(a) As used in this section:(1) “Healthcare provider” means:(A) An oral and maxillofacial surgeon;(B) A dentist;(C) A dental specialist such as an endodontist, orthodontist, periodontist, or prosthodontist;(D) An anesthesiologist or other anesthesia provider;(E) A pediatric dentist; or(F) Support staff for an oral and maxillofacial surgeon, dentist, specialty dentist, pediatric dentist, or anesthesiologist or other anesthesia provider;(2) “High complexity oral health care” means any oral health care that is complicated due to:(A) A craniofacial condition as diagnosed by a plastic surgeon, oral and maxillofacial surgeon, otolaryngologist, or geneticist who is a member of a nationally approved cleft-craniofacial team of the American Cleft Palate-Craniofacial Association and has evaluated the patient; or(B) An intellectual or developmental disability; and(3) “Intellectual or developmental disability” means the same as defined in § 20-48-202.
(1) “Healthcare provider” means:(A) An oral and maxillofacial surgeon;(B) A dentist;(C) A dental specialist such as an endodontist, orthodontist, periodontist, or prosthodontist;(D) An anesthesiologist or other anesthesia provider;(E) A pediatric dentist; or(F) Support staff for an oral and maxillofacial surgeon, dentist, specialty dentist, pediatric dentist, or anesthesiologist or other anesthesia provider;
(A) An oral and maxillofacial surgeon;
(B) A dentist;
(C) A dental specialist such as an endodontist, orthodontist, periodontist, or prosthodontist;
(D) An anesthesiologist or other anesthesia provider;
(E) A pediatric dentist; or
(F) Support staff for an oral and maxillofacial surgeon, dentist, specialty dentist, pediatric dentist, or anesthesiologist or other anesthesia provider;
(2) “High complexity oral health care” means any oral health care that is complicated due to:(A) A craniofacial condition as diagnosed by a plastic surgeon, oral and maxillofacial surgeon, otolaryngologist, or geneticist who is a member of a nationally approved cleft-craniofacial team of the American Cleft Palate-Craniofacial Association and has evaluated the patient; or(B) An intellectual or developmental disability; and
(A) A craniofacial condition as diagnosed by a plastic surgeon, oral and maxillofacial surgeon, otolaryngologist, or geneticist who is a member of a nationally approved cleft-craniofacial team of the American Cleft Palate-Craniofacial Association and has evaluated the patient; or
(B) An intellectual or developmental disability; and
(3) “Intellectual or developmental disability” means the same as defined in § 20-48-202.
(b) (1) The Arkansas Medicaid Program shall reimburse the dental schools who are accredited by the Commission on Dental Accreditation and academic medical centers for dental and anesthesia costs not to exceed three thousand seven hundred fifty dollars ($3,750) per episode of care for individuals with high complexity oral health care who are eighteen (18) years of age or older and who require sedation dentistry with an annual cap per individual of five thousand dollars ($5,000).(2) The dental and anesthesia costs under subdivision (b)(1) of this section:(A) Shall only be reflective of professional fees and supply costs; and(B) Shall not include discounts or rebates received by the dental schools who are accredited by the Commission on Dental Accreditation and academic medical centers.(3) The dental and anesthesia costs under subdivision (b)(1) of this section that exceed the annual cap of five thousand dollars ($5,000) may be approved by the Department of Human Services through a request for an extension of benefits.
(1) The Arkansas Medicaid Program shall reimburse the dental schools who are accredited by the Commission on Dental Accreditation and academic medical centers for dental and anesthesia costs not to exceed three thousand seven hundred fifty dollars ($3,750) per episode of care for individuals with high complexity oral health care who are eighteen (18) years of age or older and who require sedation dentistry with an annual cap per individual of five thousand dollars ($5,000).
(2) The dental and anesthesia costs under subdivision (b)(1) of this section:(A) Shall only be reflective of professional fees and supply costs; and(B) Shall not include discounts or rebates received by the dental schools who are accredited by the Commission on Dental Accreditation and academic medical centers.
(A) Shall only be reflective of professional fees and supply costs; and
(B) Shall not include discounts or rebates received by the dental schools who are accredited by the Commission on Dental Accreditation and academic medical centers.
(3) The dental and anesthesia costs under subdivision (b)(1) of this section that exceed the annual cap of five thousand dollars ($5,000) may be approved by the Department of Human Services through a request for an extension of benefits.
(c) The department shall apply for any federal waiver, Medicaid state plan amendment, or other authorization necessary to implement this section.