An Act To Promote Cost-effectiveness in the MaineCare Program and Improve the Oral Health of Maine Adults and Children
Maine Legislature, Session 129, LD 1955
Committee: Health and Human Services
Sponsors: GATTINE, SANBORN, CRAVEN, MARTIN, MEYER, BREEN, GRATWICK
Amends: 22 MRSA §3174-F

Legislative Document
No. 1955
H.P. 1399
House of Representatives, January 8, 2020
An Act To Promote Cost-effectiveness in the MaineCare Program 
and Improve the Oral Health of Maine Adults and Children
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative GATTINE of Westbrook.
Cosponsored by Senator SANBORN, L. of Cumberland and
Representatives: CRAVEN of Lewiston, MARTIN of Eagle Lake, MEYER of Eliot, Senators: 
BREEN of Cumberland, GRATWICK of Penobscot.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3174-F, sub-§1, as amended by PL 1997, c. 159, §§1 and 2 
and PL 2003, c. 689, Pt. B, §6, is further amended to read:
1.  Coverage provided.  The Department of Health and Human Services shall 
provide the following dental services, reimbursed under the United States Social Security 
Act, Title XIX, or successors to it, to individuals 21 years of age and over, limited to:
A.  Acute surgical care directly related to an accident where traumatic injury has 
occurred.  This coverage will only be provided for the first 3 months after the 
accident;
B.  Oral surgical and related medical procedures not involving the dentition and 
gingiva;
C.  Extraction of teeth that are severely decayed and pose a serious threat of infection 
during a major surgical procedure of the cardiovascular system, the skeletal system or 
during radiation therapy for a malignant tumor;
D.  Treatment necessary to relieve pain, eliminate infection or prevent imminent 
tooth loss; and
F.  Other dental services, including full Full and partial dentures, medically necessary 
to correct or ameliorate an underlying medical condition, if the department 
determines that provision of those services will be cost-effective in comparison to the 
provision of other covered medical services for the treatment of that condition.; and
G.  Other comprehensive preventive, diagnostic and restorative dental services that 
are medically necessary to maintain good oral and overall health in accordance with 
rules adopted by the department.
Sec. 2.  Department of Health and Human Services to work with 
providers to encourage participation.  The Department of Health and Human 
Services shall work with providers of oral health care and dental services to encourage 
participation in the MaineCare program to ensure access to the services required by the 
Maine Revised Statutes, Title 22, section 3174-F, subsection 1.
Sec. 3.  Department of Health and Human Services to develop a public 
education campaign.  The Department of Health and Human Services shall develop 
public education materials and strategies for distribution of those materials including:
1.  Materials provided to adult MaineCare members who receive dental services 
pursuant to the Maine Revised Statutes, Title 22, section 3174-F, subsection 1 on the 
necessity of dental services for children and infants, the recommended timetable for 
services to children and information relating to oral health care and dental providers who 
provide services to children in the MaineCare program; and
2.  Materials provided to MaineCare members who are aging out of children's 
coverage under the MaineCare program and who are eligible to enroll as an adult 
MaineCare member regarding the availability of the comprehensive adult dental benefit 
under the Maine Revised Statutes, Title 22, section 3174-F, subsection 1.
The department shall engage stakeholders, including providers of pediatric medical 
services and oral health care and dental services, in developing materials for distribution 
and strategies for the distribution of those materials required under this section.
Sec. 4.  Report.  The Department of Health and Human Services shall determine 
the costs of the comprehensive adult dental benefit under the Maine Revised Statutes, 
Title 22, section 3174-F, subsection 1 and the savings from reduced hospital emergency 
room visits and prescription drug costs from the provision of the comprehensive adult 
dental benefit for a period of 5 years beginning with the effective date of this Act.  The 
costs and savings must be provided in a report to the joint standing committees of the 
Legislature having jurisdiction over health and human services matters and appropriations 
and financial affairs no later than January 1, 2026.
SUMMARY
This bill adds comprehensive, medically necessary preventive, diagnostic and 
restorative dental services to the limited dental services currently available to MaineCare 
members 21 years of age and over.  It requires the Department of Health and Human 
Services to work with providers of oral health care and dental services to encourage 
participation in the MaineCare program.  It requires the department to develop 
educational materials and strategies for the distribution of those educational materials 
relating to the importance of dental services for children and the availability of the 
comprehensive adult dental benefit to children covered by the MaineCare program who 
are aging out of the program.  The department is required to provide a 5-year report on 
costs and savings relating to the comprehensive adult dental benefit to the joint standing 
committees of the Legislature having jurisdiction over health and human services matters 
and appropriations and financial affairs no later than January 1, 2026.