Committee hears bill to require medical insurers to cover anesthesia for medically necessary pediatric dental care
Loading...
Summary
Sen. Shortner’s SB 527 would require medical plans to cover general anesthesia for children under 13 when medically necessary for dental procedures, proponents said, citing cases where insurers denied coverage despite medical need.
Sen. Shortner laid out Senate Bill 5-27, which would require medical insurance plans to cover general anesthesia for medically necessary pediatric dental procedures for children under age 13 who have documented physical, mental or medical conditions that prevent them from safely undergoing dental treatment without sedation.
"This current practice places the youngest Texans, particularly those with autism or intellectual and developmental disabilities, at risk," Shortner said, noting that 34 states have taken similar steps.
Dr. Alexandra Otto, a board-certified pediatric dentist in Austin, testified in support, describing cases she said were delayed or denied by insurers despite cardiologists or other specialists recommending prompt dental treatment before major surgery. "I had a 5-year-old patient who was scheduled for an open heart surgery... Though the hospital was in network, the carrier denied her general anesthesia because it was for a dental procedure," Otto said.
Jerome (Jeremy) Heaton, president of the Texas Society of Dentist Anesthesiologists, also supported the bill and described the procedure’s safety record and the clinical need to use general anesthesia for certain young or developmentally disabled patients to permit necessary dental work and avoid ER visits for acute infections.
Senators pressed about safeguards and definitions; Shortner said the bill would not change who performs anesthesia and noted existing state safeguards and permits for dental anesthesia.
No committee action was recorded; the bill was left pending.
Supporters framed the bill as resolving coverage disputes where medical plans cover anesthesia for medically necessary non-dental procedures but deny similar coverage when the anesthetic is used to enable essential dental care. Insurers did not present testimony at this hearing.
