Resolve, Directing the Department of Health and Human Services To Adjust Reimbursement Rates for Dental Services under the MaineCare Program
Maine Legislature, Session 127, LD 0860
Committee Amendment CA_A-SA_A_S493 (Senate)

SENATE AMENDMENT "A " to COMMITTEE AMENDMENT "A" to S.P. 304, 
L.D. 860, "Resolve, Directing the Department of Health and Human Services To Adjust 
Reimbursement Rates for Dental Services under the MaineCare Program" 
Amend the amendment by striking out all of sections 1 to 6 and inserting the 
following: 
'Sec. 1. Dental services for pregnant women. Resolved: That, by January 1, 
2017, the Department of Health and Human Services shall amend its rule Chapter 101: 
MaineCare Benefits Manual, Chapter II, Section 25 to cover diagnostic and preventive 
services to pregnant women and postpartum women for one year after the birth to 
ameliorate conditions or reduce complications that exist because of or are exacerbated by 
the pregnancy or that, if left untreated, could adversely affect fetal or child development; 
and be it further 
Sec. 2. Dental services to avoid more costly medical or dental care. 
Resolved: That, by January 1, 2017, the Department of Health and Human Services 
shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 25 to 
cover adult dental services provided to avoid more costly medical or dental care; and be it 
further 
Sec. 3. Notice to MaineCare members and providers of dental services. 
Resolved: 
That the Department of Health and Human Services shall provide to 
MaineCare members and providers of dental services notice of changes in benefits to 
MaineCare members pursuant to rule changes under sections 1 and 2; and be it further 
Sec. 4. Stakeholder group. Resolved: That prior to adopting rules pursuant to 
section 2, the Department of Health and Human Services shall convene a stakeholder 
group to identify dental services necessary to avoid more costly medical or dental care. 
The stakeholder group must consist of members representing dentists, federally qualified 
health centers, dental hygienists, hospitals and a clinical health system with experience in 
adult oral health-initiatives; and be it further 
Sec. 5. 
Appropriations and allocations. Resolved: 
That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
SENATE AMENDMENT 
~ ~ ....... -
·'"" 
SENATE AMENDMENT "A" to COMMITTEE AMENDMENT "A" to S.P. 304, L.D. 860 
Medical Care - Payments to Providers 0147 
Initiative: Provides funding to add restorative, diagnostic and preventive dental services 
to pregnant women and postpartum women for one year after delivery. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOT AL 
Office for Family Independence Z020 
2015-16 
$0 
$0 
2015-16 
$0 
$0 
2016-17 
$301,113 
$301,113 
2016-17 
$505,511 
$505,511 
Initiative: Provides funding for the Automated Client Eligibility System changes, testing 
and oversight to add restorative, diagnostic and preventive dental services to pregnant 
women and postpartum women for one year after delivery. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
OTHER SPECIAL REVENUE FUNDS -
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Office of MaineCare Services 0129 
2015-16 
$0 
$0 
2015-16 
$0 
$0 
2016-17 
$5,600 
$5,600 
2016-17 
$5,600 
$5,600 
Initiative: Provides funding for the Maine Integrated Health Management Solution 
changes, testing and oversight to add restorative, diagnostic and preventive dental 
services to pregnant women and postpartum women for one year after delivery. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2015-16 
$0 
$0 
SENATE AMENDMENT 
2016-17 
$41,556 
$41,5J6 
SENATE AMENDMENT" A 
"to COMMITTEE AMENDMENT "A" to S.P. 304, L.D. 860 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOT AL 
HEAL TH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
SUMMARY 
2015-16 
$0 
$0 
2015-16 
$0 
$0 
$0 
$0 
2016-17 
$124,667 
$124,667 
2016-17 
$348,269 
$630,178 
$5,600 
$984,047 
This amendment strikes from Committee Amendment "A" language regarding 
reimbursement rates under the MaineCare program for certain dental codes, changes the 
date by which the Department of Health and Human Services must amend its rules to 
cover specified dental services from January 1, 2016 to January 1, 2017, and adjusts 
funding accordingly. 
· 
FISCAL NOTE REQUIRED 
, (See attached) 
SPONSORED~ 
(Senator 
) 
COUNTY: Oxford 
SENATE AMENDMENT 
Approved: 04/07/16 feac 
LD860 
LR 1699(05) 
Resolve, Directing the Department of Health and Human Services To Adjust Reimbursement Rates 
for Dental Services under the MaineCare Program 
Fiscal Note for Senate Amendment ':4" to Committee Amendment "A" 
Sponsor: Sen. Hamper of Oxford 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
(S-lfq :,) 
Fiscal Note 
FY 2015-16 
FY 2016-17 
($1,187,721) 
($1,187,721) 
($2,039,459) 
($5,600) 
($2,039,459) 
($5,600) 
($2,492,495) 
($2,492,495) 
($4,138,928) 
$5,600 
($4, 138,928) 
$5,600 
Projections 
FY 2017-18 
($3,357,808) 
($3,357,808) 
($5,637,125) 
$0 
($5,637,125) 
$0 
Projections · 
FY 2018-19 
($4,477,078) 
($4,477,078) 
($7,516,166) 
$0 
($7,516,166) 
$0 
This amendment reduces the General Fund appropriations to the Department of Health and Human Services by 
$1,187,721 in fiscal year 2015-16 and $2,492,495 in fiscal year 2016-17 to eliminate the provision to incrementally 
adjust the MaineCare reimbursement rates for certain dental services annually over the next 5 years until the rates 
reach the 10th percentile of certain fees and to remove all fiscal year 15-16 appropriations. Federal Expenditures Fund 
allocations required for the FMAP match will also be reduced. 
LR1699(05) - Fiscal Note - Page 1 of 1