No. HB 1507
Filed under Healthcare.
Medicaid Dental Pilot Program; Requires AHCA to establish & operate 3-year Medicaid dental pilot program in Region B of Statewide Medicaid Managed Care program for persons with disabilities; provides eligibility criteria; specifies covered benefits; provides reimbursement requirements; requires managed care participation; directs AHCA to seek federal approval; requires AHCA to collect specified data & submit report to Governor & Legislature by specified date; provides for expiration.
Plain English Summary
AI-GENERATEDAHCA must run a 3-year pilot program giving enhanced dental care to Medicaid enrollees with disabilities who live in Region B, covering everything from cleanings to root canals, crowns, dentures, and emergencies.
Only people already getting SSI for a disability, on a home-and-community-based-services waiver, or meeting federal disability criteria can enroll, and only if they live in Region B and are on Medicaid.
Dentists get paid 80% of the 50th percentile of usual dental fees, and the program has to run through at least two dental managed care companies with disability-care experience.
The whole program automatically expires June 30, 2028 unless lawmakers act to renew it, after AHCA reports back on whether it worked well enough to take statewide.
AIAHCA must establish and run a 3-year Medicaid dental pilot program in Region B of Statewide Medicaid Managed Care to provide enhanced dental services to Medicaid enrollees with disabilities.
AIRequired benefits range from routine exams and cleanings through fillings and extractions up to root canals, crowns, dentures, other prostheses, and emergency dental care.
AIAHCA must reimburse dental providers under the pilot at 80 percent of the 50th percentile of usual, customary, and reasonable fees, as benchmarked by the American Dental Association or a comparable measure.
AIThis new section expires on June 30, 2028 unless the Legislature reviews it and saves it from repeal through reenactment before then.
AIThe enhanced dental services under this pilot supplement, and do not replace, the dental benefits already available under the state's existing Medicaid dental statutes.
AIThe pilot must be delivered through at least two licensed dental managed care organizations that meet agency standards and have demonstrated experience serving people with disabilities.