Florida HB 1507: Medicaid Dental Pilot Program

Bill Text

HB 1507 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1507-00
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A bill to be entitled 1
An act relating to a Medicaid dental pilot program; 2
creating s. 409.9079, F.S.; defining the term "persons 3
with disabilities"; requiring the Agency for Health 4
Care Administration to establish and operate a 3-year 5
Medicaid dental pilot program in Region B of the 6
Statewide Medicaid Managed Care program for persons 7
with disabilities; providing eligibility criteria; 8
specifying covered benefits; providing reimbursement 9
requirements; requiring managed care participation; 10
directing the agency to seek federal approval; 11
requiring the agency to collect specified data and 12
submit a report to the Governor and Legislature by a 13
specified date; providing for expiration; providing an 14
effective date. 15
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Be It Enacted by the Legislature of the State of Florida: 17
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Section 1. Section 409.9079, Florida Statutes, is created 19
to read: 20
409.9079 Medicaid dental pilot program for persons with 21
disabilities in Region B.— 22
(1) As used in this section, the term "persons with 23
disabilities" means Medicaid-eligible individuals who: 24
(a) Receive Supplemental Security Income on the basis of 25

HB 1507 2026

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disability; 26
(b) Are enrolled in a home and community-based services 27
waiver program under s. 1915(c) of the Social Security Act; or 28
(c) Meet federal disability criteria under 42 U.S.C. s. 29
1382c(a)(3) as determined by the Social Security Administration 30
or the state Medicaid program. 31
(2) The agency shall establish and operate a 3-year 32
Medicaid dental pilot program in Region B of the Statewide 33
Medicaid Managed Care program to provide enhanced dental 34
services to persons with disabilities. 35
(3) Participation in the pilot program is limited to 36
persons with disabilities who reside in Region B and are 37
enrolled in the state Medicaid program. 38
(4) Dental services provided under the pilot program must 39
include: 40
(a) Routine diagnostic and preventive care, including 41
examinations, cleanings, and radiographs. 42
(b) Basic dental services, including fillings and 43
extractions. 44
(c) Major dental services, including root canals, crowns, 45
and dentures and other dental prostheses. 46
(d) Emergency dental services. 47
(e) Any additional dental services that the agency 48
determines are necessary to promote oral health and prevent 49
disease. 50

HB 1507 2026

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51
Services provided under this subsection supplement and do not 52
replace the dental benefits available under ss. 409.906 and 53
409.973. 54
(5) The agency shall reimburse providers of dental 55
services under the pilot program at a rate equivalent to 80 56
percent of the 50th percentile of the usual, customary, and 57
reasonable fees as determined by the American Dental Association 58
or a comparable benchmark approved by the agency. 59
(6) The pilot program must be delivered through at least 60
two licensed dental managed care organizations that meet agency 61
standards and have demonstrated experience in providing dental 62
services to persons with disabilities. 63
(7) The agency shall submit any Medicaid state plan 64
amendments or federal waiver applications necessary to implement 65
the pilot program. 66
(8)(a) The agency shall collect data on: 67
1. Access to dental care. 68
2. Utilization of services. 69
3. Reimbursement expenditures. 70
4. Oral health outcomes for participants. 71
(b) By January 1, 2028, the agency shall submit a report 72
to the Governor, the President of the Senate, and the Speaker of 73
the House of Representatives evaluating the effectiveness of the 74
pilot program and recommending whether the pilot program should 75

HB 1507 2026

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be expanded statewide. 76
(9) This section expires June 30, 2028, unless reviewed 77
and saved from repeal through reenactment by the Legislature. 78
Section 2. This act shall take effect July 1, 2026. 79