Florida Senate - 2026 SB 1640 By Senator Smith 17-01369A-26 20261640__ Page 1 of 4 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1

An act relating to the Medicaid dental pilot program 2 for persons with disabilities; creating s. 409.9079, 3 F.S.; defining the term “persons with disabilities”; 4 requiring the Agency for Health Care Administration to 5 establish and operate a Medicaid dental pilot program 6 in a specified region to provide enhanced dental 7 services to persons with disabilities; specifying 8 eligibility for participation in the pilot program; 9 specifying dental services covered by the pilot 10 program; providing construction; requiring the agency 11 to reimburse dental providers under the pilot program 12 at a specified rate; providing for the delivery of 13 services under the pilot program through at least two 14 licensed dental managed care organizations meeting 15 certain criteria; requiring the agency to submit any 16 necessary state plan amendments or federal waiver 17 applications for federal approval; requiring the 18 agency to collect certain data on the pilot program; 19 requiring the agency to submit a report on the pilot 20 program to the Governor and the Legislature by a 21 specified date; providing for expiration of the pilot 22 program; providing an effective date. 23 24 Be It Enacted by the Legislature of the State of Florida: 25 26

Section

Section 409.9079, Florida Statutes, is created 27 to read: 28 409.9079 Medicaid dental pilot program for persons with 29 Florida Senate - 2026 SB 1640 17-01369A-26 20261640__ Page 2 of 4 CODING: Words stricken are deletions; words underlined are additions. disabilities in Region E.— 30

(1) DEFINITION.—As used in this section, the term “persons 31 with disabilities” means Medicaid-eligible individuals who: 32 (

a) Receive Supplemental Security Income (SSI) on the basis 33 of disability; 34 (

b) Are enrolled in a home and community-based services 35 (HCBS) waiver program under s. 1915(

c) of the Social Security 36 Act; or 37 (

c) Meet federal disability criteria under 42 U.S.C. s. 38 1382c(a)(3), as determined by the Social Security Administration 39 or the state Medicaid program. 40

(2) PILOT PROGRAM ESTABLISHED.—The agency shall establish 41 and operate a 3-year Medicaid dental pilot program in Region E 42 of the Statewide Medicaid Managed Care program to provide 43 enhanced dental services to persons with disabilities. 44

(3) ELIGIBILITY.—Participation in the pilot program is 45 limited to persons with disabilities who reside in Region E and 46 are enrolled in the Medicaid program. 47

(4) COVERED SERVICES.— 48 (

a) Dental services provided under the pilot program must 49 include all of the following: 50 1. Routine diagnostic and preventive care, including 51 examinations, cleanings, and radiographs. 52 2. Basic dental services, including fillings and 53 extractions. 54 3. Major dental services, including root canals, crowns, 55 dentures, and other dental prostheses. 56 4. Emergency dental services. 57 5. Any additional dental services the agency determines are 58 Florida Senate - 2026 SB 1640 17-01369A-26 20261640__ Page 3 of 4 CODING: Words stricken are deletions; words underlined are additions. necessary to promote oral health and prevent disease. 59 (

b) Services provided under this subsection supplement, and 60 do not replace, dental benefits available under ss. 409.906 and 61 409.973. 62

(5) REIMBURSEMENT.—The agency shall reimburse providers of 63 dental services under the pilot program at a rate equivalent to 64 80 percent of the 50th percentile of the 2024 Usual, Customary, 65 and Reasonable fees, as determined by the American Dental 66 Association or a comparable benchmark approved by the agency. 67

(6) MANAGED CARE PARTICIPATION.—The pilot program must be 68 delivered through at least two licensed dental managed care 69 organizations that meet agency standards and have demonstrated 70 experience in providing dental services to persons with 71 disabilities. 72

(7) FEDERAL APPROVAL.—The agency shall submit for federal 73 approval any Medicaid state plan amendments or federal waiver 74 applications necessary to implement the pilot program. 75

(8) EVALUATION; REPORT.— 76 (

a) The agency shall collect pilot program data on all of 77 the following: 78 1. Access to dental care. 79 2. Utilization of services. 80 3. Reimbursement expenditures. 81 4. Oral health outcomes for participants. 82 (

b) By January 1, 2029, the agency shall submit a report to 83 the Governor, the President of the Senate, and the Speaker of 84 the House of Representatives evaluating the effectiveness of the 85 pilot program and recommending whether it should be expanded 86 statewide. 87 Florida Senate - 2026 SB 1640 17-01369A-26 20261640__ Page 4 of 4 CODING: Words stricken are deletions; words underlined are additions.

(9) EXPIRATION.—This

section expires June 30, 2029. 88

Section 2. This act shall take effect July 1, 2026. 89