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DEPARTMENT OF HEALTH CARE FINANCE
NOTICE OF FINAL RULEMAKING
The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code §1-307.02 (2006 Repl.; & 2012 Supp.)), and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code §7-771.05(6) (2008 Supp.)), hereby gives notice of the adoption, of an amendment to Section 964 (Dental Services) of Chapter 9 (Medicaid Program) of Title 29 of the District of Columbia Municipal Regulations (DCMR).
DHCF currently reimburses costs associated with 149 dental procedure codes. These rules will authorize DHCF, effective January 1, 2013, to: (1) discontinue reimbursement for services related to six (6) dental procedure codes for non-institutionalized adults, mainly due to the fact that these codes are more appropriate for children than for adults; (2) reduce reimbursement for services related to approximately one hundred and twenty six (126) dental procedure codes for non-institutionalized adults; and (3) add twenty-two (22) dental procedure codes to all dental fee schedules and two (2) additional codes to the EPSDT dental fee schedule for beneficiaries under twenty-one (21) years of age. There are no reductions in the reimbursement related to dental procedure codes for children, beneficiaries enrolled in the Waiver for Individuals with Intellectual and Developmental Disabilities, and beneficiaries residing in Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities. The District will realize savings of approximately 1.8 million dollars as a result of these changes.
A notice of emergency and proposed rulemaking was published in the D.C. Register on January 18, 2013 (60 DCR 000432). No comments were received and no substantive changes have been made. This final rulemaking was adopted on April 18, 2013 and will become effective on the date of publication of this notice in the DC Register.
Section 964.10 (DENTAL SERVICES) of Chapter 9 (MEDICAID PROGRAM) of Title 29 (PUBLIC WELFARE) of the DCMR is deleted in its entirety and amended to read as follows:
964.10 Effective for services rendered on or after January 1, 2013, reimbursement for dental procedure codes for non-institutionalized adults shall be reduced. Reimbursement for dental services shall be made according to the District of Columbia Medicaid fee schedule available online at http://www.dc-medicaid.com and shall cover all services related to the procedure.
