An Act To Improve Dental Health Access for Maine Children and Adults with Low Incomes
Maine Legislature, Session 130, LD 0996
Committee: Health and Human Services
Sponsors: FECTEAU, BREEN, BROOKS, MEYER, MILLETT, O'CONNOR, STOVER, SUPICA, TALBOT ROSS, MOORE
Amends: 22 MRSA §3174-F

Legislative Document
No. 996
H.P. 734
House of Representatives, March 10, 2021
An Act To Improve Dental Health Access for Maine Children and 
Adults with Low Incomes
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Speaker FECTEAU of Biddeford.
Cosponsored by Senator BREEN of Cumberland and
Representatives: BROOKS of Lewiston, MEYER of Eliot, MILLETT of Waterford, 
O'CONNOR of Berwick, STOVER of Boothbay, SUPICA of Bangor, TALBOT ROSS of 
Portland, Senator: MOORE of Washington.
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 to 
maintain good oral and overall health in accordance with rules adopted by the 
department.
Sec. 2.  Rulemaking.  By April 1, 2022, the Department of Health and Human 
Services shall adopt emergency rules to implement provisions of the Maine Revised 
Statutes, Title 22, section 3174-F.  When adopting rules under this section, the department 
shall consider recommendations provided by the stakeholder group established pursuant to 
section 3.
Sec. 3.  Convene stakeholder group.  No later than October 1, 2021, the 
Department of Health and Human Services shall convene a stakeholder group to develop a 
plan for adult comprehensive preventive, diagnostic and restorative dental benefits under 
the MaineCare program.
1.  Members.  The stakeholder group consists of the Commissioner of Health and 
Human Services or the commissioner's designee and 12 members appointed by the 
commissioner as follows:
A.  One member representing a statewide organization representing dentists;
B.  One member representing a statewide organization representing dental hygienists;
C.  One member representing a federally qualified health center;
D.  One member representing a nonprofit dental clinic;
E.  One member representing a nonprofit dental managed care organization;
F.  One member with policy expertise or experience in promoting access to dental care 
for low-income individuals;
G.  One member representing a philanthropic organization concerned with oral health;
H.  One member with experience in public health policy and oral health;
I.  One member with expertise in racial and ethnic health disparities;
J.  Two members currently enrolled in the MaineCare program who would benefit from 
access to an adult dental benefit; and
K.  One member of the general public.
2.  Stakeholder group duties.  The stakeholder group shall consider the matters in 
paragraphs A to I and develop a plan that includes:
A.  Dental procedures and services that are aligned with evidence-based care, are 
medically necessary to maintain good oral and overall health and are appropriate to be 
included in an adult dental benefit under the MaineCare program;
B.  Current MaineCare expenditures for emergency dental care;
C.  Projected expenditures for adult dental services that include an adult comprehensive 
preventive, diagnostic and restorative dental benefit;
D.  Anticipated cost savings resulting from reduced use of hospital emergency 
departments and prescription medication related to the relief of pain and infection as a 
result of the implementation of the plan;
E.  Delivery and provider reimbursement models that will best ensure adequate access 
to quality dental care for all enrollees, improve provider participation, achieve healthy 
outcomes and promote fiscal and administrative efficiency for the long-term success 
of the MaineCare program;
F.  Delivery methods including fee-for-service state administration and risk-based 
dental managed care organization carve-out models.  The stakeholder group shall take 
into account differences among dental practice settings, including any differences in 
service delivery, payment methods and reimbursement amounts between private 
practices, community dental clinics, federally qualified and similarly situated health 
centers and hospital-affiliated providers;
G.  An evaluation of existing oral health disparities for Maine racial minority, 
Indigenous and tribal populations and recommendations for strategies to reduce 
disparities through the implementation of the adult dental benefit;
H.  Strategies to improve oral health education within the MaineCare program;
I.  Metrics to measure outcomes including measures of provider participation and 
utilization of services; and
J.  The plan must be submitted in a report to the Joint Standing Committee on Health 
and Human Services no later than January 2, 2022.
Sec. 4.  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. 5.  Department of Health and Human Services to develop a public 
education campaign.  The Department of Health and Human Services shall develop 
public education 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;
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 adult MaineCare members 
regarding the availability of the comprehensive adult dental benefit under Title 22, section 
3174-F, subsection 1; and
3.  Materials provided to MaineCare members and providers about the importance of 
oral health care in reducing health disparities experienced by Maine racial minority, 
Indigenous and tribal populations.
The department shall engage stakeholders, including providers of pediatric medical 
services, oral health care and dental services and community organizations with deep 
connections to Maine racial minority, Indigenous and tribal populations, in developing 
materials for distribution and strategies for the distribution of those materials.
Sec. 6.  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 department shall 
also provide demographic data on the utilization of the benefit, including by race, ethnicity, 
age and geographic location.  The department shall also provide a report on its efforts to 
reduce oral health disparities for Maine racial minority, Indigenous and tribal populations.  
The costs and savings, demographic data and impact on disparities 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 
2, 2027.
SUMMARY
This bill adds comprehensive 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 convene a stakeholder 
group no later than October 1, 2021 to assist in creating a plan to implement the adult health 
benefit.  It requires the department to work with providers of oral health care and dental 
services to encourage participation in the MaineCare program.  It requires the department 
to develop public education materials and strategies for the distribution of those 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.  It requires the department to provide a 5-year report relating to 
the comprehensive adult dental benefit on costs and savings, demographic data related to 
benefit use and efforts to reduce oral health disparities for Maine racial minority, 
Indigenous and tribal populations 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 2, 2027.