The proposed legislation, General Assembly Raised Bill No. 1299, aims to enhance Medicaid-covered dental care by modifying existing statutes related to nonemergency dental services. Effective July 1, 2025, the bill stipulates that all nonemergency dental services under the Department of Social Services' dental programs will require prior authorization, with certain exceptions for diagnostic, preventive, and basic restoration procedures, as well as nonsurgical extractions. Notably, the bill introduces a payment cap of $1,000 per calendar year for adult individuals, while prevention services such as oral exams and dental cleanings, along with medically necessary services like dentures, will not be subject to this cap. Additionally, the Commissioner of Social Services is granted the authority to recoup payments for services deemed unnecessary and to review payments for emergency dental services periodically.

Furthermore, the bill modifies the extent of nonemergency adult dental services provided under Medicaid, allowing for two dental cleanings and one set of bitewing x-rays annually for healthy adults. It also establishes that separate dental services provided at mobile dental clinics and school-based health centers will be reimbursed individually rather than through a bundled payment system. The bill replaces the requirement for the commissioner to "print" notices in the Connecticut Law Journal with a mandate to "post" them on the eRegulations System, streamlining the regulatory process. Overall, the legislation seeks to expand preventive oral health services and improve access to dental care for Medicaid recipients.

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