HB 601 Summary

• Creates a statewide Medicaid prepaid dental program separate from the Medicaid managed medical assistance program, with intent to begin enrollment no later than September 1, 2016

• Requires the Agency for Health Care Administration to contract with at least two licensed prepaid dental health plans demonstrating extensive experience administering Medicaid dental benefits and maintaining statewide provider networks

• Mandates prepaid dental plans submit encounter data and maintain a medical loss ratio of 85 percent, with calculations using uniform financial data consistent with 45 C.F.R. part 158

• Requires annual reports to the Governor and Legislature by January 15 comparing plan utilization data, program costs, contract compliance, access to care, and oral health indicators

• Removes the requirement that managed care plans participating in the Medicaid managed assistance program provide pediatric dental services, as these services transfer to the new dental program