Title: Dental Care Services

Summary: Authorizing the Agency for Health Care Administration to provide Medicaid reimbursements for dental services provided by a mobile dental unit owned by, operated by, or having a contractual agreement with a health access setting or a similar setting or program under certain circumstances; deleting the requirement that applicants for dental hygienist licensure demonstrate specified skills on a live patient; revising specified tasks that may be delegated only to a licensed dental hygienist; revising specified remediable tasks licensed dental hygienists may perform in health access settings without the physical presence, prior examination, or authorization of a dentist, etc.

Full Text:
An act relating to dental care services; amending s. 409.906, F.S.; authorizing the Agency for Health Care Administration to provide Medicaid reimbursements for dental services provided by a mobile dental unit owned by, operated by, or having a contractual agreement with a health access setting or a similar setting or program under certain circumstances; authorizing the agency to reimburse a licensed dental hygienist for certain remediable tasks; amending s. 466.007, F.S.; deleting the requirement that applicants for dental hygienist licensure demonstrate specified skills on a live patient; amending s. 466.023, F.S.; revising specified tasks that may be delegated only to a licensed dental hygienist; amending s. 466.024, F.S.; revising specified remediable tasks licensed dental hygienists may perform in health access settings without the physical presence, prior examination, or authorization of a dentist; deleting a requirement that a licensed dentist or physician provide medical clearance before a licensed dental hygienist may perform certain tasks on a patient; deleting a requirement that a licensed dentist perform a dental examination of the patient within a specified timeframe after a dental hygienist performs such tasks; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Paragraph (c) of subsection (1) and subsection (6) of section 409.906, Florida Statutes, are amended to read: 409.906 Optional Medicaid services. Subject to specific appropriations, the agency may make payments for services which are optional to the state under Title XIX of the Social Security Act and are furnished by Medicaid providers to recipients who are determined to be eligible on the dates on which the services were provided. Any optional service that is provided shall be provided only when medically necessary and in accordance with state and federal law. Optional services rendered by providers in mobile units to Medicaid recipients may be restricted or prohibited by the agency. Nothing in this section shall be construed to prevent or limit the agency from adjusting fees, reimbursement rates, lengths of stay, number of visits, or number of services, or making any other adjustments necessary to comply with the availability of moneys and any limitations or directions provided for in the General Appropriations Act or chapter 216. If necessary to safeguard the state s systems of providing services to elderly and disabled persons and subject to the notice and review provisions of s. 216.177, the Governor may direct the Agency for Health Care Administration to amend the Medicaid state plan to delete the optional Medicaid service known as  Intermediate Care Facilities for the Developmentally Disabled.  Optional services may include: (1) ADULT DENTAL SERVICES.  (c) However, Medicaid will not provide reimbursement for dental services provided by in a mobile dental unit, except for a mobile dental unit: 1. Owned by, operated by, or having a contractual agreement with the Department of Health and complying with Medicaid s county health department clinic services program specifications as a county health department clinic services provider. 2. Owned by, operated by, or having a contractual arrangement with a federally qualified health center and complying with Medicaid s federally qualified health center specifications as a federally qualified health center provider. 3. Rendering dental services to Medicaid recipients, years of age and older, at nursing facilities. 4. Owned by, operated by, or having a contractual agreement with a state-approved dental educational institution. 5.   Owned by, operated by, or having a contractual agreement with a health access setting as defined in s. 466.003(14) or a similar setting or program that serves underserved or vulnerable populations that face barriers to accessing dental services, including, but not limited to, homeless shelters or group homes for adults with disabilities. (6) CHILDREN S DENTAL SERVICES. The agency may pay for diagnostic, preventive, or corrective procedures, including orthodontia in severe cases, provided to a recipient under age 21, by or under the supervision of a licensed dentist. The agency may also reimburse a health access setting as defined in s. 466.003(14) or a licensed dental hygienist s. 466.003 for the remediable tasks that a licensed dental hygienist is authorized to perform under s. 466.024(2). Services provided under this program include treatment of the teeth and associated structures of the oral cavity, as well as treatment of disease, injury, or impairment that may affect the oral or general health of the individual. However, Medicaid will not provide reimbursement for dental services provided by in a mobile dental unit, except for a mobile dental unit: (a) Owned by, operated by, or having a contractual agreement with the Department of Health and complying with Medicaid s county health department clinic services program specifications as a county health department clinic services provider. (b) Owned by, operated by, or having a contractual arrangement with a federally qualified health center and complying with Medicaid s federally qualified health center specifications as a federally qualified health center provider. (c) Rendering dental services to Medicaid recipients, years of age and older, at nursing facilities. (d) Owned by, operated by, or having a contractual agreement with a state-approved dental educational institution. (e)   Owned by, operated by, or having a contractual agreement with a health access setting as defined in s. 466.003(14) or a similar setting or program that serves underserved or vulnerable populations that face barriers to accessing dental services, including, but not limited to, homeless shelters, schools, Early Head Start programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children. Section 2. Paragraph (b) of subsection (4) of section 466.007, Florida Statutes, is amended to read: 466.007 Examination of dental hygienists.  (4) Effective July 1, 2012, to be licensed as a dental hygienist in this state, an applicant must successfully complete the following: (b) A practical or clinical examination approved by the board. The examination shall be the Dental Hygiene Examination produced by the American Board of Dental Examiners, Inc., (ADEX) or its successor entity, if any, if the board finds that the successor entity s clinical examination meets or exceeds the provisions of this section. The board shall approve the ADEX Dental Hygiene Examination if the board has attained and continues to maintain representation on the ADEX House of Representatives, the ADEX Dental Hygiene Examination Development Committee, and such other ADEX Dental Hygiene committees as the board deems appropriate through rulemaking to ensure that the standards established in this section are maintained organizationally. The ADEX Dental Hygiene Examination or the examination produced by its successor entity is a comprehensive examination in which an applicant must demonstrate skills within the dental hygiene scope of practice on a live patient and any other components that the board deems necessary for the applicant to successfully demonstrate competency for the purpose of licensure. Section 3. Subsection (1) of section 466.023, Florida Statutes, is amended to read: 466.023 Dental hygienists; scope and area of practice.  (1) Except as otherwise provided in s. 466.024, only dental hygienists may be delegated the task of removing calculus deposits and,accretions,and stains from exposed surfaces of the teeth and from tooth surfaces within the gingival sulcus and the task of performing root planing and gingival curettage. In addition, dental hygienists may expose dental X-ray films, apply topical preventive or prophylactic agents, and perform all tasks delegable by the dentist in accordance with s. 466.024. The board by rule shall determine whether such functions shall be performed under the direct, indirect, or general supervision of the dentist. Section 4. Present paragraph (f) of subsection (2) of section 466.024, Florida Statutes, is redesignated as paragraph (g) and amended, and a new paragraph (f) is added to that subsection, to read: 466.024 Delegation of duties; expanded functions.  (2) A dental hygienist licensed in this state may perform the following remediable tasks in a health access setting as defined in s. 466.003 without the physical presence, prior examination, or authorization of a dentist: (f)   Apply interim therapeutic restorations. (g) (f)  Remove calculus deposits and,accretions,and stains from exposed surfaces of the teeth and from tooth surfaces within the gingival sulcus. 1.   A dentist licensed under this chapter or a physician licensed under chapter or chapter must give medical clearance before a dental hygienist removes calculus deposits, accretions, and stains from exposed surfaces of the teeth or from tooth surfaces within the gingival sulcus. 2.   A dentist shall conduct a dental examination on a patient within months after a dental hygienist removes the patient s calculus deposits, accretions, and stains from exposed surfaces of the teeth or from tooth surfaces within the gingival sulcus. Additional oral hygiene services may not be performed under this paragraph without a clinical examination by a dentist who is licensed under this chapter. This subsection does not authorize a dental hygienist to perform root planing or gingival curettage without supervision by a dentist. Section 5. This act shall take effect July 1, 2022.