How do the revised rules in the Bipartisan Budget Act of 2015 affect you and your business?
The new benefit provides Medicaid adults age 21 and older with access to up to $1,000 in dental services per state fiscal year, according to a release from the Colorado Department of Health Care Policy and Financing.
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“A healthy mouth and health body go hand-in-hand,´ said Susan Birch, executive director of the department in a statement. “We have already heard from many of our clients how grateful they are since the initial benefit began in April. Having this enhanced benefit in place will help our clients maintain good oral health and improve their overall health and quality of life.”
The extended benefit covers basic preventive dental exams, diagnostic and restorative dental services including extractions, root canals, crowns, partial dentures, complete dentures, periodontal scaling, root planning and other procedures requiring prior authorization.
The expansion is funded through the federal and state government. Colorado’s share of the funding comes from a state fund that formerly funded Cover Colorado.
CoverColorado was created by the state Legislature in 1991 to cover individuals with pre-existing conditions that other carriers would not cover. Elements of the Patient Protection and Affordable Care Act prohibit the rejection of patients for pre-existing conditions, rendering CoverColorado obsolete. The program’s authorizing legislation was repealed in July 2013, shutting down Cover Colorado.
Some of the funds were shifted to the expansion of Medicaid’s dental benefit.
For the remaining months in fiscal 2013-14, the expansion will cost $32 million, $11 million of which will be paid by Colorado. In fiscal 2014-15, the program will cost $86 million, with $22 million of that paid by Colorado.