The bill amends the Medicaid Provider-Led Organized Care Act to ensure that sedation dentistry is covered by risk-based provider organizations. It defines "direct service provider" to include organizations or individuals that deliver healthcare services, specifically mentioning sedation dentistry. Additionally, a new definition for "sedation dentistry" is introduced, which encompasses the administration of sedative medications during dental procedures for various care needs, including minimal to general anesthesia.

Furthermore, the bill modifies the list of excluded services under the Medicaid provider-led organized care system to specify that dental benefits in a capitated program will now include sedation dentistry. It also mandates that risk-based provider organizations process claims for sedation dentistry and ensure timely payment to direct service providers. This legislative change aims to enhance access to necessary dental care for Medicaid beneficiaries by integrating sedation dentistry into the coverage provided by these organizations.

Statutes affected:
Old version HB1840 Original - 3-18-2025 03:13 PM: 20-77-2703(6), 20-77-2703, 20-77-2705(b), 20-77-2706(f)
Old version HB1840 V2 - 4-3-2025 04:21 PM: 20-77-2703(6), 20-77-2703, 20-77-2705(b), 20-77-2706(f)
Old version HB1840 V3 - 4-3-2025 04:27 PM: 20-77-2703(6), 20-77-2703, 20-77-2705(b), 20-77-2706(f)
HB 1840: 20-77-2703(6), 20-77-2703, 20-77-2705(b), 20-77-2706(f)
Act 967: 20-77-2703(6), 20-77-2703, 20-77-2705(b), 20-77-2706(f)