House Bill 975 amends Florida Statutes to enhance dental service coverage under the Medicaid program by establishing a statewide Medicaid prepaid dental health program for both children and adults. The bill specifies that recipients will have a choice of at least two licensed dental providers, with comprehensive dental services mandated for those under 21 and essential dental care, including preventive, basic, and emergency services, for those aged 21 and older. Additionally, the Agency for Health Care Administration (AHCA) will reimburse providers for adult dental services at a rate equivalent to 80% of the 50th percentile of the 2024 Usual, Customary, and Reasonable fees, as determined by the American Dental Association. The agency is also required to seek federal approval for these changes.

In addition to dental services, the bill outlines various healthcare services that may be covered by Medicaid, including registered nurse first assistant services, visual services, assistive-care services, and home and community-based services for individuals with developmental disabilities. It introduces provisions for biomarker testing, allowing Medicaid to cover such tests when they demonstrate clinical utility based on established medical evidence. The legislation removes obsolete language and previous legislative findings related to dental services, replacing them with a directive for the implementation of the dental health program. The act is set to take effect on July 1, 2025.

Statutes affected:
H 975 Filed: 409.906, 409.973