Legislature(2005 - 2006)

2005-01-24 House Journal

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2005-01-24                     House Journal                      Page 0151
HB 105                                                                                            
HOUSE BILL NO. 105 by the House Rules Committee by request of                                       
the Governor, entitled:                                                                             
                                                                                                    
     "An Act relating to coverage for adult dental services under                                   
     Medicaid; and providing for an effective date."                                                
                                                                                                    
was read the first time and referred to the Health, Education & Social                              
Services and Finance Committees.                                                                    
                                                                                                    
The following fiscal note(s) apply:                                                                 
                                                                                                    
1.  Fiscal, Dept. of Health & Social Services                                                       
                                                                                                    
The Governor's transmittal letter dated January 21, 2005, follows:                                  
                                                                                                    
"Dear Speaker Harris:                                                                               
                                                                                                    
Under the authority of art. III, sec. 18, of the Alaska Constitution, I am                          
transmitting a bill relating to coverage for adult dental services for                              
eligible recipients under the Medicaid program (AS 47.07).                                          
                                                                                                    
The State of Alaska's Medicaid program currently provides inadequate                                
coverage for adult dental services.  The services covered under                                     
existing law are limited to procedures for relief of pain and acute                                 
infection, and don't include necessary preventative or restorative                                  
treatment.  This level of service often leads to the extraction of                                  
permanent teeth.  Missing and decayed teeth (especially front teeth)                                
can affect an individual's employability and/or career advancement                                  
opportunities.  Furthermore, studies have documented the links and/or                               

2005-01-24                     House Journal                      Page 0152
complications between dental disease and other chronic diseases                                     
including cardiovascular disease and diabetes.  Recent studies have                                 
also implicated periodontal disease as a risk factor for pre-term, low                              
birth-weight births.                                                                                
                                                                                                    
Diseases of the mouth are not distinctly different from diseases in the                             
rest of the body.  The limitation for dental coverage is largely a                                  
distinction based on the type of health care provider; in that diseases of                          
the oral cavity are largely treated by dentists.  The lack of coverage to                           
prevent more severe dental problems and/or extractions before they                                  
become "dental emergencies" often results in more expensive dental                                  
care and limits the dentist's ability to address dental problems.                                   
Dentists have reported frustration with not being able to treat teeth                               
earlier before the person is in pain and when less costly treatment                                 
could be provided.                                                                                  
                                                                                                    
This bill would allow the Department of Health and Social Services to                               
expand dental coverage to encompass preventative and restorative care                               
for approximately 41,000 Alaskans enrolled in the Medicaid program.                                 
Specifically, this bill would repeal AS 47.07.900(1), defining adult                                
dental services as the minimum treatment for the immediate relief of                                
pain and acute infection provided by a licensed dentist.  Under the bill,                           
the Department of Health and Social Services would adopt regulations                                
implementing the expanded service, which could include regulations                                  
defining the scope of services, a maximum amount of benefits per                                    
fiscal year, and the amount of reimbursement for dental services.                                   
                                                                                                    
The Alaska Mental Health Trust Authority has recognized access to                                   
dental services as a priority issue for their beneficiaries and has                                 
committed funding for part of the matching funds needed for this                                    
service expansion.  The expanded services would be provided under                                   
an annual cap of $1,150 per adult at the outset.  The cap is intended to                            
control costs of the service expansion and encourage the dentist and                                
client to discuss priorities and treatment options.  The Department of                              
Health and Social Services and the Alaska Mental Health Trust                                       
Authority agreed to use this expenditure cap as a starting point to                                 
provide a level of service that would allow elderly Alaskans to receive                             
a complete set of dentures over a two-year period.  The dental                                      
expenditure cap for expanded services would not apply to the existing                               
Medicaid coverage for emergency dental services.                                                    
                                                                                                    

2005-01-24                     House Journal                      Page 0153
I urge your prompt and favorable action on this measure.                                            
                                                                                                    
                                Sincerely yours,                                                    
                                /s/                                                                 
                                Frank H. Murkowski                                                  
                                 Governor"