[Provider] MaineCare Adopted Rule for Fluoride Topical Varnish by Physicians

[Provider Notification]

ATTENTION:  MaineCare Physician Providers with Subspecialties of General
or Family Practice, Preventative Medicine, Pediatrics and Internal
Medicine

This is notice of an adopted rule for the MaineCare Benefits Manual,
Chapter II, Section 90, Physician Services

 

Concise Summary

The Department has adopted rules to add coverage of application of
fluoride topical varnish by physicians with subspecialties of general or
family practice, preventative medicine, pediatric, or internal medicine
for members under the age of twenty-one (21) who are at high risk for
caries.  Coverage by physicians will increase access to this service
that is already covered when by provided by a dentist.  Research shows
that provision of this preventative service reduces the need for
restorative dental services for children.  The changes for Physician
Services are in Chapter II only of the MaineCare Benefits Manual. 

 

The Department did not adopt the other initiative proposed in this
rulemaking that would have increased reimbursement for procedure codes
to 61.7% of the current Medicare rate (from 53%).  The Department
withdrew this proposal as a result of errors in calculations that would
have inadvertently decreased reimbursement for some specialty
procedures.  The Department will immediately propose a fee increase in a
separate rulemaking that assures that there are no decreases in current
reimbursement rates.   The Department does not anticipate any adverse
impact on small businesses from this rulemaking. 

 

Effective Date

September 1, 2008 

 

Agency Contact Person                 

Patty Dushuttle

 

 

This is a one-way communication.  Please do not respond to this message.

 

 

 

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