Tallahassee – Florida House Bill 7047 —Medicaid Managed Care, which is sponsored by Rep. Shawn Harrison (R) is moving its way through the committees and it appears to be on its way to becoming a law. Sponsored by Rep. Garrison (R), HB 7074 implements several changes to the Florida Medicaid program.
Rep. Harrison's bill would implement several important changes to the Florida Medicaid program, including requiring the Agency for Health Care Administration (AHCA) to ensure compliance with contracting requirements, negotiate contracts on a regional basis, and specify that certain cancer hospitals are statewide essential providers, among other important changes.
The bill also removes the requirement for AHCA to provide dental benefits separate from Medicaid. Under the current system, dental benefits through Medicaid are provided through private dental insurance companies contracted by the state. There are currently three dental care plans that operate statewide, which provide comprehensive dental services to children and expended benefits to adults.
This is not the first time the state has changed its mind on whether dental coverage should be carved-in or out of the state-run Medicaid program. Should HB 7047 pass with this provision, it will be the 3rd change to the program, causing widespread provider network disruptions and significant financial ramifications.
Since the state carved out and privatized dental coverage from the Statewide Medicaid Managed Care (SMMC) Program, access to dental care has significantly improved, particularly among the special-needs population. Proponents for keeping dental benefits separate from Medicaid’s managed care plans argue that the carve-out model promotes transparency and accountability, increases patient and provider satisfaction, and is the most cost-effective option.
There are more than 1,000 dental offices across Florida rendering services to special needs members, and there is no case here dentists have failed to deliver care. Even with the challenges of the COVID-19 pandemic, under the current carve-out model, dental providers have continued providing services despite lockdowns and supply chain interruptions.
There are legitimate fears surrounding HB 7047’s carve-in provision. Reintegrating dental benefits into Medicaid’s managed medical assistant program may pose a threat to children’s dental care as well as a recurring fiscal impact.
The bill is now in the Health & Human Services Committee.
