1999 Session

Budget Amendments - SB800 (Conference Report)

View Budget Item
View Budget Item amendments

Dental Care Reimbursement (language only)

Item 335 #6c

Item 335 #6c

Health And Human Resources
Medical Assistance Services, Department of

Page 271, after line 40, insert:
"Z.  The Department of Medical Assistance Services shall develop a plan for an appropriate reimbursement methodology, using data from commercial insurers, to comply with the General Assembly's directive to the Department to raise dental reimbursement rates to the 85th percentile of usual, customary and reasonable charges.  The Department shall present the payment system plan to the Governor and the Chairmen of the Senate Finance and House Appropriations Committees by September 1, 1999.  In the development of a reimbursement methodology plan, the Department shall examine the impact of retaining fee-for-service reimbursement for the delivery of dental services in the managed care system on expanding access to pediatric dental care.  The Department shall not require dentists who agree to participate in the delivery of Medicaid services to pediatric dental patients to also deliver services to subscribers enrolled in the commercial plan of the managed care vendor."

(This amendment requires the Department of Medical Assistance Services to develop a plan for raising dental rates to the 85th percentile of usual, customary, and reasonable charges. The plan would also include a review of fee-for-service rates within managed care plans on access to care. Also, dentists providing services to Medicaid-eligible children in a managed care plan would not be required to serve other recipients in commercial plans that might also be offered by the managed care vendor.)