SB 205-FN - AS AMENDED BY THE SENATE
4/8/99 0746s
1999 SESSION
SENATE BILL 205-FN
AN ACT expanding medical coverage to pay dental assistance for adults on medicaid.
SPONSORS: Sen. Wheeler, Dist 21; Sen. McCarley, Dist 6; Sen. Hollingworth, Dist 23; Rep. Copenhaver, Graf 10; Rep. M. Fuller Clark, Rock 36; Rep. Francoeur, Rock 22
This bill expands medical coverage to pay dental assistance for adults on medicaid.
This bill is the result of the study committee established under 1997, 48.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
4/8/99 0746s
99-0388
05/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord One Thousand Nine Hundred and Ninety-Nine
AN ACT expanding medical coverage to pay dental assistance for adults on medicaid.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Dental Assistance Included. Amend RSA 167:4 by inserting after paragraph III the following new paragraph:
IV. For the purposes of this section the term "medical assistance" shall include dental assistance.
2 Dental Assistance Included. Amend RSA 167:6, VII to read as follows:
VII. For purposes hereof, a person shall be eligible for medical assistance as categorically needy or as medically needy. A person shall be eligible as categorically needy if [he] the person receives financial assistance under RSA 167:6, I, IV, V or VI, or is otherwise eligible to receive such assistance but does not. A person shall be eligible as medically needy if [he] the person meets the categorical, age, and technical requirements under RSA 167:6, I, IV, V or VI, and if [his] such person's income and assets meet the standards as prescribed for the medically needy program. A person shall also be eligible as categorically needy or as medically needy who is eligible for medical assistance pursuant to the mandates of federal law or regulation or pursuant to optional state coverage groups which are allowed by federal regulation and defined by the commissioner of the department of health and human services in accordance with rules adopted under RSA 541-A, but who does not receive assistance or would not be otherwise eligible to receive assistance under paragraph I, IV, V, or VI of this section. For the purposes of this paragraph "medical assistance" shall include dental assistance.
3 New Paragraph; Types of Dental Assistance Covered. Amend RSA 167:6 by inserting after paragraph VII the following new paragraph:
VIII. Persons deemed medically and categorically needy shall be eligible for dental assistance including emergency dental care for relief of pain, bleeding and infection, selected preventative and restorative procedures designed to cease disease progression, and necessary diagnostic and consultative services. Such services shall include complete full denture and denture repair coverage. The annual per person benefit maximum shall be $400. In addition to the annual benefit, one full set of dentures per lifetime, with lifetime repairs, shall also be covered.
4 Effective Date. This act shall take effect 60 days after its passage.
LBAO
99-0388
1/28/99
SB 205-FN - FISCAL NOTE
AN ACT expanding medical coverage to pay dental assistance for adults on medicaid.
FISCAL IMPACT:
The Department of Health and Human Services stated this bill will increase state expenditures by $444,943 in FY 2000, $2,369,953 in FY 2001, $3,264,496 in FY 2002 and $3,313,463 in FY 2003. State revenue will increase by $242,728 in FY 2000, $1,292,869 in FY 2001, $1,780,864 in FY 2002 and $1,807,577 in FY 2003. County expenditures will increase by $20,256 in FY 2000, $107,892 in FY 2001, $148,616 in FY 2002, and $150,845 in FY 2003. There will be no impact on county and local revenue or local expenditures.
METHODOLOGY:
The Department stated that dental assistance for adults is currently limited to extractions to relieve pain and infection. The Department determined that 7.71% (3,047 of 39,479) of Medicaid covered adults expended $522,273 on this dental care for an average of $171.41 per user in FY 1998. This is down slightly from FY 1997. The Department prepared a revised list of services to adults and calculated the cost per person at $226.33. The Department compared New Hampshire's current program to a Vermont program similar to this bill and assumed a utilization level of 25.45% over three years. Denture recipients are estimated to reach 5% over three years ad the cost of denture services will be $756 each. In addition, the cost of hospital outpatient use for dental care procedures was considered because the rate of use was 3 times that of the general population. The Department further assumed a rate increase of 1.5% and an inflation rate of 1.5% annually. The first year cost is for ½ year. No administrative costs are included and will only be required if services require intensive prior authorization. Federal Medicaid reimbursement is ½ of the cost. County expenditures are estimated at 18.21% of the total, times 25% to account for medicaid payments at different rates under provider payments and nursing home provider payments. Calculations of cost were computed as follows:
Total #
FY Adults Participants Cost Each Total Federal General County
1998 39,479 @7.718%=3,047 $171.41 $522,273 $261,137 $261,137
2000(6/mo.)
Current 39,479 @7.718%=3,047 $171.41 ($261,136) ($130,568) ($118,680) ($11,888)
Proposed @12.718%=5,021 $226.33 568,204 284,102 258,235 25,867
Denture Srvc. @1.000%=395 $765.00 151,008 75,504 68,629 6,875
LBAO
99-0388
1/28/99
Page 2
SB 205-FN - FISCAL NOTE
Emergency Care 30 $887.00 (13,132) (6,566) (5,968) _ _(598)
Total Increase $444,944 $222,472 $202,216 $20,256mailto:Svc.@80%