Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 103 (2021GS)

Sponsor

Sen. Weiler, T.

Final action

Governor Signed 3/16/2021

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• requires the Department of Health to reimburse a dental hygienist directly for certain services provided through the Medicaid program;
• creates a deadline for the department to begin reimbursing dental hygienists directly;
• creates a reporting requirement; and
• provides a sunset date for the provisions of this bill.

Every vote on this bill

Bill text

DENTAL HYGIENIST AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Todd D. Weiler
House Sponsor: 
V. Lowry Snow
LONG TITLE
General Description:
This bill enacts provisions related to Medicaid reimbursement for dental hygienists.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ requires the Department of Health to reimburse a dental hygienist directly for
certain services provided through the Medicaid program;
▸ creates a deadline for the department to begin reimbursing dental hygienists
directly;
▸ creates a reporting requirement; and
▸ provides a sunset date for the provisions of this bill.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-18-2.6
, as last amended by Laws of Utah 2020, Chapter 225
63I-1-226
, as last amended by Laws of Utah 2020, Chapters 19, 154, 172, 181, 221,
232, 303, 347, and 429
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-18-2.6
 is amended to read:
26-18-2.6.
Dental benefits.
(1) (a) Except as provided in Subsection (8), the division may establish a competitive
bid process to bid out Medicaid dental benefits under this chapter.
(b) The division may bid out the Medicaid dental benefits separately from other
program benefits.
(2) The division shall use the following criteria to evaluate dental bids:
(a) ability to manage dental expenses;
(b) proven ability to handle dental insurance;
(c) efficiency of claim paying procedures;
(d) provider contracting, discounts, and adequacy of network; and
(e) other criteria established by the department.
(3) The division shall request bids for the program's benefits at least once every five
years.
(4) The division's contract with dental plans for the program's benefits shall include
risk sharing provisions in which the dental plan must accept 100% of the risk for any difference
between the division's premium payments per client and actual dental expenditures.
(5) The division may not award contracts to:
(a) more than three responsive bidders under this section; or
(b) an insurer that does not have a current license in the state.
(6) (a) The division may cancel the request for proposals if:
(i) there are no responsive bidders; or
(ii) the division determines that accepting the bids would increase the program's costs.
(b) If the division cancels a request for proposal or a contract that results from a request
for proposal described in Subsection (6)(a), the division shall report to the Health and Human
Services Interim Committee regarding the reasons for the decision.
(7) Title 63G, Chapter 6a, Utah Procurement Code, shall apply to this section.
(8) (a) The division may:
(i) establish a dental health care delivery system and payment reform pilot program for
Medicaid dental benefits to increase access to cost effective and quality dental health care by
increasing the number of dentists available for Medicaid dental services; and
(ii) target specific Medicaid populations or geographic areas in the state.
(b) The pilot program shall establish compensation models for dentists and dental
hygienists that:
(i) increase access to quality, cost effective dental care; and
(ii) use funds from the Division of Family Health and Preparedness that are available to
reimburse dentists for educational loans in exchange for the dentist agreeing to serve Medicaid
and under-served populations.
(c) The division may amend the state plan and apply to the Secretary of Health and
Human Services for waivers or pilot programs if necessary to establish the new dental care
delivery and payment reform model.
(d) The division shall evaluate the pilot program's effect on the cost of dental care and
access to dental care for the targeted Medicaid populations.
(9) (a) As used in this Subsection (9), "dental hygienist" means an individual who is
licensed as a dental hygienist under Section 
58-69-301
.
(b) The department shall reimburse a dental hygienist for dental services performed in
a public health setting and in accordance with Subsection (9)(c) beginning on the earlier of:
(i) January 1, 2023; or
(ii) 30 days after the date on which the replacement of the department's Medicaid
Management Information System software is complete.
(c) The department shall reimburse a dental hygienist directly for a service provided
through the Medicaid program if:
(i) the dental hygienist requests to be reimbursed directly; and
(ii) the dental hygienist provides the service within the scope of practice described in
Section 
58-69-801
.
(d) Before November 30 of each year in which the department reimburses dental
hygienists in accordance with Subsection (9)(c), the department shall report to the Health and
Human Services Interim Committee, for the previous fiscal year:
(i) the number and geographic distribution of dental hygienists who requested to be
reimbursed directly;
(ii) the total number of Medicaid enrollees who were served by a dental hygienist who
were reimbursed under this Subsection (9);
(iii) the total amount reimbursed directly to dental hygienists under this Subsection (9);
(iv) the specific services and billing codes that are reimbursed under this Subsection
(9); and
(v) the aggregate amount reimbursed for each service and billing code described in
Subsection (9)(d)(iv).
(e) (i) Except as provided in this Subsection (9), nothing in this Subsection (9) shall be
interpreted as expanding or otherwise altering the limitations and scope of practice for a dental
hygienist.
(ii) A dental hygienist may only directly bill and receive compensation for billing codes
that fall within the scope of practice of a dental hygienist.
Section 2. Section 
63I-1-226
 is amended to read:
63I-1-226.
Repeal dates, Title 26.
(1) Subsection 
26-1-7
(1)(f), related to the Residential Child Care Licensing Advisory
Committee, is repealed July 1, 2024.
(2) Subsection 
26-1-7
(1)(h), related to the Primary Care Grant Committee, is repealed
July 1, 2025.
(3) Section 
26-1-7.5
, which creates the Utah Health Advisory Council, is repealed July
1, 2025.
(4) Section 
26-1-40
 is repealed July 1, 2022.
(5) Section 
26-1-41
 is repealed July 1, 2026.
(6) Section 
26-7-10
 is repealed July 1, 2025.
(7) Subsection 
26-7-11
(5), regarding reports to the Legislature, is repealed July 1,
2028.
(8) Section 
26-7-14
 is repealed December 31, 2027.
(9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
1, 2025.
(10) Subsection 
26-10-6
(5), which creates the Newborn Hearing Screening Committee,
is repealed July 1, 2026.
(11) Section 
26-10-11
 is repealed July 1, 2025.
(12) Section 
26-10b-106
, which creates the Primary Care Grant Committee, is repealed
July 1, 2025.
(13) Subsection 
26-18-2.6
(9), which addresses reimbursement for dental hygienists, is
repealed July 1, 2028.
[
(13)
] 
(14)
 Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed
July 1, 2027.
[
(14) Subsection 
26-18-417
(3) relating to a report to the Health and Human services
Interim Committee is repealed July 1, 2020.
]
(15) Subsection 
26-18-418
(2), the language that states "and the Behavioral Health
Crisis Response Commission created in Section 
63C-18-202
" is repealed July 1, 2023.
(16) Title 26, Chapter 18a, Kurt Oscarson Children's Organ Transplant Coordinating
Committee, is repealed July 1, 2021.
(17) Section 
26-33a-117
 is repealed on December 31, 2023.
(18) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1, 2024.
(19) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July 1,
2024.
(20) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is repealed
July 1, 2024.
(21) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July 1, 2024.
(22) Section 
26-39-201
, which creates the Residential Child Care Licensing Advisory
Committee, is repealed July 1, 2024.
(23) Section 
26-40-104
, which creates the Utah Children's Health Insurance Program
Advisory Council, is repealed July 1, 2025.
(24) Section 
26-50-202
, which creates the Traumatic Brain Injury Advisory
Committee, is repealed July 1, 2025.
(25) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
(26) Title 26, Chapter 63, Nurse Home Visiting Pay-for-Success Program, is repealed
July 1, 2026.
(27) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed July 1,
2026.