No. CS/HB 517
Filed under Healthcare.
Medicaid Provider Networks ; Requires AHCA to establish network adequacy standards for prepaid dental plans; provides requirements for such standards; requires Medicaid managed care plan provider network databases to identify whether providers are accepting new patients; requires prepaid dental plans to to provide specified information on online provider database.
Plain English Summary
AI-GENERATEDThe state must set specific network adequacy standards, including how far and how long enrollees may have to travel, for every provider type Medicaid dental plans cover, and separately for each level of sedation dentistry.
Enrollees who need sedation dentistry for medical reasons must be able to get at least two preventive or treatment visits a year, and travel standards for that care cannot be worse than for routine dentistry.
Every Medicaid managed care plan's online provider directory must now show whether each provider is accepting additional Medicaid patients, giving enrollees that information before they choose or contact a provider.
Dental plan directories must go further, clearly marking which providers offer sedation dentistry, listing specialists separately from general dentists, and naming the specific specialty services each provider offers.
AIAHCA must set a specific network adequacy standard, including time and distance travel standards, for each provider type and specialty service that a Medicaid prepaid dental plan covers, and a separate standard for each level of sedation dentistry.
AIThe sedation dentistry standard must ensure enough provider capacity that any enrollee who medically needs sedation dentistry can get at least two preventive or treatment appointments in a year.
AIThe travel-time and distance standard set for sedation dentistry cannot require enrollees to travel farther or wait longer than the standard already set for ordinary general dentistry.
AIEvery Medicaid managed care plan's online, public provider database must now show whether each listed provider is accepting additional Medicaid patients, alongside existing information like licensure and hours of operation.
AIA prepaid dental plan's online provider database must clearly mark which providers perform sedation dentistry, list specialty dental providers separately from general dentists, and name the specific specialty services each one offers.