PRINTER'S NO. 2946
No. 2312 Session of 1978
INTRODUCED BY DOMBROWSKI, MUSTO, BELLOMINI, WANSACZ, WARGO,
ZITTERMAN, PETRARCA, SHUPNIK AND D. S. HAYES, APRIL 5, 1978
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, APRIL 5, 1978
AN ACT
1 Concerning a dental care program for persons receiving old age
2 pension public assistance, and making an appropriation.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the "Dental Care
7 Act."
8 Section 2. Legislative declaration.
9 (a) It is the purpose of this act to promote the public
10 health and welfare of the people of Pennsylvania by providing an
11 alternative to the present medicaid system which will furnish
12 necessary dental appliances and services to individuals whose
13 income and resources are insufficient to meet the costs of such
14 appliances and services, thereby enabling individuals and
15 families to attain or retain their capabilities for independence
16 and self care.
17 (b) The objectives of this act shall be implemented through
18 various executive departments, agencies, and political
1 subdivisions of the Commonwealth in cooperation with private
2 individuals and organizations.
3 Section 3. Definition.
4 As used in this act, "department" means the Department of
5 Health.
6 Section 4. Dental program; vendor payments; eligibility.
7 (a) The department shall administer a program of dental
8 assistance to provide dentures, denture maintenance, and mouth
9 preparation through vendor payments for persons eligible for
10 property tax and rent rebate assistance. The department shall
11 promulgate necessary rules and regulations for the
12 implementation of such program and may enter into contracts with
13 dental laboratories in order to purchase dentures in volume at a
14 lower cost.
15 (b) The department shall administer the program through the
16 issuance of vendor payments to dentists and shall establish a
17 central registry of dentists participating in the program.
18 (c) Any dentist who participates in the program established
19 in this act by providing services or appliances to any person
20 presenting the appropriate certification is eligible for vendor
21 payments.
22 Section 5. Copayment schedule; committee; eligibility; maximum
23 payments.
24 (a) A State and recipient copayment schedule, with a maximum
25 State contribution of 80%, shall be established. The recipient's
26 share of the copayment shall be based on a fee schedule
27 established by a dental subcommittee of the are agency on aging
28 located in each of the planning and management regions of this
29 State. Each subcommittee shall consist of seven members
30 appointed by the Governor, the composition of which shall be
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1 three dentists, two consumers, and two at-large members, neither
2 of whom shall be a dentist. All terms of service shall be at the
3 pleasure of the Governor. The subcommittee's duties shall be
4 established by the department by rule and shall include among
5 other duties: accepting and approving applications; providing
6 referrals to dentists; following up on vendor payments; and
7 establishing a list of public and private dental resources in
8 the county.
9 (b) Persons eligible for dental appliances and services
10 under this act may apply for such to the appropriate
11 subcommittee. The subcommittee shall contact the department to
12 determine eligibility of the applicant for the program and, upon
13 receiving certification therefor, shall approve such
14 application.
15 (c) The maximum fee for dental services shall be as follows:
16 (1) Full dentures, upper and lower, including
17 adjustments........................................... $350
18 (2) Single or partial dentures, including
19 adjustments........................................... 175
20 (3) Repair of fractured dentures.................. 15
21 (4) Replacement or repair of one broken tooth..... 15
22 and for each additional tooth................. 5
23 (5) Addition of a tooth to a partial denture to
24 replace a natural tooth............................... 25
25 and for each additional tooth................. 10
26 (6) Replacement of clasp, clasp intact............ 25
27 (7) Replacement of clasp, new clasp............... 35
28 (8) Relinement of dentures........................ 45
29 (9) Removal of permanent tooth.................... 8
30 (10) Surgical removal............................. 15
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1 Section 6. Operation period of program; review.
2 Claims by dentists for vendor payments under this act will be
3 accepted for dental services rendered between January 1, 1978
4 and December 31, 1978. Claims may not be accepted by the
5 department for services rendered before or after said dates.
6 Section 7. Records; complaints.
7 (a) The department shall be responsible for keeping records
8 on dental appliances and services provided under this act.
9 (b) The department shall designate a major association of
10 dentists in this Commonwealth, willing to do so, for the
11 receiving and processing of complaints of persons applying for
12 or receiving dental appliances or services under the provisions
13 of this act.
14 (c) Each dental subcommittee of the area agencies on the
15 aging shall submit a report to the department no later than
16 April 30, 1979, on the dental program functions administered by
17 it under the provisions of this act.
18 Section 8. Appropriation.
19 The sum of $2,000,000, or so much thereof as may be
20 necessary, is hereby appropriated to the Department of Health
21 from the State Lottery Fund, for the payment of dental
22 assistance provided by this act.
23 Section 9. Effective date.
24 This act shall take effect in 60 days.
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