Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 435 First Substitute (2018GS)

Sponsor

Rep. Eliason, S.

Final action

Governor Signed 3/15/2018

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• provides dental benefits to certain adults in the Medicaid program.

Every vote on this bill

Bill text

MEDICAID DENTAL BENEFITS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Steve Eliason
Senate Sponsor: 
Peter C. Knudson
LONG TITLE
General Description:
This bill addresses dental benefits in the Medicaid program.
Highlighted Provisions:
This bill:
▸ provides dental benefits to certain adults in the Medicaid program.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-18-413
, as last amended by Laws of Utah 2017, Chapter 233
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-18-413
 is amended to read:
26-18-413.
 Medicaid waiver for delivery of adult dental services.
(1) 
(a)
 [
No later than
] 
Before
 June 30, 2016, the department shall ask the United States
Secretary of Health and Human Services to grant waivers from federal statutory and regulatory
law necessary for the Medicaid program to provide dental services in the manner described in
Subsection (2).
(b) Before June 30, 2018, the department shall submit to the Centers for Medicare and
Medicaid Services a request for waivers, or an amendment of existing waivers, from federal
law necessary for the state to provide dental services, in accordance with Subsections (2)(b)
through (g), to an individual described in Subsection (2)(b).
(2) (a) To the extent funded, [
services shall be provided
] 
the department shall provide
services
 to only blind or disabled individuals, as defined in 42 U.S.C. Sec. 1382c(a)(1), who
are 18 years [
of age
] 
old
 or older and eligible for the program.
(b) Notwithstanding Subsection (2)(a), if a waiver is approved under Subsection (1)(b),
the department shall provide dental services to an individual who:
(i) qualifies for the health coverage improvement program described in Section
26-18-411
; and
(ii) is receiving treatment in a substance abuse treatment program, as defined in Section
62A-2-101
, licensed under Title 62A, Chapter 2, Licensure of Programs and Facilities.
[
(b)
] 
(c)
 To the extent possible, services 
to individuals described in Subsection (2)(a)
within Salt Lake County shall be provided through the University of Utah School of Dentistry.
(d) The department shall provide the services to individuals described in Subsection
(2)(b):
(i) by contracting with an entity that:
(A) has demonstrated experience working with individuals who are being treated for
both a substance use disorder and a major oral health disease;
(B) operates a program, targeted at the individuals described in Subsection (2)(b), that
has demonstrated, through a peer-reviewed evaluation, the effectiveness of providing dental
treatment to those individuals described in Subsection (2)(b);
(C) is willing to pay for an amount equal to the program's non-federal share of the cost
of providing dental services to the population described in Subsection (2)(b); and
(D) is willing to pay all state costs associated with applying for the waiver described in
Subsection (1)(b) and administering the program described in Subsection (2)(b); and
(ii) through a fee-for-service payment model.
(e) The entity that receives the contract under Subsection (2)(d)(i) shall cover all state
costs of the program described in Subsection (2)(b).
[
(c)
] 
(f)
 Each fiscal year, the University of Utah School of Dentistry shall transfer
money to the program in an amount equal to the program's non-federal share of the cost of
providing services under this section through the school during the fiscal year.
[
(d)
] 
(g)
 During each general session of the Legislature, the department shall report to
the Social Services Appropriations Subcommittee whether the University of Utah School of
Dentistry will have sufficient funds to make the transfer required by Subsection (2)[
(c)
]
(f)
 for
the current fiscal year.
[
(e)
] 
(h)
 Where possible, 
the department shall ensure that
 services 
that are
 not provided
by the University of Utah School of Dentistry [
shall be
] 
are
 provided:
(i) through fee for service reimbursement until July 1, 2018; and
(ii) after July 1, 2018, through the method of reimbursement used by the division for
Medicaid dental benefits.
[
(f)
] 
(i)
 Subject to appropriations by the Legislature, and as determined by the
department, the scope, amount, duration, and frequency of services may be limited.
(3) The reporting requirements of Section 
26-18-3
 apply to the waivers requested under
Subsection (1).
(4) 
(a)
 If the waivers requested under Subsection (1)
(a)
 are granted, the Medicaid
program shall begin providing dental services in the manner described in Subsection (2) no
later than July 1, 2017.
(b) If the waivers requested under Subsection (1)(b) are granted, the Medicaid program
shall begin providing dental services to the population described in Subsection (2)(b) within 90
days from the day on which the waivers are granted.
(5) If the federal share of the cost of providing dental services under this section will be
less than 65% during any portion of the next fiscal year, the Medicaid program shall cease
providing dental services under this section [
indefinitely
] no later than the end of the current
fiscal year.