Resolve, Directing the Department of Health and Human Services To Adopt Rules To Streamline and Remove Barriers for Reimbursement for Providers of Dental Care Services

Sec. 1. Remove barriers for reimbursement for providers of dental care services. Resolved: That the Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 25, Dental Services to add to covered services:

1. Dental hygiene diagnosis, with reimbursement;

2. Tobacco use counseling for the control and prevention of oral disease;

3. Periodontal scaling and root planing without prior authorization, including a fee;

4. Scaling in the presence of generalized moderate or severe gingival inflammation without prior authorization, including a fee of up to $50 per session, and including the procedure for persons under 21 years of age; and

5. Interim caries arresting medicament application.

The department shall amend the rule to remove the requirement that an independent practice dental hygienist have a written agreement with a licensed MaineCare dentist that the dentist will accept a referral of a MaineCare member who has a temporary filling from the independent practice dental hygienist and that the referral visit must be scheduled within 60 calendar days.

The department shall remove the requirement that an independent practice dental hygienist have a written agreement with a licensed dentist that provides that the licensed dentist will be available to interpret all dental radiographs within 21 days from the date the radiograph is taken and that the dentist will sign a radiographic review and findings form as developed by the Maine Board of Dental Examiners.

SUMMARY

This resolve directs the Department of Health and Human Services to amend its rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 25, Dental Services to add certain procedures as covered services and to remove the requirement that independent practice dental hygienists must have 2 written agreements with dentists, one regarding temporary fillings and another regarding dental radiographs.