Plain English Breakdown
The official source material does not provide specific details on the number of participants expected or the exact nature of additional necessary services to promote oral health, leaving these aspects uncertain.
Medicaid Dental Pilot Program
This bill establishes a three-year Medicaid dental pilot program in Region B of Florida for people with disabilities.
What This Bill Does
- Defines 'persons with disabilities' as those who receive Supplemental Security Income based on disability, are enrolled in certain home and community-based services programs, or meet federal disability criteria.
- Requires the Agency for Health Care Administration (AHCA) to establish a three-year Medicaid dental pilot program in Region B of Florida's Statewide Medicaid Managed Care program.
- Specifies that participants must be people with disabilities who live in Region B and are enrolled in the state Medicaid program.
- Outlines covered dental services, including routine care, basic treatments, major procedures, emergency services, and additional necessary services to promote oral health.
- Sets reimbursement rates for providers at 80% of the median usual fees as determined by a recognized benchmark.
- Requires AHCA to collect data on access to care, service utilization, expenditures, and oral health outcomes, and submit a report evaluating the program's effectiveness.
Who It Names or Affects
- People with disabilities who live in Region B of Florida and are enrolled in Medicaid.
- Dental providers participating in the pilot program.
- The Agency for Health Care Administration (AHCA).
Terms To Know
- persons with disabilities
- Medicaid-eligible individuals who receive Supplemental Security Income based on disability, are enrolled in certain home and community-based services programs, or meet federal disability criteria.
- Statewide Medicaid Managed Care program
- A system where the state contracts with managed care organizations to provide health coverage for Medicaid recipients.
Limits and Unknowns
- The bill only applies to Region B of Florida's Statewide Medicaid Managed Care program.
- It is unclear how many people will be eligible and participate in the pilot program.
- The effectiveness of the program will depend on data collection and analysis, which may not fully capture all aspects of dental care access.