services Commission.

(d) In appointing the representatives, the executive commissioner shall ensure a balanced representation of:

(1) different regions of this state, based on the number of medical assistance recipients in the region; and

(2) rural and urban counties.

(e) The Health and Human Services Commission shall provide administrative support and resources to the task force as necessary for the task force to perform the duties under this section.

(f) The task force is not subject to Chapter 2110, Government Code.

(g) The task force shall elect a chairperson from among the dental provider representatives on the task force.

(h) The task force shall create a plan to improve reimbursement rates under the medical assistance program for dental services. The plan must include recommendations of the task force on how to systematically and incrementally raise reimbursement rates to at least the 75th percentile of the usual and customary National Average Marker Rate.

(i) In preparing the plan required under Subsection (h), the task force shall:

(1) review and study current medical assistance policies and reimbursement methodologies related to dental services and fees;

(2) review the reimbursement rates under medical assistance programs for dental services adopted by other states;

(3) investigate the effect of medical assistance reimbursement rates for dental services on:

(A) the quality of dental care provided;

(B) the number of children who receive basic dental health care;

(C) the number of new dental providers offering dental services under the medical assistance program; and

(D) the number of dental providers in rural areas;

(4) develop and recommend procedures and reimbursement methodologies that will address concerns raised under Subdivisions (1) through (3);

(5) create a plan to systematically and incrementally increase medical assistance reimbursement rates for dental services to the rates described by Subsection (h); and

(6) ensure that the plan includes methods for adjusting reimbursement rates in the future in a manner that addresses the concerns identified by the task force.

(j) Not later than December 1, 2008, the task force shall submit the plan required by Subsection (h) to the executive commissioner, the governor, the lieutenant governor, the speaker of the house of representatives, and the clerks of the standing committees of the senate and house of representatives with primary jurisdiction over the medical assistance program.

(k) Not later than September 1, 2009, the Health and Human Services Commission shall implement the plan submitted by the task force under Subsection (j), subject to the availability of funds appropriated for that purpose.

(l) The task force shall:

(1) continue to monitor the information evaluated in creating the plan required under Subsection (h) and any changes in the medical assistance reimbursement rates for dental services adopted by the Health and Human Services Commission; and

(2) submit a report with additional recommendations to the executive commissioner, the governor, the lieutenant governor, the speaker of the house of representatives, and the clerks of the standing committees of the senate and house of representatives with primary jurisdiction over the medical assistance program not later than December 1, 2010.

(m) This section expires September 1, 2011.

SECTION 2. This Act takes effect September 1, 2007.