HP0898, LD 1301, item 1, An Act To Improve Access to Preventive, Cost-saving Dental Services

An Act To Improve Access to Preventive, Cost-saving Dental Services

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 22 MRSA §3174-F, sub-§1, ¶D, as amended by PL 1997, c. 159, §1, is further amended to read:

D. Treatment necessary to relieve pain, eliminate infection or prevent imminent tooth loss; and

Sec. 2. 22 MRSA §3174-F, sub-§1, ¶F, as enacted by PL 1997, c. 159, §2, is amended to read:

F. Other dental services, including full and partial dentures, medically necessary to correct or ameliorate an underlying medical condition, if the department determines that provision of those services will be cost-effective in comparison to the provision of other covered medical services for the treatment of that condition . ; and

Sec. 3. 22 MRSA §3174-F, sub-§1, ¶G is enacted to read:

G. Beginning October 1, 2017, dental services including an annual comprehensive oral examination, including necessary x-rays or other imaging and preventive services, including prophylaxis, topical fluoride, sealants, oral hygiene instruction, behavior management and smoking cessation counseling and other services as determined by the department. The department shall provide restorative treatment necessary to prevent or treat oral health conditions, to reduce or eliminate the need for future acute oral health care, and to avoid more costly medical or dental care.

Sec. 4. 22 MRSA §3174-F, sub-§§3 and 4 are enacted to read:

3. Notice to MaineCare members. Beginning October 1, 2017, the department shall provide notice of dental benefits available under this section to an individual when the individual enrolls as an adult member of MaineCare.

4. Notice to providers. Annually, the department shall provide to providers of services under this section educational opportunities relating to the scope of benefits covered under this section and administrative requirements for obtaining these benefits. The educational opportunities required under this subsection may be delivered by electronic newsletters, educational training meetings, policy briefings and fact sheets. This subsection takes effect October 1, 2017.

Sec. 5. Notice to MaineCare members. By November 1, 2017, the Department of Health and Human Services shall provide to MaineCare members notice of adult dental benefits available under the Maine Revised Statutes, Title 22, section 3174-F, subsection 1.

Sec. 6. Written notice to providers. By November 1, 2017, the Department of Health and Human Services shall provide to providers of dental care enrolled as MaineCare providers written notice of adult dental benefits available under the Maine Revised Statutes, Title 22, section 3174-F, subsection 1.

Sec. 7. Rulemaking; stakeholder group. By October 1, 2017, the Department of Health and Human Services shall adopt rules in accordance with this section to implement the provisions of the Maine Revised Statutes, Title 22, section 3174-F, subsection 1, paragraph G.

1. Stakeholder group. Prior to adopting rules to implement the provisions of Title 22, section 3174-F, subsection 1, paragraph G, the Department of Health and Human Services shall convene a stakeholder group to identify those dental services that are necessary to prevent more costly medical or dental care. The stakeholder group must consist of members representing dentists, federally qualified health centers, consumers, dental hygienists, hospitals and a clinical health system with experience in adult oral health initiatives.

2. Rulemaking. When adopting rules to implement the provisions of Title 22, section 3174-F, subsection 1, paragraph G, the department shall consider dental services identified by a stakeholder group pursuant to subsection 1.

Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

summary

This bill requires that, beginning October 1, 2017, MaineCare coverage for adult dental services include an annual comprehensive oral examination and preventive services, including prophylaxis, topical fluoride, sealants, oral hygiene instruction, behavior management and smoking cessation counseling.

HP0898 LD 1301	Session - 128th Maine Legislature		LR 1690 Item 1
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