2004 Session

Budget Amendments - SB30 (Member Request)

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Chief Patron: Houck
Medicaid Dental Services Carve-Out

Item 326 #15s

Item 326 #15s

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

Page 250, line 37, strike "$4,057,098,577" and insert "$4,058,374,777".
Page 250, line 37, strike "$4,428,632,619" and insert "$4,429,261,419".
Page 326, after line 47, insert:
"BBB.  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 S2.2-4011 of the Administrative Process Act, to effect this provision."

(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 enhance dental fees and be used to handle provider outreach, case management, help-line, and other provider enrollment functions currently handled by managed care organizations.)