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Updated Draft Rule for the Medicaid Children’s Benefit

August 6, 2014

The state recently released an updated draft of the rules outlining approved Medicaid dental benefits for children ages 0 to 20. A copy of the draft children’s benefit rule can be accessed by clicking here. The draft children’s benefit rule addresses coverage for exams, diagnostic imaging, preventive, restorative, periodontal, prosthetic, oral surgery and anesthesia services. The document lists code descriptions for procedures and any frequency limitations or prior authorizations required. This rule does not address adult dental benefits or children’s orthodontic benefits, as these topics are addressed in separate rules.

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After Years of Waiting, EPA Finally Moves on Proposed Amalgam Separator Rule

August 6, 2014

The ADA has learned that the federal Office of Management and Budget (OMB) is now reviewing an Environmental Protection Agency (EPA) proposed rule to reduce the amount of dental amalgam that dental offices release into wastewater systems. Following the OMB's review (assuming OMB approval, usually within 90 days) EPA will publish the proposed rule for comment. This is the first significant development on an amalgam separator mandate since the EPA first announced its intention to develop a rule in September 2010.

The ADA has consulted with the EPA a number of times since 2010. The EPA understands that the ADA supports a reasonable national pretreatment standard for amalgam waste as long as it is not unduly burdensome on dental professionals.

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All Dentists Must Register with Colorado’s PDMP by Oct. 31

August 6, 2014

A recently passed bill, HB14-1283, requires all dentists with a DEA registration to register with Colorado’s Prescription Drug Monitoring Program (PDMP) by Oct. 31. The PDMP is a secure, online database created in 2005 that provides objective information about patients’ controlled substance prescription records to assist Colorado healthcare providers in offering appropriate treatment to their patients. If you have not already signed up to use the PDMP, you may register for an account at: http://www.hidinc.com/copdmp. If you are already registered or are a current user of the PDMP database, no future action is needed at this time to meet the state requirement.

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CO Medical Services Board Member Needed

August 6, 2014

The governor’s office is seeking applicants for a vacant position on the Medical Services Board (the state board that oversees the Medicaid program across many professions). While a dentist has served in the past, currently no dentist serves on this board.  Having a dentist would provide good expertise, given the ongoing changes to Medicaid dental benefits. The person appointed to this position must reside in Congressional District 7 (generally north and west metro Denver area), be either a registered republican or an unaffiliated voter and have knowledge of medical assistance programs. Anyone who is interested in being considered for an appointment to the board should submit an application for membership through the Governor’s Office of Boards and Commissions.

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Full Medicaid Adult Dental Benefit Launches July 1

July 1, 2014

Starting today, July 1, a comprehensive dental benefit for Medicaid-eligible adults is available.

What does that mean?
This means that over 300,000 adults who qualify for Medicaid can access a robust schedule of dental services including restorative treatment, root canals, crowns, surgical procedures and full/partial dentures (note that prior authorization is required for certain designated codes).

What else is new?
Starting today, July 1, DentaQuest is the new administrator of the Colorado Medicaid Dental Program.  This means that all Medicaid claims billed on or after July 1, for both adults and children, will be processed through DentaQuest.  DentaQuest also has a team in Colorado dedicated to serving providers, and their provider service phone number is equipped to answer any day-to-day questions that providers may have: 855-225-1731.

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