Oral health

Low-income Minnesotans enrolled in Medical Assistance and MinnesotaCare experience higher rates of dental disease and greater difficulty accessing dental services than Minnesotans with private dental insurance. The Legislature took major steps in 2021 and 2023 to bridge this dental divide, passing historic dental legislation.

Key changes aim to encourage more dental providers to sign up to serve public health care program enrollees and help those already signed up serve more Medical Assistance and MinnesotaCare patients. DHS has made it easier to sign up to serve public health care program enrollees through its Minnesota Provider Screening and Enrollment Portal and portal training videos.

The key dental package legislative changes include:

Simplifying the payment structure

The previous payment structure for dental services considered many complicating factors to arrive at a rate, including the types and ages of patients, the geographic location of the provider, and the provider type. The Legislature created a simpler, more efficient payment model across public health care programs by paying all dentists the same rates for the same services in both Medical Assistance and MinnesotaCare. Equalizing payment rates removes payment disparities among dental providers.

The Legislature also required managed care organizations to share their fee schedules with dental providers who request them, giving dental providers greater transparency into how they get paid.
Increasing dental visits

More than 80% of public health care program enrollees get their coverage through a managed care plan. To increase dental visits in public health care programs, the Legislature set dental utilization benchmarks for managed care organizations and invested more money to help them hit the targeted goals.

According to the statute, in 2022, 2023 and 2024, managed care organizations must have 45% or more of their attributed public health care program enrollees see a dentist annually. If an individual health plan fails to hit the benchmark, they must submit a corrective action plan to the Department of Human Services.

By 2024, the statute mandates managed care organizations in the aggregate must hit dental participation rates of 55% for public health care program enrollees. If the benchmark is not met, DHS will carve out the dental benefit from managed care and contract with a dental benefits administrator for all enrollees.
Improving dental benefits
Reducing administrative burdens for dental providers

As required by federal law, all Medical Assistance providers who contract with managed care organizations must enroll with DHS and pass regular screenings. If managed care organizations have additional credentialing requirements beyond DHS, the Minnesota Legislature has mandated they make those requirements uniform across all managed care plans. This reduces the burden and costs dental providers faced with multiple credentialing requirements.
Paying providers a fairer rate for their work

Dental reimbursement rates set more than 30 years ago meant many dental clinics couldn’t afford to serve Minnesotans on public health care programs. The Legislature authorized a base rate increase for all dental services effective Jan. 1, 2022, which can result in up to a 98% increase for some providers. Critical access providers receive an additional 20% on top of the base rate. The Legislature also required managed care organizations to pay at least the fee-for-service rates for dental services.

This dashboard displays dental participations rates by county (which can be filtered by adult and child), by health plan, and by race and ethnicity.

Download dashboard data

Looking to the future

The Legislature directed DHS and its Dental Services Advisory Committee to research several issues to inform the future of dental care in public health care programs.

Dental homes: The dental home model aims to improve oral health by providing a regular source of care to vulnerable populations. The Legislature instructed DHS and its Dental Services Advisory Committee to design a dental home pilot program with a report due to the Legislature in early 2022.
Dental rebasing: Base rates for dental care have remained the same for 30 years. To ensure dental rates keep up with costs, the Legislature asked the Dental Services Advisory Committee to provide recommendations on regular rebasing of dental rates.
Provider reimbursement study: This study will research average dental reimbursement rates by managed care organizations.
Program delivery study: This study will research how other states administer their dental benefits, in particular those that carve out their dental benefit.

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