26B-3-107. Dental benefits.
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Effective 5/6/2026
26B-3-107. Dental benefits.
(a)The division may:
(i)establish a dental health care delivery system and payment reform pilot program for Medicaid dental benefits to increase access to cost effective and quality dental health care by increasing the number of dentists available for Medicaid dental services; and
(ii)target specific Medicaid populations or geographic areas in the state.
(b)The pilot program shall establish compensation models for dentists and dental hygienists that:
(i)increase access to quality, cost effective dental care; and
(ii)use funds from the Division of Family Health that are available to reimburse dentists for educational loans in exchange for the dentist agreeing to serve Medicaid and under-served populations.
(c)The division may amend the state plan and apply to the Secretary of the United States Department of Health and Human Services for waivers or pilot programs if necessary to establish the new dental care delivery and payment reform model.
(d)The division shall evaluate the pilot program's effect on the cost of dental care and access to dental care for the targeted Medicaid populations.
(a)As used in this Subsection (2), "dental hygienist" means an individual who is licensed as a dental hygienist under Section 58-69-301 .
(b)The department shall reimburse a dental hygienist for dental services performed in a public health setting and in accordance with Subsection (2)(c) beginning on the earlier of:
(i)January 1, 2023; or
(ii)30 days after the date on which the replacement of the department's Medicaid Management Information System software is complete.
(c)The department shall reimburse a dental hygienist directly for a service provided through the Medicaid program if:
(i)the dental hygienist requests to be reimbursed directly; and
(ii)the dental hygienist provides the service within the scope of practice described in Section 58-69-801 .
(i)Except as provided in this Subsection (2), nothing in this Subsection
(2)shall be interpreted as expanding or otherwise altering the limitations and scope of practice for a dental hygienist.
(ii)A dental hygienist may only directly bill and receive compensation for billing codes that fall within the scope of practice of a dental hygienist.
Amended by Chapter 145 , 2026 General Session