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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).


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