§3174-F. Coverage for adult dental services

1.  Coverage provided.  The Department of Health and Human Services shall provide dental services, reimbursed under the United States Social Security Act, Title XIX, or successors to it, to individuals 21 years of age and over, limited to:

A. Acute surgical care directly related to an accident where traumatic injury has occurred. This coverage will only be provided for the first 3 months after the accident;   [PL 1989, c. 502, Pt. A, §72 (NEW).]

B. Oral surgical and related medical procedures not involving the dentition and gingiva;   [PL 1989, c. 502, Pt. A, §72 (NEW).]

C. Extraction of teeth that are severely decayed and pose a serious threat of infection during a major surgical procedure of the cardiovascular system, the skeletal system or during radiation therapy for a malignant tumor;   [PL 1997, c. 159, §1 (AMD).]

D. Treatment necessary to relieve pain, eliminate infection or prevent imminent tooth loss; and   [PL 1997, c. 159, §1 (AMD).]

E. [PL 1991, c. 528, Pt. P, §14 (RP); PL 1991, c. 528, Pt. RRR (AFF); PL 1991, c. 591, Pt. P, §14 (RP).]

F. Other 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.   [PL 1997, c. 159, §2 (NEW).]

[PL 1997, c. 159, §§1, 2 (AMD); PL 2003, c. 689, Pt. B, §6 (REV).]

2.  Demonstration projects.  The department shall promptly take all appropriate steps to obtain necessary waivers, if necessary, from the federal Department of Health and Human Services that enable the State to provide within the limits of available funds, on a demonstration basis, comprehensive dental services to Medicaid-eligible individuals who are 21 years of age or older in public or private, nonprofit clinic settings. The department's goal in pursuing these waivers or demonstration projects not requiring waivers is to determine whether providing services in these settings promotes cost effectiveness or efficiency or promotes other objectives of the federal Social Security Act, Title XIX.

By January 15, 1992, the department shall report to the joint standing committee of the Legislature having jurisdiction over health matters regarding the progress of its efforts under this subsection. The report must outline the department's progress and recommend further action required in pursuit of any demonstration project under this subsection.

[PL 1991, c. 528, Pt. P, §15 (AMD); PL 1991, c. 528, Pt. RRR (AFF); PL 1991, c. 591, Pt. P, §15 (AMD).]

SECTION HISTORY

PL 1989, c. 502, §A72 (NEW). PL 1989, c. 904 (AMD). PL 1991, c. 528, §§P13-15 (AMD). PL 1991, c. 528, §RRR (AFF). PL 1991, c. 591, §§P13-15 (AMD). PL 1997, c. 159, §§1,2 (AMD). PL 2003, c. 689, §B6 (REV).