STATE OF NEW YORK
________________________________________________________________________
3487
2011-2012 Regular Sessions
IN ASSEMBLY
January 25, 2011
___________
Introduced by M. of A. WRIGHT -- read once and referred to the Committee
on Social Services
AN ACT to amend the social services law, in relation to limiting the
method of payment for dental services under the medical assistance
program; and providing for the repeal of such provisions upon expira-
tion thereof
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The social services law is amended by adding a new section
2 365-l to read as follows:
3 § 365-l. Payments for dental services. Payments for all dental
4 services authorized pursuant to subdivision two of section three hundred
5 sixty-five-a of this title shall not be included in the capitation
6 payment for services or supplies provided to medical assistance recipi-
7 ents by a health maintenance organization or other entity which is
8 certified under article forty-four of the public health law or licensed
9 pursuant to article forty-three of the insurance law or otherwise
10 authorized by law to offer comprehensive health services plans to
11 medical assistance recipients.
12 § 2. Section 367-a of the social services law is amended by adding a
13 new subdivision 13 to read as follows:
14 13. Notwithstanding any inconsistent provision of law or regulation to
15 the contrary, for all dental services for which payment is authorized
16 pursuant to subdivision two of section three hundred sixty-five-a of
17 this title, payments under this title shall be made at the following
18 amount: for all dental services provided by dentists and other author-
19 ized dental practitioners under title VIII of the education law and for
20 all dental appliances, the actual cost of such dental services and
21 dental appliances subject to the maximum limit established by the
22 department of health for those dental services and dental appliances
23 covered under the medical assistance program.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06946-01-1
A. 3487 2
1 § 3. The social services law is amended by adding a new section 369-a
2 to read as follows:
3 § 369-a. Analysis of dental expenditures and patterns in relation to
4 the medical assistance program. 1. The department of health shall
5 analyze and compare expenditures, utilization rates and utilization
6 patterns for all dental services and dental appliances (along with any
7 related effects on expenditures, rates and patterns for other services)
8 for medical assistance recipients:
9 (a) for the period during which medical assistance reimbursement for
10 such dental services and dental appliances was provided prior to the
11 effective date of this section; and
12 (b) for the period beginning with the date on which medical assistance
13 reimbursement for such dental services and dental appliances was
14 provided after the effective date of this section.
15 2. The department of health shall include in its analyses and compar-
16 isons, the expenditures, utilization rates and utilization patterns for
17 all dental services and dental appliances (along with any related
18 effects on expenditures, rates and patterns for other services) paid for
19 by private third-party payors.
20 3. The department of health shall report its findings to the governor,
21 the temporary president of the senate and the speaker of the assembly by
22 December thirty-first, two thousand twelve.
23 § 4. This act shall take effect on the one hundred twentieth day after
24 it shall have become a law, and shall expire and be deemed repealed
25 March 31, 2014.
