2004 Session

Budget Amendments - SB30 (Committee Approved)

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Medicaid Dental Services Carve-Out

Item 322 #5s

Item 322 #5s

First Year - FY2005 Second Year - FY2006
Health And Human Resources
Medical Assistance Services, Department of FY2005 $638,100 FY2006 $638,100 GF
FY2005 $314,400 FY2006 $314,400 NGF
FY2005 4.00 FY2006 4.00 FTE

Page 246, line 25, strike "$75,013,771" and insert "$75,966,271".
Page 246, line 25, strike "$75,013,728" and insert "$75,966,228".
Page 248, after line 17, insert:
"G.  The Department of Medical Assistance Services shall have the authority to amend the Medallion II waiver to allow the Department to carve out dental services provided to children under the age of 21 from Medicaid managed care.  In addition, the Department shall have the authority to amend the State Plans for Titles XIX (Medical Assistance Services) and XXI (Family Access to Medical Insurance Security) of the Social Security Act, as required by applicable statute and regulations to provide dental services to children enrolled in these programs on a fee-for-service basis.  The Department shall have the authority to enact emergency regulations under Section 2.2-4011 of the Administrative Process Act, to effect this provision.  The Department of Medical Assistance Services may consider outsourcing such dental services to children under age 21 to an administrative services program."

(This amendment carves out dental services from Medicaid managed care and provides for reimbursement of these services on a fee-for-service basis. Currently, only 20 percent of children enrolled in the Medicaid or FAMIS program are receiving dental services they are eligible to receive and only 16 percent of licensed dentists in Virginia participate in the Medicaid program. This is one strategy to encourage more dentists to participate in Medicaid. Funding will be used to handle provider outreach, case management, help-line, and other provider enrollment functions currently handled by managed care organizations.)