Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 19 (2023GS)

Sponsor

Sen. Vickers, E.

Final action

Governor Signed 3/15/2023

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• requires the Department of Health and Human Services to request authorization to provide dental services to Medicaid-eligible adults not already eligible for dental services; and
• makes technical amendments.

Every vote on this bill

Bill text

MEDICAID DENTAL WAIVER AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Evan J. Vickers
House Sponsor: 
Steve Eliason
LONG TITLE
General Description:
This bill amends the Medical Assistance Act.
Highlighted Provisions:
This bill:
▸ requires the Department of Health and Human Services to request authorization to
provide dental services to Medicaid-eligible adults not already eligible for dental
services; and
▸ makes technical amendments.
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 2020, Chapter 225
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) Before June 30, 2016, the department shall ask CMS 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)(a).
(b) Before June 30, 2018, the department shall submit to CMS 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)(i) and (d) through [
(g)
] 
(f)
, to an individual
described in Subsection (2)(b)(i).
(c) Before June 30, 2019, the department shall submit to [
the Centers for Medicare and
Medicaid Services
] 
CMS
 a request for waivers, or an amendment to existing waivers, from
federal law necessary for the state to:
(i) provide dental services, in accordance with Subsections (2)(b)(ii) and (d) through
[
(g)
] 
(f),
 to an individual described in Subsection (2)(b)(ii); and
(ii) provide the services described in Subsection [
(2)(h)
] 
(2)(g)
.
(d) On or before January 1, 2024, the department shall submit to CMS 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)(iii) and (d) through (f), to an
individual described in Subsection (2)(b)(iii).
(2) (a) To the extent funded, the department shall provide 
dental
 services to only blind
or disabled individuals, as defined in 42 U.S.C. Sec. 1382c(a)(1), who are 18 years old or older
and eligible for the program.
(b) Notwithstanding Subsection (2)(a):
(i) if a waiver is approved under Subsection (1)(b), the department shall provide dental
services to an individual who:
(A) qualifies for the health coverage improvement program described in Section
26-18-411
; and
(B) 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;
[
and
]
(ii) if a waiver is approved under Subsection (1)(c)(i), the department shall provide
dental services to an individual who is an aged individual as defined in 42 U.S.C. Sec.
1382c(a)(1)[
.
]
; and
(iii) if a waiver is approved under Subsection (1)(d), the department shall provide
dental services to an individual who is:
(A) not described in Subsection (2)(a);
(B) not described in Subsection (2)(b)(i);
(C) not described in Subsection (2)(b)(ii);
(D) not pregnant;
(E) 21 years old or older; and
(F) eligible for full services through the Medicaid program.
(c) To the extent possible, services to individuals described in Subsection (2)(a) shall
be provided through the University of Utah School of Dentistry and the University of Utah
School of Dentistry's associated statewide network.
(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).
(f) Each fiscal year, the University of Utah School of Dentistry shall, in compliance
with state and federal regulations regarding intergovernmental transfers, transfer funds 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.
(g) If a waiver is approved under Subsection (1)(c)(ii), the department shall provide
coverage for porcelain and porcelain-to-metal crowns if the services are provided:
(i) to an individual who qualifies for dental services under Subsection (2)(b); and
(ii) by an entity that covers all state costs of:
(A) providing the coverage described in this Subsection [
(2)(h)
] 
(2)(g)
; and
(B) applying for the waiver described in Subsection (1)(c).
(h) Where possible, the department shall ensure that 
dental
 services described in
Subsection (2)(a) that are not provided by the University of Utah School of Dentistry or the
University of Utah School of Dentistry's associated network are provided:
(i) through [
fee for service
] 
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.
(i) Subject to appropriations by the Legislature, and as determined by the department,
the scope, amount, duration, and frequency of services 
provided under this section
 may be
limited.
(3) (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.
(c) If the waivers requested under Subsection (1)(c)(i) are granted, the Medicaid
program shall begin providing dental services to the population described in Subsection
(2)(b)(ii) within 90 days after the day on which the waivers are granted.
(d) If the waivers requested under Subsection (1)(d) are granted, the Medicaid program
shall begin providing dental services to the population described in Subsection (2)(b)(iii)
within 90 days after the day on which the waivers are granted.
(4) If the federal share of the cost of providing dental services under this section will be
less than [
] 
% during any portion of the next fiscal year, the Medicaid program shall cease
providing dental services under this section no later than the end of the current fiscal year.