An Act to Improve
Maine Legislature, Session 132, LD 2123
Committee Amendment CA_A_H876 (House)

COMMITTEE AMENDMENT "/^" to H,P. 1438, L.D, 2123, "An Act to Improve
Dental Care Access for Children 13y Modifying the MaineCare Reimbursement
Methodology for the Provision of Anesthesia for Certain Dental Services"
Amend the bill by striking out the title and substituting the following:
'Resolve, to Improve Dental Care Access by Modifymg the IMaineCare
Reimbursement Methodology for the Provision of Certain Dental Services'
Amend the bill by striking out everything after the title and inserting the following:
'See. 1. Department of Health and Human Services to remove requirement
for prior authorization for deep sedation or general anesthesia for dental
services. Resolved: That, effective July 1, 2026, the Department of Health and Human
Services shall provide that prior authorization may not be required for the provision of deep
sedation or general anesthesia for dental services to MaineCare members,
Sec. 2. Department of Health and Human Services to modify fee schedule;
reimbursement rates for anesthesia provided for dental services. Resolved:
That, effective July 1, 2026, the Department of Health and Human Services shall update
the department's fee schedule for MaineCare reimbursement for dental services as follows:
1. The reimbursement rate for deep sedation and general anesthesia for dental services
must be established at 67% of the commercial median benchmark and this rate must, at a
minimum, be maintained until June 30, 2028 or until rates established pursuant to a dental
rate determination conducted according to the Maine Revised Statutes, Title 22, section
3173-J are effective, whichever is sooner; and
2. Deep sedation and general anesthesia services must be billed using current dental
terminology codes D9222, D9223, D9224 and D9225.
Sec. 3. Department of Health and Human Services to modify fee schedule;
reimbursement rates for certain dental services. Resolved: That the Department
of Health and Human Services shall provide for the following in its fee schedule for
MaineCare reunbursement for dental services:
COMMITTEE AMENDMENT
-^A COMMm-EE AMENDMENT "A " to H.P. 1438, L.D. 2123
1. The temporary reimbursement rates for toofh extractions billed using current dental
terminology code D7140 must, at a minimum, be maintained until June 30, 2028 or until
rates established pursuant to a dental rate determination conducted according to the Maine
Revised Statites, Title 22, section 3173-J are effective, whichever is sooner; and
2. The temporary reimbursement rate for dental caries arresting medicament
application billed using current dental terminology code D 13 54 must, at a minimum, be
maintained until June 30, 2028 or until rates established pursuant to a dental rate
determination conducted according to the Maine Revised Statutes, Title 22, section 3173-J
are effective, whichever is sooner.
Sec. 4. Appropriations and allocations. Resolved: That the following
appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Mfedical Care - Payments to Providers 0147
Initiative: Provides funding for the Department of Health and Human Services to prohibit
requirements for prior authorization for deep sedation or general anesfhesia for dental
services provided to MaineCare members and establish a reunbursement rate for these
services at 67% of the commercial median benchmark.
GENERAL FUND
AU Other
GENERAL FUND TOTAL
FEDERAL EXPENDITURES FUND
All Other
FEDERAL EXPENDITURES FUND TOTAL
FEDERAL BLOCK GRANT FUND
All Other
FEDERAL BLOCK GRANT FUND TOTAL $0 $5,787
Sec. 5. Retroactivity. Resolved: That this resolve applies retroactively to July 1,
2026.'
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
5 number to read consecutively.
SUMMARY
This amendment replaces the bill with a resolve and removes the emergency preamble
and emergency clause. It requires the Department of Health and Human Services to do the
following, effective July 1, 2026:
1. Provide that prior authorization may not be required for the provision of deep
sedation or general anesthesia for dental services; and
Page2-132LR2747(02)
COMMITTEE AMENDMENT
2025-26
$0
$0
2025-26
$0
$0
2025-26
$0
2026-27
$17,580
$17,580
2026-27
$31,647
$31,647
2026-27
$5,787
COMMHTEE AMENDMENT "A, " to H.P.1438, L.D.2123
2. Establish the reimbursement rate for deep sedation and general anesthesia for dental
services at 67% of the commercial median benchmark, to be maintained until June 30,2028
or until rates established pursuant to a dental rate determination conducted according to the
Maine Revised Statutes, Title 22, section 3173-J are effective, whichever is sooner.
It also requires the department to maintain temporary reimbursement rates for tooth
extractions and dental caries arresting medicament applications until June 30,2028 or until
rates established pursuant to a dental rate determination conducted according to Title 22,
section 3173-J are effective, whichever is sooner,
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Revised: 03/04/26 <^Kt-
LD 2123 LR 2747(02)
An Act to Improve Dental Care Access for Children by Modifying the IVIaineCare Reimbursement
IVIethodology for the Provision of Anesthesia for Certain Dental Services
Fiscal Note for Bill as Amended by Committee Amendment '^' ,14 -)
Committee: Health and Human Services
Fiscal Note Required: Yes
Fiscal Note
Net Cost (Savings)
General Fund
Appropriations/Allocations
General Fund
Federal Expenditures Fund
Federal Block Grant Fund
Revenue
Federal Expenditures Fund
Federal Block Grant Fund
Projections Projections
FY 2025-26 FY 2026-27 FY 2027-28 FY 2028-29
$0
$17,580
$17,651
$p ^1
$0
$0
$0
$0
$0
$17,580
$31,647
$5,787
$31,647
$5,787
$17,651
$31,585
$5,778
$31,585
$5,778
$17,651
$31,585
$5,778
$31,585
$5,778
Fiscal Detail and Notes
This bill provides General Fund appropriations of $17,580 in fiscal year 2026-27 to the Department of Health and
Human Services for the Office ofMaineCare Services to not require prior authorization for deep sedation or general
anesthesia for dental services, and establish a reimbursement rate for these services at 67% of the commercial median
benchmark, Federal Expenditures Fund allocations will also be required for the PMAP match.
LR2747C02^ - Fiscal Note - Paee 1 of 1