HP1068, LD 1486, item 1, An Act To Reduce the Use of Hospital Emergency Departments for Preventable Oral Health Conditions

An Act To Reduce the Use of Hospital Emergency Departments for Preventable Oral Health Conditions

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 22 MRSA §3174-F, sub-§1, ¶D, as amended by PL 1997, c. 159, §1, is further amended to read:

D. Treatment necessary to relieve pain, eliminate infection or prevent imminent tooth loss; and

Sec. 2. 22 MRSA §3174-F, sub-§1, ¶D-1 is enacted to read:

D-1. Services necessary to treat oral health conditions upon referral from a person's primary care provider or from a hospital emergency department to a dental clinic certified by the department to accept referrals. The dental clinic is authorized to provide treatment to an individual, in accordance with rules adopted by the department, to reduce or eliminate the need for future acute oral health care by that individual, including the screening, diagnosis and treatment of other conditions identified upon referral to the clinic. A dental clinic certified by the department to accept referrals and provide care under this paragraph must have procedures in place to ensure prompt access to care for individuals referred by a hospital emergency department or by a primary care provider. Rules adopted under this paragraph are routine technical rules under Title 5, chapter 375, subchapter 2-A; and

summary

This bill expands MaineCare coverage of oral health treatment for persons 21 years of age and older who seek treatment from their primary care provider or in a hospital emergency department for an acute oral health or related condition and are referred by the primary care provider or the hospital to a dental clinic certified by the Department of Health and Human Services to receive referrals. The bill requires MaineCare to cover medically necessary treatment of the underlying oral health conditions that led to the referral, as well as the screening, diagnosis and treatment of other conditions identified upon referral to the dental clinic. The department is authorized to adopt routine technical rules to determine the extent of covered services and the dental clinics that qualify to provide the expanded scope of services, including ensuring that those clinics provide prompt access to treatment.

HP1068 LD 1486	Session - 126th Maine Legislature		LR 1782 Item 1
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