Proposed Rulemaking Hearing for Chapter 182-535 Dental-Related Services

Dental Medicaid

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Proposed Rulemaking Hearing for Chapter 182-535 Dental-Related Services

HCA will hold a public rulemaking hearing for Chapter 182-535 Dental-related services on June 8 at 10:00 AM.
HCA will hold a public rulemaking hearing for Chapter 182-535 Dental-related services on June 8 at 10:00 AM.

There are several alterations in the proposed rules, including added definitions for alveoloplasty, mobile anesthesiologist, and resin-based composite restorations. The rule clarifies that tobacco cessation is not reimbursable for dental providers, glass ionomer cements are now considered a suitable material to be used as sealants, coverage of replacement restorations that are cracked or broken between 6 and 24 months of original placement (with prior authorization) is allowed, and coverage for prefabricated stainless-steel crowns for permanent posterior teeth (excluding 1, 16, 17 and 32) in lieu of a restoration requiring three or more surfaces is no longer restricted to clients age 21 and younger. Additional modifications include a requirement for the prior authorization for replacement dentures with evidence of medical necessity, among other clarifying amendments.

Please RSVP for the rulemaking hearing here.

Hearing Registration

Medicaid Transition to Managed Care Cancelled

The 2019 Legislature has directed the Washington State Health Care Authority (HCA) to continue to administer the dental Medicaid program through fee-for-service. The HCA may not proceed with a carved-out or carved-in managed care dental option at this time.

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Questions? Please email info@wsda.org.
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