Includes implants, replacement dental prosthetic appliances, crowns and root canals as medically necessary dental care and services for coverage under the Medicaid program if a qualified dentist authorizes the procedures.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1931
SPONSOR: Paulin 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:
Amended January 2024 to include crowns, certain replacements and more
precise language about posterior and anterior teeth., ordered to third
reading rules cal. 453/S7667A, passed senate
FISCAL IMPLICATIONS:
No additional costs.
EFFECTIVE DATE:
This act shall shall take effect on the ninetieth day after it shall
have become law.
STATE OF NEW YORK
________________________________________________________________________
1931
2025-2026 Regular Sessions
IN ASSEMBLY
January 14, 2025
___________
Introduced by M. of A. PAULIN, SAYEGH, WOERNER -- read once and referred
to the Committee on Health
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
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 2 of section 365-a of the social services law
2 is amended by adding a new paragraph (f-1) to read as follows:
3 (f-1) including but not limited to dental implants, implant-related
4 services, dental prosthetic appliances, replacement dental prosthetic
5 appliances, crowns and root canals for posterior and anterior teeth,
6 crown lengthening when associated with a covered crown and/or root canal
7 if a qualified dentist authorizes the procedures;
8 § 2. This act shall take effect on the ninetieth day after it shall
9 have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05284-01-5
