Bill Text: DE SB262 | 2011-2012 | 146th General Assembly | Draft


Bill Title: An Act To Amend Title 31 Of The Delaware Code Relating To Preventive And Urgent Dental Care For Medicaid Recipients.

Spectrum: Slight Partisan Bill (Democrat 6-2)

Status: (Introduced - Dead) 2012-06-20 - Assigned to Health & Social Services Committee in Senate [SB262 Detail]

Download: Delaware-2011-SB262-Draft.html


SPONSOR:

Sen. Hall-Long & Rep. Keeley

 

Sens. Blevins, Cloutier, Henry & Sorenson;

Reps. Mitchell & Kowalko

DELAWARE STATE SENATE

146th GENERAL ASSEMBLY

SENATE BILL NO. 262

AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO PREVENTIVE AND URGENT DENTAL CARE FOR MEDICAID RECIPIENTS.


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:


Section 1.Amend §502(2), Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(2) "Assistance" means assistance to or on behalf of eligible needy persons or eligible families to enable them to improve their standard of living, including money payments, child care, job training, education, other support services, medical or surgical care, preventative or urgent dental care, nursing, burial, board and care in a private institution, adult foster care, rest residential facility for adults, public medical institution as a patient, or such other aid as may be deemed necessary.

Section2.Amend §502(5), Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(5) "Medical assistance" means medical care including preventative or urgent dental care furnished on behalf of recipients who are eligible for assistance in any of the categories in §505 of this title.

Section 3.Amend §502, Title 31 of the Delaware Code byrenumbering existingsubsections (7), (8), (9) and (10) as subsections "(8)", "(9)", "(10)" and "(11)" respectively by making insertions as shown by underlining and deletions as shown by strike through as follows:

(7) ‘Preventative dental care' means payment of all or part of the costs on behalf of eligible recipients for fluoride treatments, teeth cleaning, restorative treatments, treatments to prevent periodontal disease and dental caries disease, and any other dental care or treatment which the Department of Health and Social Services shall authorize by regulation.

Section 4.Amend §502, Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(12) ‘Urgent dental care' means payment of all or part of the costs on behalf of eligible recipients for examinations, diagnostic radiographs, treatment of pain or infections, including tooth extractions, incisions and drainage, and any other dental care or treatment which the Department of Health and Social Services shall authorize by regulation.

Section 5.Amend §503(b), Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(b) Medicaid -- Medical assistance may be granted to medically and financially eligible persons in accordance with Titles IV-A, IV-E, XVI, and XIX of the Social Security Act [42 U.S.C. §§601 et seq., 670 et seq., 1381 et seq., and 1396 et seq.], federally approved waivers of these sections of the act, and rules and regulations established by the Department of Health and Social Services. Eligibility for and payment of medical assistance shall be determined under policies and regulations established by the Department of Health and Social Services. Eligibility standards, recipient copay and provider reimbursement shall be set in accordance with state and federal mandates, state and federal funding levels, approved waivers and rules and regulations established by the Department. The amount of assistance in each case of medical care shall not duplicate any other coverage or payment made or available for the costs of such health services and supplies.

(b)(1) Medicaid - - Medical assistance, including preventative or urgent dental care, may be granted to medically and financially eligible persons in accordance with Titles IV-A, IV-E, XVI, and XIX of the Social Security Act [42 U.S.C. §§601 et. seq., 1381 et. seq., and 1396 et. seq.], federally approved waivers of these sections of the act, and rules and regulations established by the Department of Health and Social Services.Eligibility for and payment of medical assistance shall be determined under policies and regulations established by the Department of Health and Social Services.Eligibility standards, recipient co-pay and provider reimbursement shall be set in accordance with state and federal mandates, state and federal funding levels, approved waivers and rules and regulations established by the Department.The amount of assistance in each case of medical care shall not duplicate any other coverage or payment made or available for the costs of such health services and supplies.

(2) The amount of assistance provided to a recipient for preventative or urgent dental care, or any combination thereof, shall not exceed $1000.00 per year; provided, however, that in cases where multiple conditions which can or are causing pain exist, the State Dental Director may establish a review process through which extra benefit dollars, not exceeding an additional $1500.00 per eligible participant, may be authorized on an emergency basis for urgent dental care treatments.The reimbursement rate to participating dentists providing preventative or urgent dental care shall be the same as the reimbursement rate to participating dentists providing dental care to children enrolled in the Medicaid program.All payments for preventative or urgent dental care treatments shall be subject to a $10.00 recipient co-pay.

Section 6. Amend §505(3), Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(3) Medicaid assistance; assistance granted in the form of medical care, including preventative or urgent dental care, to individuals eligible in accordance with Title IV-A, XVI, XIX of the Social Security Act [42 U.S.C. §§601 et seq., 1381 et seq., and 1396 et seq.], federally approved waivers, and rules and regulations established by the Department of Health and Social Services.

Section 7.Amend §512(7), Title 31 of the Delaware Code by making insertions as shown by underlining and deletions as shown by strike through as follows:

(7) Guarantee that assistance provided as medical care, including preventative or urgent dental care, when paid to providers of such medical care shall be on a prompt basis, usually not later than 30 days from the report of services by a physician, pharmacist or other professional health care provider, or 20 days from the report of services by a hospital or skilled nursing facility; provided, however, that should financial advances from the Department of Finance be necessary to carry out this chapter, they shall be permitted upon the concurrence of the Secretary of the Department of Finance and the Secretary of the Department of Health and Social Services.

Section 8. Effective Date.

This Act shall become effective upon appropriation by the General Assembly of funds sufficient to accomplish the purposes of this Act.


SYNOPSIS

This Bill expands Delaware's Public Assistance Code to provide preventative and urgent dental care to all eligible Medicaid recipients.Payments for preventative or urgent dental care treatments shall be subject to a $10.00 recipient copay and the total amount of dental care assistance provided to an eligible recipient shall not exceed $1,000.00 per year, except that an additional $1,500.00 may be authorized on an emergency basis for urgent dental care treatments through a review process established by the State Dental Director.

Author: Senator Hall-Long

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