HOUSE DOCKET, NO. 611        FILED ON: 1/13/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1032

The Commonwealth of Massachusetts

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PRESENTED BY:

John W. Scibak

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to cost reduction in the Medicaid program by improving early childhood oral health.

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PETITION OF:

HOUSE DOCKET, NO. 611        FILED ON: 1/13/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1032

The Commonwealth of Massachusetts

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In the One Hundred and Eighty-Ninth General Court
(2015-2016)

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An Act relative to cost reduction in the Medicaid program by improving early childhood oral health.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

Section 1.  The Executive Office of Health and Human Services (EOHHS or Executive Office) shall design a pilot program for the enhanced management of early childhood caries among MassHealth patients.   EOHHS shall consult with the researchers involved in the Early Childhood Caries (ECC) Management Demonstration Project at Boston Children’s Hospital, Holyoke Health Center and other sites, where feasible, on the criteria by which providers should identify high risk of early childhood caries in patients under the age of five.   EOHHS shall also consult those researchers on the types and amount of treatment that should be billable to the MassHealth program for effective management of the disease in those patients.  These shall include, but not be limited to: more frequent preventive visits and fluoride treatments, as well as family education and training in self-management, as established by the researchers in the ECC Management Demonstration Program in their early childhood caries disease management protocol. 

              The Executive Office shall release a request for proposals with these design criteria no later than February 1, 2016 and select provider participants no later than April 1, 2016, for a start date no later than July 1, 2016.  EOHHS shall widely publicize the request for proposals in the provider community, including but not limited to its mention in a bulletin to all childhood dental and pediatric primary care providers.  Eligible entities shall include primary care providers co-located in the same facility with oral health providers who see the same patients. To the extent feasible, EOHHS shall select providers in both rural and urban areas in a wide geographic distribution across the Commonwealth.

              The selected providers must agree to submit their results relative to costs, the incidence of cavities before and after use of the new protocol, the experience of pain before and after and the number of referrals for operating room procedures.  The Executive Office shall release a report of those results to the Joint Committee on Health Care Financing and the House and Senate Committees on Ways and Means by February 1, 2019.