1.1 	A bill for an act
1.2 	relating to human services; establishing uniform prior authorization and 
1.3 	credentialing processes for dental services;amending Minnesota Statutes 2020, 
1.4 	section 256B.0625, by adding subdivisions.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision 
1.7 	to read:
1.8 		Subd. 9c.Uniform prior authorization for dental services. (a) For purposes of this 
1.9 	subdivision, "dental benefits administrator" means an organization licensed under chapter 
1.10 	62C or 62D that contracts with a managed care plan or county-based purchasing plan to 
1.11 	provide covered dental care services to enrollees of the plan.
1.12 	(b) By January 1, 2022, the commissioner, in consultation with dental benefits 
1.13 	administrators, shall develop uniform prior authorization criteria for all dental services 
1.14 	requiring prior authorization. The commissioner shall publish a list of the dental services 
1.15 	requiring prior authorization and the process for obtaining prior authorization on the 
1.16 	department's website. Dental services on the list and the process for obtaining prior 
1.17 	authorization approval must be consistent. The commissioner shall require that dental 
1.18 	providers, managed care plans, county-based purchasing plans, and dental benefit 
1.19 	administrators use the dental services on the list regardless of whether the services are 
1.20 	provided through a fee-for-service system or through a prepaid medical assistance program.
1.21 	(c) Managed care plans and county-based purchasing plans may require prior 
1.22 	authorization for additional dental services not on the list described in paragraph (b) if a 
1.23 	uniform process for obtaining prior approvals is applied, including a process for 
2.1 	reconsideration when a prior approval request is denied that can be utilized by both the 
2.2 	patient and the patient's dental provider.

2.3 	Sec. 2. Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision 
2.4 	to read:
2.5 		Subd. 9d.Uniform credentialing process. (a) For purposes of this subdivision, "dental 
2.6 	benefits administrator" has the meaning given in subdivision 9c.
2.7 	(b) By January 1, 2022, in consultation with dental benefits administrators, the 
2.8 	commissioner shall develop a uniform credentialing process for dental providers. Upon 
2.9 	federal approval, the credentialing process must be accepted by all managed care plans, 
2.10 	county-based purchasing plans, and dental benefit administrators that contract with the 
2.11 	commissioner or subcontract with plans to provide dental services to medical assistance or 
2.12 	MinnesotaCare enrollees.
2.13 	(c) The process developed in this subdivision must include a uniform credentialing 
2.14 	application that must be available in electronic format and accessible on the department's 
2.15 	website. The process developed under this subdivision must include an option to submit a 
2.16 	completed application electronically. The uniform credentialing application must be available 
2.17 	to providers for free.
2.18 	(d) If applicable, a managed care plan, county-based purchasing plan, dental benefit 
2.19 	administrator, contractor, or vendor that reviews and approves a credentialing application 
2.20 	must notify a provider regarding a deficiency on a submitted credentialing application form 
2.21 	no later than 30 business days after receiving the application form from the provider.