Second Substitute H.B. 24

Representative Stephen D. Clark proposes the following substitute bill:

1 MEDICAID DENTAL AND PHYSICIAN
2 REIMBURSEMENT AMENDMENTS
3 2006 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Steven R. Mascaro
6 Senate Sponsor: Peter C. Knudson
7
8 LONG TITLE
9 General Description:
10 This bill establishes a statutory requirement, within appropriations from the Legislature,
11 to reimburse dentists providing children's Medicaid dental services at 70% of the
12 aggregate PEHP fee schedule for dental services, and to reimburse physicians providing
13 Medicaid services at 70% of the aggregate PEHP fee schedule.
14 Highlighted Provisions:
15 This bill:
16 . enacts a statute:
17 . to establish a standard for reimbursing dentists providing Medicaid services for
18 children; and
19 . establish a minimum standard for reimbursing physicians providing Medicaid
20 services.
21 Monies Appropriated in this Bill:
22 This bill appropriates:
23 . as an ongoing appropriation subject to future budget constraints, $5,795,342 from
24 the General Fund for fiscal year 2006-07 to the Department of Health to fund
25 $1,509,463 for the children's dental services in the Medicaid program, and to fund
26 $4,285,880 million for Medicaid reimbursement rates for physicians.

27 Other Special Clauses:
28 None
29 Utah Code Sections Affected:
30 ENACTS:
31 26-18-3.2, Utah Code Annotated 1953
32
33 Be it enacted by the Legislature of the state of Utah:
34 Section 1. Section 26-18-3.2 is enacted to read:
35 26-18-3.2. Dental and physician services -- Medicaid program.
36 (1) The purpose of this section is to:
37 (a) increase the number of dentists that will be able to financially support dental
38 services to children in the Medicaid program and increase access to dental services for children
39 on Medicaid; and
40 (b) increase the number of physicians that will be able to financially support medical
41 services to individuals in the Medicaid program and increase access to medical services for
42 individuals on Medicaid.
43 (2) Within appropriations from the Legislature, the department may amend the state
44 plan for medical assistance to establish and maintain a Medicaid reimbursement rate:
45 (a) for dental services for children, at 70% of the aggregate reimbursement rate for
46 dental services provided by the Public Employee's Health Plan established under Title 49,
47 Chapter 20, Public Employee's Benefit and Insurance Program Act; and
48 (b) for physician services for individuals on Medicaid, at 70% of the aggregate
49 reimbursement rate for physician services provided by the Public Employee's Health Plan
50 established under Title 49, Chapter 20, Public Employee's Benefit and Insurance Program Act.
51 Section 2. Appropriation.
52 As an ongoing appropriation subject to future budget constraints, there is appropriated
53 from the General Fund for fiscal year 2006-07, $5,795,342 to the Department of Health,
54 $1,509,463 of which shall be used to raise the reimbursement rate for dental services for
55 children in the Medicaid program, pursuant to Subsection 26-18-3.2 (1)(a), and $4,285,880 of
56 which shall be used to raise the reimbursement rate for physicians providing Medicaid services,
57 pursuant to Subsection 26-18-3.2 (1)(b).