Bill Introduced to Provide Consistent Adult Dental Benefit Through Medicaid

  • by AGD Washington Advocacy Representative
  • Jul 29, 2021

On July 19, Rep. Nanette Diaz Barragán (D-CA) introduced the Medicaid Dental Benefit Act (H.R.4439), which would require all state Medicaid programs to provide mandatory adult dental and oral health services.

This coverage would include:

  • routine diagnostic and preventive care including but not limited to dental cleanings, exams, prophylaxis, fluoride treatments, X-rays, and other necessary services;
  • basic dental services such as fillings and extractions and major dental services such as root canals, crowns, restorations, and both complete and partial dentures including adjustments, repairs, and relines;
  • emergency dental care;
  • Temporomandibular (TMD) and orofacial pain disorder treatment;
  • other necessary services related to dental and oral health (as defined by the U.S. Secretary of HHS)

Currently, states have the flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states offer at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage under Medicaid.

Impact on General Dentistry: AGD is currently evaluating the legislation and firmly believes that the success of providing oral health care services to vulnerable populations is dependent upon ensuring provider participation is robust and appropriately incentivized. AGD appreciates that the legislation includes a focus on increasing oral health literacy and utilization rates within the Medicaid population.