An Act To Promote Cost-effectiveness in the MaineCare Program and Improve the Oral Health of Maine Adults and Children
Maine Legislature, Session 130, LD 0062
Committee: Health and Human Services
Sponsors: BROOKS, CLAXTON, ARFORD, CRAVEN, MARTIN, MEYER, TEPLER, BREEN
Amends: 22 MRSA §3174-F

Legislative Document
No. 62
H.P. 28
House of Representatives, January 13, 2021
An Act To Promote Cost-effectiveness in the MaineCare Program 
and Improve the Oral Health of Maine Adults and Children
Received by the Clerk of the House on January 11, 2021.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative BROOKS of Lewiston.
Cosponsored by Senator CLAXTON of Androscoggin and
Representatives: ARFORD of Brunswick, CRAVEN of Lewiston, MARTIN of Eagle Lake, 
MEYER of Eliot, TEPLER of Topsham, Senator: BREEN of Cumberland.
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.  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 adult MaineCare members 
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, 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 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 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, 2027.