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HD 2423

An Act relative to ensuring access to dental care for MassHealth recipients

194th Legislature (2025-2026) Introduced by Kip Diggs

Dentists must accept a minimum MassHealth patient share to be licensed, with penalties for noncompliance, plus incentives and an emergency care provision.

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Bill Summary · HD 2423

Summary: An Act relative to ensuring access to dental care for MassHealth recipients (House Docket No. 2423)

Overview

This proposed Massachusetts bill would reform licensing requirements for dentists to improve access to dental care for MassHealth recipients. It creates a new licensing criterion tied to MassHealth patient participation, establishes mechanisms to locate participating providers, offers incentives to encourage MassHealth participation, and provides an emergency care exception. The act would be implemented through regulatory actions and annual reporting, with a defined effective date.

Purpose and intent

  • Increase the number of dental providers who actively serve MassHealth patients.
  • Improve transparency around provider participation and regional access.
  • Provide incentives (financial and career-related) to attract and retain dentists in MassHealth.
  • Ensure MassHealth recipients can access timely dental care, including in emergencies.

Key provisions

  • Added licensing requirement (Section 52H):

    • The Board of Registration of Dentistry cannot license a dentist to practice unless the dentist agrees to:
    • (i) Accept a minimum percentage of MassHealth patients as part of their active patient base (minimum to be set by the Department, based on regional needs and practice capacity).
    • (ii) Provide annual documentation to the Department confirming compliance with the MassHealth patient requirement.

  • Minimum rate and exemptions:

    • The Department, in consultation with the Executive Office, will establish:
    • (i) A minimum MassHealth patient percentage (not less than 5% of a dentist’s total patient caseload).
    • (ii) A process for hardship exemptions or adjustments based on practice size, location, or other factors.

  • Enforcement and penalties:

    • Dentists who fail to meet the MassHealth participation requirements may face:
    • (i) Suspension of their license by the Board until compliance is achieved; or
    • (ii) Administrative penalties determined by the Department.

  • Online provider portal (Section 52H(e)):

    • The Executive Office will develop an online portal to:
    • Help MassHealth recipients locate participating dental providers by region.
    • Provide transparency on dentist participation rates and available services.

  • Incentives to encourage participation:

    • (f)(i) Student loan forgiveness for newly licensed dentists who meet or exceed the required MassHealth participation percentage for at least 3 years (subject to appropriation).
    • (f)(ii) Increased reimbursement rates for MassHealth services to support financial sustainability for participating providers.

  • Emergency care provision (Section 52H(g)):

    • In emergencies, any licensed dentist may treat a MassHealth recipient regardless of MassHealth participation status.
    • Reimbursement for emergency care: standard MassHealth rate plus 10% for services rendered within 60 days.

  • Regulatory and reporting requirements:

    • The Executive Office will promulgate rules to implement the section.
    • An annual report must be prepared noting:
    • (i) Number of participating dentists by region.
    • (ii) Percentage of MassHealth patients served relative to statewide dental care needs.
    • (iii) Recommendations to address gaps in access.
    • The annual report is due by December 31 each year to the chairs of the Joint Committee on Public Health and the clerks of the House and Senate.

  • Effective date:

    • The act takes effect 180 days after passage.

Affected parties

  • Dentists and dental practices: Subject to new participation requirements, potential license suspension for noncompliance, and eligibility for loan forgiveness and higher reimbursements.
  • MassHealth recipients: Improved ability to find in-network dentists and increased access to care.
  • Dental boards and regulatory agencies: Implement new licensing criterion, monitor compliance, and issue penalties or exemptions.
  • State agencies (Executive Office and Department): Create the online portal, set participation standards, administer incentives, approve regulations, and publish annual access reports.

Timeline and process

  • Regulatory framework to be established by the Executive Office (through promulgated rules).
  • Annual reporting starting after enactment, with the first report due December 31 of the first year following implementation.
  • Licensure eligibility would begin only after the department sets the minimum MassHealth participation thresholds and processes for exemptions.
  • Effective date is 180 days post-enactment.

Note: The bill text indicates a filing and sponsorship in the 2025-2026 General Court session, with detailed provisions for MassHealth participation, provider incentives, and emergency care protections.

Compiled from official sources — confirm details with the bill’s official record.

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