7 LONG TITLE
8 General Description:
9 This bill addresses dental benefits in the Medicaid program.
10 Highlighted Provisions:
11 This bill:
12 ▸ provides dental benefits to certain adults in the Medicaid program.
13 Money Appropriated in this Bill:
15 Other Special Clauses:
17 Utah Code Sections Affected:
19 26-18-413, as last amended by Laws of Utah 2017, Chapter 233
21 Be it enacted by the Legislature of the state of Utah:
22 Section 1. Section 26-18-413 is amended to read:
23 26-18-413. Medicaid waiver for delivery of adult dental services.
24 (1) (a) [
25 Secretary of Health and Human Services to grant waivers from federal statutory and regulatory
26 law necessary for the Medicaid program to provide dental services in the manner described in
27 Subsection (2).
28 (b) Before June 30, 2018, the department shall submit to the Centers for Medicare and
29 Medicaid Services a request for waivers, or an amendment of existing waivers, from federal
30 law necessary for the state to provide dental services, in accordance with Subsections (2)(b)
31 through (g), to an individual described in Subsection (2)(b).
32 (2) (a) To the extent funded, [
33 services to only blind or disabled individuals, as defined in 42 U.S.C. Sec. 1382c(a)(1), who
34 are 18 years [
35 (b) Notwithstanding Subsection (2)(a), if a waiver is approved under Subsection (1)(b),
36 the department shall provide dental services to an individual who:
37 (i) qualifies for the health coverage improvement program described in Section
38 26-18-411; and
39 (ii) is receiving treatment in a substance abuse treatment program, as defined in Section
40 62A-2-101, licensed under Title 62A, Chapter 2, Licensure of Programs and Facilities.
42 within Salt Lake County shall be provided through the University of Utah School of Dentistry.
43 (d) The department shall provide the services to individuals described in Subsection
45 (i) by contracting with an entity that:
46 (A) has demonstrated experience working with individuals who are being treated for
47 both a substance use disorder and a major oral health disease;
48 (B) operates a program, targeted at the individuals described in Subsection (2)(b), that
49 has demonstrated, through a peer-reviewed evaluation, the effectiveness of providing dental
50 treatment to those individuals described in Subsection (2)(b);
51 (C) is willing to pay for an amount equal to the program's non-federal share of the cost
52 of providing dental services to the population described in Subsection (2)(b); and
53 (D) is willing to pay all state costs associated with applying for the waiver described in
54 Subsection (1)(b) and administering the program described in Subsection (2)(b); and
55 (ii) through a fee-for-service payment model.
56 (e) The entity that receives the contract under Subsection (2)(d)(i) shall cover all state
57 costs of the program described in Subsection (2)(b).
59 money to the program in an amount equal to the program's non-federal share of the cost of
60 providing services under this section through the school during the fiscal year.
62 the Social Services Appropriations Subcommittee whether the University of Utah School of
63 Dentistry will have sufficient funds to make the transfer required by Subsection (2)[
64 the current fiscal year.
66 by the University of Utah School of Dentistry [
67 (i) through fee for service reimbursement until July 1, 2018; and
68 (ii) after July 1, 2018, through the method of reimbursement used by the division for
69 Medicaid dental benefits.
71 department, the scope, amount, duration, and frequency of services may be limited.
72 (3) The reporting requirements of Section 26-18-3 apply to the waivers requested under
73 Subsection (1).
74 (4) (a) If the waivers requested under Subsection (1)(a) are granted, the Medicaid
75 program shall begin providing dental services in the manner described in Subsection (2) no
76 later than July 1, 2017.
77 (b) If the waivers requested under Subsection (1)(b) are granted, the Medicaid program
78 shall begin providing dental services to the population described in Subsection (2)(b) within 90
79 days from the day on which the waivers are granted.
80 (5) If the federal share of the cost of providing dental services under this section will be
81 less than 65% during any portion of the next fiscal year, the Medicaid program shall cease
82 providing dental services under this section [
83 fiscal year.