Legislature(2005 - 2006)BUTROVICH 205
02/16/2005 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
Audio | Topic |
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Start | |
SB82 | |
SB78 | |
SB79 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
+= | SB 82 | TELECONFERENCED | |
*+ | SB 78 | TELECONFERENCED | |
*+ | SB 79 | TELECONFERENCED | |
+ | TELECONFERENCED |
SB 79-MEDICAID FOR ADULT DENTAL SERVICES CHAIR FRED DYSON announced SB 79 to be up for consideration. 3:08:43 PM BRAD WHISTLER, dental officer, Department of Health and Social Services (DHSS), introduced himself. COMMISSIONER JOEL GILBERTSON, Department of Health and Social Services (DHSS), explained this is a Governor proposal under Medicaid. It would provide capped preventative dental healthcare benefit to all low-income adults in Alaska. Currently, Medicaid dental coverage for people over age 21 is restricted to emergency dental services, which basically means pulling a tooth if a problem arises. SB 79 proposes to enhance the emergency dental Medicaid services for adults to include preventative and/or restorative care. Because of the lack of preventative Medicaid dental services in years past, a backlog exists, which justifies the proposed annual benefit cap for preventative services to $1,150 per client. The annual limit amounts to what it would cost to replace an upper or lower denture so that a senior could replace a full denture over a two-year period. He noted currently there are about 41,000 Medicaid beneficiaries in Alaska. 3:11:09 PM COMMISSIONER GILBERTSON said the Mendenhall Trust Authority is a partner in the proposal and has allocated some of its money to pay part of the state match. Recent studies have shown a link between oral health and chronic diseases and the trust recognizes the trustees have a pressing need for oral health care. "This transition will allow us to position the Medicaid program around preventative services, which is a good investment for the state." He noted the associated fiscal note and explained the general fund match is augmented with Mental Health Trust money for the next six years. There are a number of optional services under Medicaid and this proposal is to include preventative dental services. 3:13:06 PM SENATOR KIM ELTON asked the number of Alaska dentists that do Medicaid services. COMMISSIONER GILBERTSON acknowledged access has been an issue. MR. WHISTLER said access varies across the state but overall, about 85 percent of Alaska dentists are enrolled in the Medicaid program. Although he didn't know how many dentists are accepting new Medicaid clients he did acknowledge the real access issue is when new clients who are enrolled in Medicaid go for care. With regard to the adult program, the proposal would augment the tribal dental programs that are already serving adults. 3:15:32 PM SENATOR ELTON referenced the fee information in the fiscal note and said it would be helpful to have a list of the Juneau dentists that provide two cleanings a year for $250 because he pays considerably more. MR. WHISTLER replied the fiscal note is based on Medicaid reimbursement rates and private rates would be higher. CHAIR DYSON commented most medical practitioners aren't happy with the Medicaid reimbursement rates. He was curious about the view dentists might have. MR. WHISTLER replied most dental practices wouldn't have more than 5 to 10 percent of its clients in the Medicaid program so dentists don't typically rely on those clients for practice income. He suggested it might make dentists more vocal about reimbursement rates. The program has tried to maintain reimbursement at between 70 and 80 percent of usual customary reasonable fees. COMMISSIONER GILBERTSON added the department has always been concerned about provider participation in the Medicaid program. Across the board, between 55 and 60 percent of the licensed providers in the state accept Medicaid as a portion of the insurance they accept. 3:18:04 PM SENATOR DONNY OLSON noted chronic diseases were addressed, but he saw no mention of acute diseases such as gingivitis and resultant septicemia. He was curious how the bill would address those issues. MR. WHISTLER said that sort of case would fit an emergency dental service, which would be covered in the current program. This bill proposes to cover preventive and restorative dental services in addition to the emergency services. Hopefully this would augment existing services so fewer people would get into an acute condition. COMMISSIONER GILBERTSON restated Mr. Whistler's response. 3:19:22 PM CHAIR DYSON recognized Mr. Jessie and asked whether he was testifying that the Mental Health Board agrees with the bill and the funding provided by the Mental Health Trust. JEFF JESSIE said that is correct. He informed members the trust issues over $1 million per year in mini grants paid directly to beneficiaries and nearly 70 percent of the requests are for dental needs that aren't covered by Medicaid. It's clear there is need in this area. PAT LUBY, AARP representative, testified in of SB 79. ROSEMARY HAGEVIG, executive director, Catholic Community Services, testified in strong support of SB 79. She pointed out that providing dental care would help many people get back into the workforce so they see this as a workplace issue. 3:23:26 PM CHAIR DYSON asked for the will of the committee. SENATOR ELTON moved CSSB 79(HES) \G version, and attached fiscal note from committee with individual recommendations. There being no objection, it was so ordered.
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