WEST VIRGINIA LEGISLATURE
2024 REGULAR SESSION
ENROLLED
Committee Substitute for House Bill 4933
BY DELEGATE SUMMERS
[Passed March 1, 2024; in effect July 1, 2024.]
 Enr CS for HB 4933
1 AN ACT to amend and reenact §9-5-12a of the Code of West Virginia, 1931, as amended, relating
2 to Medicaid dental coverage; providing coverage is limited to $2,000 per two-year budget
3 period; providing recipients must pay for services over the $2,000; requiring reporting; and
4 removing expired internal effective date.
Be it enacted by the Legislature of West Virginia:
ARTICLE 5. MISCELLANEOUS PROVISIONS.
§9-5-12a. Medicaid program; dental care.
1 (a) The following terms are defined:
2 (1) "Cosmetic services" means dental work that improves the appearance of the teeth,
3 gums, or bite, including, but not limited to, inlays or onlays, composite bonding, dental veneers,
4 teeth whitening, or braces.
5 (2) "Diagnostic and preventative services" means dental work that maintains good oral
6 health and includes oral evaluations, routine cleanings, x-rays, fluoride treatment, fillings, and
7 extractions.
8 (3) "Restorative services" means dental work that involves tooth replacement, including,
9 but not limited to, dentures, dental implants, bridges, crowns, or corrective procedures such as
10 root canals.
11 (b) The Department of Human Services shall extend Medicaid coverage to adults aged 21
12 and over covered by the Medicaid program for diagnostic and preventative dental services and
13 restorative dental services, excluding cosmetic services. This coverage is limited to $2,000 per
14 two-year budget period. Recipients must pay for services over the $2,000 limit. No provision in
15 this section shall restrict the department in exercising new options provided by, or to be in
16 compliance with, new federal legislation that further expands eligibility for dental care for adult
17 recipients.
18 (c) The department is responsible for the implementation of, and program design for, a
19 dental care system to reduce the continuing harm and continuing impact on the health care
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 Enr CS for HB 4933
20 system in West Virginia. The dental health system design shall include oversight, quality
21 assurance measures, case management, and patient outreach activities. The department shall
22 assume responsibility for claims processing in accordance with established fee schedules and
23 financial aspects of the program necessary to receive available federal dollars and to meet federal
24 rules and regulations. The department shall seek authority from the Centers for Medicare and
25 Medicaid Services to implement the provisions of this section.
26 (d) On or before December 1, 2027, the Bureau for Medical Services shall file a report
27 with the Legislative Oversight Commission on Health and Human Resources Accountability and
28 the Joint Committee on Government and Finance analyzing Medicaid expenditures related solely
29 to the dental program for the plan year immediately prior to the passage of this legislation and
30 each plan year until the date of submission of the required report. The report shall include at a
31 minimum an analysis of the enrollees served, the state share of the Medicaid expenditures, and
32 the federal share of expenditures.
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Enr CS for HB 4933
The Clerk of the House of Delegates and the Clerk of the Senate hereby certify that the foregoing bill is correctly enrolled.
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Clerk of the House of Delegates
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Clerk of the Senate Originated in the House of Delegates.
In effect July 1, 2024.
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Speaker of the House of Delegates
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President of the Senate __________
The within is ................................................ this the...........................................
Day of ..........................................................................................................., 2024.
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Governor
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Statutes affected:
Introduced Version: 9-5-12a
Committee Substitute: 9-5-12a
Engrossed Committee Substitute: 9-5-12a
Enrolled Committee Substitute: 9-5-12a