SENATE DOCKET, NO. 1960        FILED ON: 1/17/2025

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Paul W. Mark

_________________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act increasing access to MassHealth dental providers.

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PETITION OF:

SENATE DOCKET, NO. 1960        FILED ON: 1/17/2025

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 779 OF 2023-2024.]

The Commonwealth of Massachusetts

_______________

In the One Hundred and Ninety-Fourth General Court
(2025-2026)

_______________

An Act increasing access to MassHealth dental providers.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 118E of the General Laws as appearing in the 2022 Official Edition is hereby amended by inserting after Section 82 the following section:-

SECTION 83. (a) Notwithstanding any general or special law to the contrary, and subject to appropriation, the secretary of health and human services shall provide MassHealth supplemental payments to eligible MassHealth-participating dental providers who render covered dental services to an additional ten or greater MassHealth beneficiaries age 21 and older  in a given year compared to the number of MassHealth beneficiaries they provided services to in the prior year.

(b) The supplemental payment established in section (a) shall initially be set at $31 for the first year and shall be distributed to eligible dental providers as a rate add-on for each patient encounter in which a MassHealth-covered dental service is administered to an actively enrolled  MassHealth beneficiary age 21 and older. The payment rate shall be subject to re-evaluation by the secretary of health and human services under Section 13C and 13D of this chapter.

(c) The supplemental payment established in section (a) shall be available to providers located in ten specific municipalities that are designated by the secretary of health and human services as having a high number or proportion of MassHealth enrollees and low rates of utilization of dental services.

(d) To be eligible for supplemental payments a dental provider must meet each of the following criteria:

(1) Be a dentist or public health dental hygienist licensed in the state of Massachusetts.

(2) Be enrolled with MassHealth as an approved billing provider.

(3) Provide dental services to a minimum of ten additional MassHealth beneficiaries age 21 and older than the number of MassHealth beneficiaries the dental provider provided services to in the previous year.

(4) Provide dental services at a location in eligible municipalities, as determined by the secretary of health and human services under section (c).

(e) MassHealth shall promulgate regulations to implement this section. These regulations shall define provider-eligible municipalities using available data on past year MassHealth enrollment and utilization.