HP0313, LD 474, item 1, An Act To Improve Access to Dental Care in Maine

An Act To Improve Access to Dental Care in Maine

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 Diagnostic services and related 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 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 . ;

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

G. Dental services including diagnostic and preventive services to pregnant women and postpartum women for one year after delivery to ameliorate conditions or reduce complications that exist because of or are exacerbated by the pregnancy or that, if left untreated, could adversely affect fetal or child development; and

H. Dental services necessary to avoid more costly medical or dental care when authorized by the department in accordance with rules adopted by the department.

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

3. Notice to MaineCare members. 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 and administrative requirements. Such educational opportunities may be delivered by electronic newsletters, educational training meetings, policy briefings and fact sheets.

Sec. 5. Notice to MaineCare members. By November 1, 2015, 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, 2015, 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.

1. Rulemaking. By October 1, 2015, the Department of Health and Human Services shall adopt rules to implement the provisions of the Maine Revised Statutes, Title 22, section 3174-F, subsection 1, paragraphs D, G and H. When adopting rules to implement paragraph H, the department shall consider dental services identified by a stakeholder group pursuant to subsection 2. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

2. Stakeholder group. Prior to adopting rules pursuant to subsection 1 to implement the provisions of the Maine Revised Statutes, Title 22, section 3174-F, subsection 1, paragraph H, the Department of Health and Human Services shall convene a stakeholder group to identify dental services necessary to avoid 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.

Sec. 8. Effective date. Those sections of this Act that amend the Maine Revised Statutes, Title 22, section 3174-F take effect October 5, 2015.

SUMMARY

This bill provides MaineCare coverage for dental services including diagnostic and preventive services to pregnant and postpartum women and dental services necessary to avoid more costly medical or dental care as identified by a stakeholder group. It requires the Department of Health and Human Services to provide information concerning adult dental benefits to adult MaineCare members and providers. It requires the department to adopt rules relating to the dental coverage by October 1, 2015.

HP0313 LD 474	Session - 127th Maine Legislature		LR 1536 Item 1
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