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NM
center on
law and poverty |
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Comments on Dental Services
May 11, 2004
Pamela Hyde, Secretary, JD Human Services Department P.O. Box 2348 Santa Fe, NM 87504
Re: Comments to Proposed Regulations contained in Human Services Register Vol. 27, 13
SENT VIA FACSIMILE AND US MAIL
Dear Secretary Hyde:
The New Mexico Center on Law and Poverty submits the following comments to the Human Services Department’s proposed regulatory changes regarding the provision of dental services. In general, The Center on Law and Poverty supports the proposed changes. The Human Services decision to eliminate the placement of sealants for premolar teeth is understandable, given the low evidence of decay in these particular teeth. We were also pleased to see that the Department has increased the number of denture adjustments a person can receive from one to two a year which is consistent with the standard of care in the dental community. However, we do have some comments specific regulatory changes.
We recommend that the Department cover prophylaxis treatment for adults every six months. The Department currently covers one prophylaxis treatment a year for adults even though the standard of care in the dental community is to perform these treatments every six months. See 8.310.7.12(B)(1) Given that the Medicaid rules do not meet the current standard of care, it is questionable whether they are “sufficient in amount, duration, and scope to reasonably achieve their purpose” as required by federal law. See 42 CFR 440.230(b) ; Mitchell v. Johnson, 701 F.2d 337 (1983). Only having prophylaxis treatment available every year will adversely impact people who have mental retardation or who are developmentally delayed. These individuals often do not have the capacity needed to perform adequate oral hygiene. In addition limiting necessary services to once a year may not be cost effective. There is a correlation between poor oral hygiene and increased cardiovascular disease, which is more difficult and costly to treat.
We are also concerned by the Department’s proposal to eliminate general anesthesia, intravenous sedation, and nitrous oxide for all individuals older than twenty-one. See 8.310.7.12(K) This will negatively impact individuals with developmental disabilities and mentally retardation who because of their level of functionality are unable to receive services unless they are sedated. The Center on Law and Poverty recommends that the state cover general anesthesia, intravenous sedation and nitrous oxide for all individuals. In the alternative, we recommend that the Department continuing to provide these services to adults over the age of twenty-one.
Thank you for your time and consideration of these issues. If you have questions regarding any of our proposed changes, please do not hesitate to contact me at 255-2840.
Sincerely, Staff Attorney |