Modernize Medicaid Dental Rates.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 60

Short Title: Modernize Medicaid Dental Rates. (Public)
Sponsors: Representatives Biggs, Lambeth, Potts, and Cotham (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Appropriations, if favorable, Rules, Calendar, and Operations of the House
February 6, 2025
*H60-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO MODERNIZE MEDICAID DENTAL RATES. 2
Whereas, good oral health is vital to good overall health, and untreated oral health 3
conditions negatively affect overall health and have associations with chronic disease, including 4
diabetes, heart disease, kidney disease, Alzheimer's disease, and even mental illness; and 5
Whereas, the failure to adjust reimbursement rates to account for increasing inflation 6
and costs over the last fifteen years has resulted in reduced dental provider participation in 7
Medicaid; and 8
Whereas, regular preventative dental care is the most cost effective method available 9
to prevent minor oral conditions from developing into more complex oral and physical health 10
conditions that would eventually require emergency and palliative care; and 11
Whereas, in order to improve overall health and access to quality care, increase 12
provider participation in Medicaid, and prevent future health conditions caused by overall health 13
problems, it is in the best interest of the State to raise Medicaid reimbursement rates paid to dental 14
care providers from 35% to 46% of the average dentist charges in 2023 in order to provide rates 15
that are comparable with the Medicaid rates of surrounding states; Now, therefore, 16
The General Assembly of North Carolina enacts: 17
SECTION 1.(a) There is appropriated from the General Fund to the Department of 18
Health and Human Services, Division of Health Benefits, the sum of fifty -two million dollars 19
($52,000,000) in recurring funds for each year of the 2025 -2027 fiscal biennium to be used to 20
increase the Medicaid rates paid for dental services. These funds shall provide a State match for 21
ninety-five million dollars ($95,000,000) in recurring federal funds for each year of the 22
2025-2027 fiscal biennium, and those funds are appropriated to the Division of Health Benefits 23
for the same purpose. 24
SECTION 1.(b) The rate increases required by this section shall be implemented as 25
soon as practicable after July 1, 2025. 26
SECTION 2. This act becomes effective July 1, 2025. 27