MEDICAID DENTAL COVERAGE

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that targeted dental services that are provided to adults and children under the Medical Assistance Program shall be established and paid at no less than the rates established under the State of Illinois Dental Benefit Schedule and shall include specified dental procedures. Sets forth the reimbursement rates for certain anesthesia services. Provides that the Department of Healthcare and Family Services shall administer and regulate a school-based dental program that allows for the out-of-office delivery of preventative dental services in a school setting to children under 19 years of age. Provides that the medical assistance program shall cover charges incurred, and anesthetics provided, in conjunction with dental care that is provided in a hospital or an ambulatory surgical treatment center if the individual is otherwise eligible for medical assistance and the individual (1) has a medical condition that requires hospitalization or general anesthesia for dental care or (2) is a person with a disability. Provides that the medical assistance program shall cover charges incurred, and anesthetics provided by a dentist, in conjunction with dental care that is provided in a dental office or other specified setting if the individual is otherwise eligible for medical assistance and has been diagnosed with (i) an autism spectrum disorder or (ii) a developmental disability. Requires the Department to reimburse providers at no less than the rates established under the State of Illinois Dental Benefit Schedule used for State employees. Effective January 1, 2022. Senate Floor Amendment No. 1 Deletes reference to: 305 ILCS 5/5-5.28 new Replaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall administer and regulate a school-based dental program that allows for the out-of-office delivery of preventative dental services in a school setting to children under 19 years of age. Provides that the Department shall establish, by rule, guidelines for participation by providers and set requirements for follow-up referral care based on the requirements established in the Dental Office Reference Manual published by the Department that establishes the requirements for dentists participating in the All Kids Dental School Program. Provides that every effort shall be made by the Department when developing the program requirements to consider the different geographic differences of both urban and rural areas of the State for initial treatment and necessary follow-up care. Provides that no provider shall be charged a fee by any unit of local government to participate in the school-based dental program administered by the Department. Provides that nothing in the amendatory Act shall be construed to limit or preempt a home rule unit's or school district's authority to establish, change, or administer a school-based dental program in addition to, or independent of, the school-based dental program administered by the Department. Effective January 1, 2022.