 |
ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
AHCCCS; comprehensive dental care
Purpose
Expands Arizona Health Care Cost Containment System (AHCCCS) coverage of dental services, from only emergency dental care and extractions, to include coverage of comprehensive dental care for members age 21 and older.
Background
AHCCCS contractors must provide medically necessary dental services to members that include: 1) emergency dental care and extractions, in a maximum annual amount of $1,000 per member who is at least 21 years old; and 2) for persons treated at an Indian Health Service or tribal facility, adult dental services that are eligible for a Federal Medical Assistance Percentage of 100 percent and that exceed the $1,000 annual cap. AHCCCS contractors must also provide for medical supplies, durable medical equipment, insulin pumps and prosthetic devices ordered by a physician or primary care practitioner, not including hearing aids, dentures, bone-anchored hearing aids or cochlear implants (A.R.S. § 36-2907).
A dental emergency is an acute disorder of oral health resulting in
severe pain and or infection as a result of pathology or trauma, including but
not limited to: 1) emergency oral diagnostic examinations; 2) radiographs and
laboratory services for symptomatic teeth;
3) prefabricated crowns to eliminate tooth pain; 4) root canals when indicated
for the treatment of an acute infection or to eliminate pain; 5) tooth
reimplantation; and 6) initial treatment for acute infection (AHCCCS).
If there is a cost associated with expanding AHCCCS services to provide comprehensive dental care for persons over 21 years old, there may be a fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires AHCCCS contractors to provide coverage of comprehensive dental care for persons who are at least 21 years old, with a maximum annual amount of $1,000 per member.
2. Removes dentures from the list of prosthetic devices that are excluded from AHCCCS coverage for persons who are at least 21 years old.
3. Makes technical and conforming changes.
4. Becomes effective on the general effective date.
Prepared by Senate Research
January 19, 2024
MM/DM/slp