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