HEALTH ACCESS SETTING REIMBURSEMENT

FOR SERVICES PROVIDED BY

LICENSED DENTAL HYGIENISTS

 

Background:

In 2011, the Florida Dental Hygiene Association (FDHA) and the Florida Dental

Association (FDA) worked collaboratively to pass legislation, which would increase access to care in health access settings. The bill authorized registered dental hygienists to provide preventive services in health access settings without prior authorization, examination or presence of a dentist. It passed the House and Senate unanimously and was signed into law by the Governor on May 31, 2011.

 

After becoming law, a Medicaid billing glitch was discovered prohibiting full implementation of this cost saving access to care action. Presently Florida Statute (F.S.), 409.906 requires the supervision of a dentist for reimbursement. This has created an unnecessary barrier to children’s preventive dental care programs awaiting implementation.

 

This legislation will do the following:

• Provides the needed changes in F.S., 409.906 to grant the Agency for Health Care Administration (AHCA) express authority to reimburse health access settings for the services provided by licensed dental hygienists.

• ONLY applies to health access settings for billing and reimbursement of dental hygiene services according to F.S., 466.024.

• Maintains the requirement for licensed dental hygienists to provide a dental referral and encourage the establishment of a dental home.

• Increases access to preventive services in health access settings. Health access settings are defined in F.S., 466.003 (14).

• Supported in the Florida State Health Improvement Plan 2012-2015, Access to Care goal AC4.4 objective AC4.4.1

 

The FDHA is encouraged that legislation will provide full implementation of the law.