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Arkansas General Assembly· HB 1241Notification that HB1241 is now Act 568

An act TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM 10 REIMBURSES FOR DENTAL AND ANESTHESIA COSTS FOR HIGH 11 COMPLEXITY ORAL HEALTH CARE, the official text

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1 State of Arkansas      As Engrossed: H2/10/25 H3/19/25
2 95th General Assembly
                                  A Bill

3 Regular Session, 2025                                        HOUSE BILL 1241

4

5 By: Representatives J. Mayberry, L. Johnson

6 By: Senator Irvin

7

8                        For An Act To Be Entitled

9   AN ACT TO ENSURE THAT THE ARKANSAS MEDICAID PROGRAM

10  REIMBURSES FOR DENTAL AND ANESTHESIA COSTS FOR HIGH

11  COMPLEXITY ORAL HEALTH CARE; AND FOR OTHER PURPOSES.

12

13

14                                             Subtitle

15                       TO ENSURE THAT THE ARKANSAS MEDICAID

16                       PROGRAM REIMBURSES FOR DENTAL AND

17                       ANESTHESIA COSTS FOR HIGH COMPLEXITY

18                       ORAL HEALTH CARE.

19

20 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

21

22  SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 1, is

23 amended to add an additional section to read as follows:

24  20-77-154. High complexity oral health care -- Reimbursement --

25 Definitions.

26  (a) As used in this section:

27  (1) "Healthcare provider" means:

28                       (A) An oral maxillofacial surgeon;

29                       (B) A dentist;

30                       (C) A dental specialist such as a endodontist,

31 orthodontist, periodontist, or prosthodontist;

32                       (D) An anesthesiologist or other anesthesia provider;

33                       (E) A pediatric dentist; or

34                       (F) Support staff for an oral maxillofacial surgeon,

35 dentist, specialty dentist, pediatric dentist, or anesthesiologist, or other

36 anesthesia provider;

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    As Engrossed: H2/10/25 H3/19/25                                         HB1241

1   (2) "High complexity oral health care" means any oral health

2 care that is complicated due to:

3                     (A) A craniofacial condition as diagnosed by a plastic

4 surgeon, oral and maxillofacial surgeon, otolaryngologist, or geneticist who

5 is a member of a nationally approved cleft-craniofacial team of the American

6 Cleft Palate-Craniofacial Association and has evaluated the patient; or

7                     (B) An intellectual or developmental disability; and

8   (3) "Intellectual or developmental disability" means the same as

9 defined in � 20-48-202.

10  (b)(1) The Arkansas Medicaid Program shall reimburse the dental

11 schools who are accredited by the Commission on Dental Accreditation and

12 academic medical centers for dental and anesthesia costs not to exceed three

13 thousand seven hundred fifty dollars ($3,750) per episode of care for

14 individuals with high complexity oral health care who are eighteen (18) years

15 of age or older and who require sedation dentistry with an annual cap per

16 individual of five thousand dollars ($5,000).

17  (2) The dental and anesthesia costs under subdivision (b)(1) of

18 this section:

19                    (A) Shall only be reflective of professional fees and

20 supply costs; and

21                    (B) Shall not include discounts or rebates received by the

22 dental schools who are accredited by the Commission on Dental Accreditation

23 and academic medical centers.

24  (3) The dental and anesthesia costs under subdivision (b)(1) of

25 this section that exceed the annual cap of five thousand dollars ($5,000) may

26 be approved by the Department of Human Services through a request for an

27 extension of benefits.

28  (c) The department shall apply for any federal waiver, Medicaid state

29 plan amendment, or other authorization necessary to implement this section.

30

31                                /s/J. Mayberry

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