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Committee amends SB2231 to add medically necessary dental services for Medicaid expansion; amendment and bill pass unanimously
Summary
The Senate Human Services Committee amended SB2231 to require medically necessary dental services for Medicaid expansion members, directing claims be processed through the state Medicaid claims system; staff estimated about $3.5 million in annual cost with a 90/10 federal match.
The Senate Human Services Committee voted unanimously to amend Senate Bill 2231 to include coverage of medically necessary dental services for Medicaid expansion members and to require the Department of Health and Human Services to process those claims through the state—s dentistry claim system and Medicaid management information system.
The amendment, moved by Senator Hogan and seconded by Senator Weston, passed 6–0. Committee members then approved the amended bill to pass and to be re‑referred on a 6–0 vote.
DHHS staff said the change would carve dental services out of the managed care arrangement for Medicaid expansion members so the department would administer those benefits directly, similar to the pharmacy carve‑out adopted in 2020. Sarah Aker, executive director of the Division of Medical Services, explained: “We traditionally operate our managed care plan through a, or our Medicaid expansion benefits through a managed care organization. … In 2020, we carved out pharmacy, which means that we operate pharmacy for our Medicaid expansion members and our traditional members the exact same way.” She said processing through the department—s existing dentistry claims system would enable a similar administrative arrangement.
On costs, DHHS staff estimated about $3.5 million in annual program cost if medically necessary dental care were added for Medicaid expansion members; Aker noted Medicaid expansion carries a roughly 90/10 federal‑state match, which the department translated to about $350,000 of state general fund dollars under that estimate.
Committee members also discussed the precise definition of “medically necessary” and the range of services it could include. Aker summarized the department—s medical‑necessity standard: services “not something that is experimental … in response to, or used to prevent or diagnose, a condition, a medical condition.” She listed typical covered services under traditional Medicaid such as cleanings, preventive exams, X‑rays, and treatment for caries.
Votes at a glance: amendment to add medically necessary dental services and MMIS processing passed 6–0; the committee voted the amended bill due pass and re‑refer to the next committee 6–0.
Next steps: the amended SB2231 will move forward from committee; staff said they will provide details and copies of the amendment language for members to review.
