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SB128 • 2025

AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO DENTAL CARE FOR ADULT MEDICAID RECIPIENTS.

AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO DENTAL CARE FOR ADULT MEDICAID RECIPIENTS.

Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Pinkney
Last action
2025-05-21
Official status
Senate Finance 5/21/25
Effective date
Not listed

Plain English Breakdown

The official source material does not provide specific details on what happens if federal approval is denied or how much additional funding will be needed for these expanded benefits.

Act to Expand Dental Care for Adult Medicaid Recipients

This act requires Delaware's Department of Health and Social Services to apply for federal approval to offer more extensive dental care benefits to adult Medicaid recipients.

What This Bill Does

  • Changes the definition of 'dental care' in Title 31 of the Delaware Code to include diagnostic, preventive, restorative, and periodontal services.
  • Removes annual monetary limits on dental care for adult Medicaid recipients.
  • Requires the Department of Health and Social Services to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services within 90 days after the act is passed.

Who It Names or Affects

  • Adult Medicaid recipients who will receive more comprehensive dental care services.
  • The Department of Health and Social Services which must apply to federal authorities for approval and implement these changes.

Terms To Know

Medicaid State Plan Amendment
A request made by a state government to the Centers for Medicare & Medicaid Services (CMS) to change or add benefits in their Medicaid program.
Periodontal services
Medical treatments related to the gums and supporting structures of teeth, such as cleaning and disease prevention.

Limits and Unknowns

  • The act does not specify what happens if federal approval is denied.
  • It's unclear how much additional funding will be needed for these expanded benefits.
  • The exact timeline for when the new dental care services will start after federal approval is uncertain.

Bill History

  1. 2025-05-21 Delaware General Assembly

    Reported Out of Committee (Health & Social Services) in Senate with 2 Favorable, 5 On Its Merits

  2. 2025-05-21 Delaware General Assembly

    Assigned to Finance Committee in Senate

  3. 2025-05-06 Delaware General Assembly

    Introduced and Assigned to Health & Social Services Committee in Senate

Official Summary Text

AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO DENTAL CARE FOR ADULT MEDICAID RECIPIENTS.
This Act requires the Department of Health and Social Services to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services to be allowed to provide comprehensive dental benefits to Medicaid-eligible adults.

Current Bill Text

Read the full stored bill text
Legislation Document

SPONSOR:

Sen. Pinkney & Sen. Townsend & Rep. Harris

Sens. Poore, Seigfried; Reps. Heffernan, K. Johnson, Lambert, Morrison, Neal, Kamela Smith, Snyder-Hall

DELAWARE STATE SENATE

153rd GENERAL ASSEMBLY

SENATE BILL NO. 128

AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO DENTAL CARE FOR ADULT MEDICAID RECIPIENTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend § 502, Title 31 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 502. Definitions.

As used in this chapter:

(4) “Dental care” means payment of all or part of the costs on behalf of an eligible recipient for

preventive and restorative treatment which the Department of Health and Social Services authorizes by regulation.

diagnostic, preventive, restorative, and periodontal services.

Section 2. Amend § 503, Title 31 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 503. Eligibility for assistance; amount; method of payment.

(b)

Medicaid. —

(1) Medical assistance may be granted to medically and financially eligible persons in accordance with Titles IV-A, IV-E, XVI, and XIX of the Social Security Act (42 U.S.C. §§ 601 et seq., 1381 et seq., and 1396 et seq.), federally approved waivers of these sections of the act, and rules and regulations established by the Department of Health and Social Services. Eligibility for and payment of medical assistance must be determined under policies and regulations established by the Department of Health and Social Services. Eligibility standards, recipient copay, and provider reimbursement must be set in accordance with state and federal mandates, state and federal funding levels, approved waivers, and rules and regulations established by the Department. The amount of assistance in each case of medical care must not duplicate any other coverage or payment made or available for the costs of such health services and supplies. To the extent permitted by federal requirements, no annual or lifetime numerical limitations may be placed on physical therapy or chiropractic care visits that are for the purpose of treating back pain.

(2) a.

Except as otherwise provided in paragraph (b)(2)b. of this section, the amount of assistance provided to an adult recipient for dental care must not exceed $1,000 per year.

The Department shall provide dental care for eligible adults.

b.

The Department may establish a review process through which extra benefit dollars, not exceeding an additional $1,500 per adult recipient, may be authorized on an emergency basis for dental care treatments.

The Department may not impose an annual monetary limit on dental care provided under paragraph (b)(2)a. of this section.

c. All payments for dental care treatments are subject to a $3.00 copay for adult recipients.

Section 3. Within 90 days of the enactment of this Act the Secretary of the Department of Health and Social Services shall submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services.

Section 4. This Act takes effect immediately on enactment of this Act and is implemented on the date of publication in the Register of Regulations of a notice by the Secretary of the Department of Health and Social Services (“Department”) that the Department’s Medicaid State Plan Amendment is approved by the Centers for Medicare & Medicaid Services.

SYNOPSIS

This Act requires the Department of Health and Social Services to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services to be allowed to provide comprehensive dental benefits to Medicaid-eligible adults.

Author: Senator Pinkney