BILL NUMBER: S3566

SPONSOR: CLEARE
 
TITLE OF BILL:

An act to amend the social services law, in relation to including dental
implants, replacement dental prosthetic appliances, crowns and root
canals as medically necessary dental care and services for coverage
under the Medicaid program

 
PURPOSE:

To ensure that medically necessary dental care, particularly as it
applies to seniors is covered, by statute, under the State's Medicaid
Program.

 
SUMMARY OF PROVISIONS:

This bill amends the Social services law to make it clear, in statute,
that implants, replacement dentures and root canals as medically neces-
sary dental care and services for coverage under the Medicaid program.

              

 
JUSTIFICATION:

Dental Health is important for everyone, and it is exponentially impor-
tant for seniors, yet access to comprehensive, affordable care for our
Elders is an absolute challenge. The rules for Medicaid Recipients have
historically been particularly arcane and medieval, favoring the pulling
of teeth and gumming of food over dentures, implants and root canals. A
stipulation was recently entered into in the case of CIARAMELLA et al.
VS. MCDONALD in the UNITED STATES DISRICT COURT 1 SOUTHERN DISTRICT OF
NEW YORK (Case1:18-cv-06945- MEVDocument305-1) that modernizes the proc-
esses, however, this is not binding in statute. Passage of this bill
will take the essence of the stipulation that- implants, replacement
dentures and root canals as recommended by a Doctor must qualify as
medically necessary dental care and services for coverage under Medi-
caid.

 
PRIOR LEGISLATIVE HISTORY:

New bill; Amended January 2024 to include crowns, certain replacements
and more precise language about posterior and anterior teeth.

 
FISCAL IMPLICATIONS:

No additional costs.

 
EFFECTIVE DATE:
90 Days.