2011 Utah Code
Title 26 Utah Health Code
Chapter 18 Medical Assistance Act
Section 2.6 Dental benefits.

26-18-2.6. Dental benefits.
(1) (a) The division shall establish a competitive bid process to bid out Medicaid dental benefits under this chapter.
(b) The division may bid out the Medicaid dental benefits separately from other program benefits.
(2) The division shall use the following criteria to evaluate dental bids:
(a) ability to manage dental expenses;
(b) proven ability to handle dental insurance;
(c) efficiency of claim paying procedures;
(d) provider contracting, discounts, and adequacy of network; and
(e) other criteria established by the department.
(3) The division shall request bids for the program's benefits:
(a) in 2011; and
(b) at least once every five years thereafter.
(4) The division's contract with dental plans for the program's benefits shall include risk sharing provisions in which the dental plan must accept 100% of the risk for any difference between the division's premium payments per client and actual dental expenditures.
(5) The division may not award contracts to:
(a) more than three responsive bidders under this section; or
(b) an insurer that does not have a current license in the state.
(6) (a) The division may cancel the request for proposals if:
(i) there are no responsive bidders; or
(ii) the division determines that accepting the bids would increase the program's costs.
(b) If the division cancels the request for proposals under Subsection (6)(a), the division shall report to the Health and Human Services Committee regarding the reasons for the decision.
(7) Title 63G, Chapter 6, Utah Procurement Code, shall apply to this section.