MaineCare Dental Advisory Committee Meeting
September 3, 2014
Agenda Item / Discussion / Action/Next StepsWelcome and Introductions / Meeting was called to order around 5:05. All members and guests were invited to introduce themselves
5:10-5:30 / Non-Emergency Transportation (NET) Bev Litchfield initiated the discussion regarding the medical necessity requirement for members to use NET when the provider is outside the radius allowed. Brian Sullivan-manager of the NET explained that the need to prove medical necessity is a federal requirement that Maine had not implemented but needed to in order to be in compliance. Brian reviewed the forms, how they should be completed, and offered additional guidance. MDAC members expressed that they feel that this policy creates additional barriers to treatment. / A suggestion of MaineCare creating a user guide for both members and providers on NET was made. Brian took the suggestion and will work with this team.
Additional discussion was had regarding the nearest provider to refer a member to and Member Services was given as a resource for providers to use as they maintain a regularly updated of MaineCare dental provider and their status in regard to accepting patients.
5:40-6:00 / LD1749 Stakeholder Meeting update Derrick Grant shared the outcome of the first meeting and the plans to deploy and dental provider survey to better assess provider’s understanding of MaineCare’s Dental Policy. Discussion took place regarding the content of Chapter III of Section 25 and how to interpret what services can be provided to adult members. / The dental provider survey outcome will be reviewed and shared with the Stakeholder Group for use in response to the letter from Senator Craven and Representative Farnsworth.
The outcome of the survey may lead to other steps such as provider education and outreach.
6:00-6:30 / Eligibility and last date of service was addressed by Devon Niedner of Molina. She shared that Provider Services has a spreadsheet method where providers can list members to be seen and verify their eligibility as well as the last date of service on codes that have limits. This is still a temporary method as a CR is in place to make this process accessible via the My HealthPAS portal. / Devon will update the group on the status of the CR43281 for the change. Instructions will be forthcoming for providers on the current and future process.
6:30-7:00 / Code discussion regarding the codes for assessment/screening of patient D0190 & D0191 and Risk Assessment D0601, D0602 & D0603 was led by Bev Litchfield. Beth shared that the use of these codes are now being suggested by CMS for states to use in assessment patient needs and tailoring their treatment to it. / Beth will initiate internal MaineCare discussion and consideration of the codes to include policy and coding committee. Updates will be made as available.