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June 29, 2022
Human Services

Coverage for preventive and other dental care expands on July 1 as part of $45M investment in oral health

AUGUSTA- The Mills Administration announced today that it is expanding MaineCare dental coverage for adults and increasing reimbursement rates for dental providers on July 1, representing an estimated $45 million investment in oral health.

Governor Mills proposed the expansion of adult dental benefits in the 2022-2023 Biennial Budget following the Health and Human Services Committee's unanimous support of Speaker of the House Ryan Fecteaus bill, LD 996, An Act To Improve Dental Health Access for Maine Children and Adults with Low Incomes. Fridays launch of the new benefit follows almost a year of work by the Maine Department of Health and Human Services (DHHS) alongside dental providers and other state oral health leaders to develop rules to implement the law.

MaineCare members aged 21 or older will be automatically enrolled in the new dental benefit on July 1. This coverage is expected to ultimately benefit more than 217,000 Maine people, as members begin to seek care over time and as DHHS continues to encourage and assist dental providers to increase the number of MaineCare members they serve, as part of a broad effort to increase access, particularly in rural areas. The benefit covers a comprehensive array of dental services, from cleanings and fillings to root canals, dentures, and other critical oral health services. Previously, coverage for adults was limited to emergency situations, such as tooth extractions. MaineCare has and continues to provide comprehensive dental coverage for children.

The updated dental rates represent a significant investment in providers who serve both adults and children covered by MaineCare. The bulk of the increase supports rates for diagnostic and preventive services, which will see an average increase of 70 percent, as early investment in these types of services can reduce future costs of oral health care.

Together, the coverage expansion and rate initiatives represent an estimated $45 million investment in oral health, more than doubling MaineCares current investment.

"Dental health is an important part of overall health," said Governor Janet Mills. Providing preventive and routine dental care will not only improve the health and wellness of hundreds of thousands of Maine people, but it will also save money in the long-run by preventing the need for expensive emergency care. I am glad to have worked with the Legislature to expand dental care for Maine people.

With MaineCare covering 1 in 4 people in Maine, this new dental coverage combined with higher reimbursement rates will benefit hundreds of thousands of Maine people, said DHHS Commissioner Jeanne Lambrew. Oral health is critical to general health and to participating in the community and the workforce. Were grateful to the Governor, Speaker Fecteau and the Legislature, and our partners throughout the state for making this important benefit a reality.

This is just one way that lawmakers have worked to expand access to health care in Maine. Our previous system had forced people to use the emergency room when their teeth reached the point of no return, which was costing folks their dignity and health. The stories I heard were simply heartbreaking. As of today, the Mainers who were willing to share their stories have helped change the face of health care in our state, said Speaker Fecteau of Biddeford. This was an effort led by Maine people and I am so proud that it received bipartisan support in the Legislature.

"Oral health is an essential element of overall health, and dental care is a critical health service for all Maine people. Research shows that children will be more likely to get the preventive care they need to stay healthy when their whole family has access to care, said Becca Matusovich, Executive Director of the Childrens Oral Health Network of Maine. We are grateful to the Department of Health and Human Services and the Mills Administration, as well as the bipartisan efforts of the 130th Legislature, for their historic efforts to enable both the expansion of the comprehensive dental benefit for adults and the rate reforms needed to ensure that providers who serve MaineCare members can be fairly compensated. Maine's dental providers are still recovering from the pandemic and ongoing workforce shortages, and while it may take time for everyone who wants an appointment to get one, our network is very excited to collaborate with the Department to encourage and support dental providers across the state who are working hard to serve more MaineCare members."

"Maine people brought painful and personal stories to Augusta about the unmet need for dental care, and we are overjoyed that because of their leadership and the work of legislators and Governor Mills, MaineCare will now cover dental care for adults, said Kathy Kilrain del Rio of Maine Equal Justice. The process of creating the new adult dental benefit, improving existing policy for children, and the significant investment in reimbursement rates is a true model for future policymaking. The Department of Health and Human Services Office of MaineCare Services has worked closely with stakeholders for nearly a year and the result is a benefit that will truly change lives."

The inclusion of the Adult Dental Benefit in MaineCare reflects the recognition of and commitment to the importance of oral health on overall health by the Administration and the 130th Legislature, said Dr. Norma Desjardins, President of the Maine Dental Association and Executive Director of St. Apollonia Dental Clinic. The Maine Dental Association has been at the table working in partnership with the Maine Department of Health and Human Services Office of MaineCare Services and other stakeholders to work towards the long-term success of this essential benefit and the best oral health for the people of the State of Maine. We look forward to our continued collaboration to help address some of the logistical challenges patients and providers may experience in the coming weeks and months, as dental offices, like many health care offices and facilities across the state, continue to experience staffing shortages as a result of the pandemic.

The design of the new dental benefit is the product of collaboration involving the Department, dental providers, dental advocates and other oral health leaders. Between August 2021 and May 2022, the Department engaged stakeholders and the MaineCare Advisory Committee, convening 11 working sessions to work through the details of the new coverage. The Department also hosted two broad stakeholder forums to gather input from the larger dental community and the public.

As a result of this process, the Department is adopting an emergency rule that includes the expanded benefit and new dental reimbursement rates that goes into effect July 1. The Department will propose a permanent rule in July.

The Department will continue working with stakeholders over the summer and beyond on outreach to dental providers statewide to advise them of these improvements and opportunities to serve lower-income Maine people.

The Mills Administration has taken action to strengthen Maines health care workforce, including dental care providers, through a $20 million effort in the Governors Jobs Plan, which she first announced in October 2021. This includes an initiative offered through the Finance Authority of Maine (FAME) to provide student loan repayment assistance to health care professionals in medicine, dentistry, behavioral health, and nursing education. Under the initiatives programs, health care professionals can apply for up to $75,000 in relief for qualifying student loan debt while nursing educators can receive up to $40,000. To be eligible, nursing educators or health care professionals must be working in Maine or must commit to working in Maine for at least three years.

Healthcare Training for ME, another initiative of her Jobs Plan, expands availability of free and low-cost career training to help health care workers advance their careers, support workforce training needs of healthcare employers, and attract new workers to fast-growing fields. Through the Healthcare Training for ME website, individuals and employers can connect with training from employers and education partners, such as adult education programs, community colleges, and the university system. Individuals and employers may then apply to receive tuition assistance to enroll in training programs, or offer training to their employees, at little or no cost.

MaineCare members interested in learning more about the new comprehensive dental benefit may call Member Services at 1-800-977-6740 or 711.