Florida Senate - 2023 SB 1000 By Senator Calatayud 38-00859A-23 20231000__ 1 A bill to be entitled 2 An act relating to dental care; amending s. 409.906, 3 F.S.; authorizing Medicaid reimbursement for dental 4 services provided by mobile dental units owned by, 5 operated by, or having contractual agreements with 6 specified entities; defining the term “mobile dental 7 unit”; amending s. 466.007, F.S.; revising licensure 8 examination requirements for dental hygienists to 9 authorize applicants to demonstrate certain clinical 10 skills on a live patient rather than only on a 11 manikin; authorizing the Board of Dentistry to require 12 persons applying to take the dental hygiene 13 examination to maintain medical malpractice insurance 14 in a specified amount; providing an effective date. 15 16 Be It Enacted by the Legislature of the State of Florida: 17 18 Section 1. Paragraph (c) of subsection (1) and subsection 19 (6) of section 409.906, Florida Statutes, are amended to read: 20 409.906 Optional Medicaid services.—Subject to specific 21 appropriations, the agency may make payments for services which 22 are optional to the state under Title XIX of the Social Security 23 Act and are furnished by Medicaid providers to recipients who 24 are determined to be eligible on the dates on which the services 25 were provided. Any optional service that is provided shall be 26 provided only when medically necessary and in accordance with 27 state and federal law. Optional services rendered by providers 28 in mobile units to Medicaid recipients may be restricted or 29 prohibited by the agency. Nothing in this section shall be 30 construed to prevent or limit the agency from adjusting fees, 31 reimbursement rates, lengths of stay, number of visits, or 32 number of services, or making any other adjustments necessary to 33 comply with the availability of moneys and any limitations or 34 directions provided for in the General Appropriations Act or 35 chapter 216. If necessary to safeguard the state’s systems of 36 providing services to elderly and disabled persons and subject 37 to the notice and review provisions of s. 216.177, the Governor 38 may direct the Agency for Health Care Administration to amend 39 the Medicaid state plan to delete the optional Medicaid service 40 known as “Intermediate Care Facilities for the Developmentally 41 Disabled.” Optional services may include: 42 (1) ADULT DENTAL SERVICES.— 43 (c) However, Medicaid will not provide reimbursement for 44 dental services provided byina mobile dental unit, except for 45 a mobile dental unit: 46 1. Owned by, operated by, or having a contractual agreement 47 with the Department of Health and complying with Medicaid’s 48 county health department clinic services program specifications 49 as a county health department clinic services provider. 50 2. Owned by, operated by, or having a contractual 51 arrangement with a federally qualified health center and 52 complying with Medicaid’s federally qualified health center 53 specifications as a federally qualified health center provider. 54 3. Rendering dental services to Medicaid recipients, 21 55 years of age and older, at nursing facilities. 56 4. Owned by, operated by, or having a contractual agreement 57 with a state-approved dental educational institution or an 58 accredited dental hygiene program. 59 5. Owned by, operated by, or having a contractual 60 relationship with the Department of Children and Families. 61 6. Owned by, operated by, or having a contractual 62 relationship with the Department of Juvenile Justice. 63 7. Owned by, operated by, or having a contractual 64 relationship with a nonprofit community health center. 65 8. Owned by, operated by, or having a contractual 66 relationship with a federally approved Head Start center. 67 9. Owned by, operated by, or having a contractual 68 relationship with a school-based prevention program as defined 69 in s. 466.003(15). 70 71 For purposes of this paragraph, “mobile dental unit” means a 72 nonfacility structure in which dental equipment, used in the 73 practice of dentistry, is transported to and used on a temporary 74 basis at an out-of-office location. 75 (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for 76 diagnostic, preventive, or corrective procedures, including 77 orthodontia in severe cases, provided to a recipient under age 78 21, by or under the supervision of a licensed dentist. The 79 agency may also reimburse a health access setting as defined in 80 s. 466.003 for the remediable tasks that a licensed dental 81 hygienist is authorized to perform under s. 466.024(2). Services 82 provided under this program include treatment of the teeth and 83 associated structures of the oral cavity, as well as treatment 84 of disease, injury, or impairment that may affect the oral or 85 general health of the individual. However, Medicaid will not 86 provide reimbursement for dental services provided byina 87 mobile dental unit, except for a mobile dental unit: 88 (a) Owned by, operated by, or having a contractual 89 agreement with the Department of Health and complying with 90 Medicaid’s county health department clinic services program 91 specifications as a county health department clinic services 92 provider. 93 (b) Owned by, operated by, or having a contractual 94 arrangement with a federally qualified health center and 95 complying with Medicaid’s federally qualified health center 96 specifications as a federally qualified health center provider. 97 (c) Rendering dental services to Medicaid recipients, 21 98 years of age and older, at nursing facilities. 99 (d) Owned by, operated by, or having a contractual 100 agreement with a state-approved dental educational institution 101 or an accredited dental hygiene program. 102 (e) Owned by, operated by, or having a contractual 103 relationship with the Department of Children and Families. 104 (f) Owned by, operated by, or having a contractual 105 relationship with the Department of Juvenile Justice. 106 (g) Owned by, operated by, or having a contractual 107 relationship with a nonprofit community health center. 108 (h) Owned by, operated by, or having a contractual 109 relationship with a federally approved Head Start center. 110 (i) Owned by, operated by, or having a contractual 111 relationship with a school-based prevention program as defined 112 in s. 466.003(15). 113 114 For purposes of this subsection, “mobile dental unit” means a 115 nonfacility structure in which dental equipment, used in the 116 practice of dentistry, is transported to and used on a temporary 117 basis at an out-of-office location. 118 Section 2. Subsection (4) of section 466.007, Florida 119 Statutes, is amended to read: 120 466.007 Examination of dental hygienists.— 121 (4)Effective July 1, 2012,To be licensed as a dental 122 hygienist in this state, an applicant must successfully complete 123 the following: 124 (a) A written examination on the laws and rules of this 125 state regulating the practice of dental hygiene. 126 (b) A practical or clinical examination approved by the 127 board. The examination shall be the Dental Hygiene Examination 128 produced by the American Board of Dental Examiners, Inc., (ADEX) 129 or its successor entity, if any, if the board finds that the 130 successor entity’s clinical examination meets or exceeds the 131 provisions of this section. The board shall approve the ADEX 132 Dental Hygiene Examination if the board has attained and 133 continues to maintain representation on the ADEX House of 134 Representatives, the ADEX Dental Hygiene Examination Development 135 Committee, and such other ADEX Dental Hygiene committees as the 136 board deems appropriate through rulemaking to ensure that the 137 standards established in this section are maintained 138 organizationally. The ADEX Dental Hygiene Examination or the 139 examination produced by its successor entity is a comprehensive 140 examination in which an applicant must demonstrate skills within 141 the dental hygiene scope of practice on a live patient or a 142 manikin that has typodont teeth with simulated dentition and 143 calculus as approved by the Commission on Dental Competency 144 Assessments and any other components that the board deems 145 necessary for the applicant to successfully demonstrate 146 competency for the purpose of licensure. The board may require 147 any person applying to take the examination to practice dental 148 hygiene in this state to maintain medical malpractice insurance 149 in amounts sufficient to cover any incident of harm to a patient 150 during the clinical examination. 151 Section 3. This act shall take effect July 1, 2023.