SB 1014
Increasing Medicaid dental provider reimbursement rates
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Sign in to take action- Introduced
- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill aims to improve dental care coverage for West Virginia adults enrolled in Medicaid. It increases reimbursement rates for dental providers, specifically for diagnostic and preventative services and restorative services, while excluding cosmetic services. The Department of Human Services will expand Medicaid coverage to include these services up to a $2,000 limit per two-year budget period, with recipients responsible for costs exceeding that limit. The bill also includes provisions for program oversight, reporting, and a future fee increase.
Key provisions
- Increases Medicaid reimbursement rates for diagnostic and preventative dental services.
- Increases Medicaid reimbursement rates for restorative dental services.
- Expands Medicaid coverage to include diagnostic and preventative and restorative dental services for adults aged 21 and over.
- Establishes a $2,000 per two-year budget period limit on dental coverage for Medicaid recipients.
- Requires recipients to pay for dental services exceeding the $2,000 limit.
- Directs the Department of Human Services to implement a dental care system with oversight and quality assurance measures.
- Requires the Bureau for Medical Services to file a report analyzing Medicaid expenditures related to the dental program.
- Mandates a minimum 20% increase in dental-related fees by December 1, 2028.
Who is affected
- West Virginia Medicaid recipients
- Dental providers in West Virginia
- Adults aged 21 and over in West Virginia
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