Maine law would require insurers to cover hygienists

Dental hygienists are already allowed to practice independently in the state of Maine, and now a new law could ensure them reimbursement from insurance companies.

A bill passed by the Maine Senate's Insurance and Financial Services Committee this week would require dental and health insurers in the state to cover procedures performed by independent practice dental hygienists (IPDHs).

Maine has real problems with access to care, especially in rural areas, Rep. Pat Jones (D-Mount Vernon), the bill's sponsor and a former hygienist, told DrBicuspid.com. The primary aim of the bill is to improve access to care, she added.

In April 2008, Maine passed a bill that established a new license option for dental hygienists, enabling them to set up their own practices without a dentist's supervision. After meeting licensing requirements, these IPDHs can perform specified procedures on their own but are required to refer patients in need of additional care to a dentist.

The IPDHs are licensed through the Maine Board of Dental Examiners and can provide independent dental hygiene services such as cleanings, sealants, fluoride treatments, oral health assessments, nutrition and tobacco cessation counseling, and referrals.

This latest bill, LD 234, "An Act to Expand Access to Oral Health Care," passed in the Senate committee almost unanimously with just one vote against it, according to Jones.

"An insurer that issues group dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist ... when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist," the bill states.

Jones is confident that the bill will be signed into law.

"We passed the law to create IPDHs last year, and now we need to get insurance to cover them," she said. "This legislation will enhance the function of the IPDHs and be of great assistance to families who don't have access to care."

Earlier this year, the Maine Legislature's Health and Human Services Committee unanimously approved a bill sponsored by Jones that would admit IPDHs into the state's MaineCare insurance program.

"Being able to accept MaineCare and private insurance not only promotes better access to basic dental care, but it lends credibility to these practitioners," Jones stated in a press release issued at the time. "Most people would be concerned about the quality of care at a dentist or a medical practitioner if they learned that the professional they were seeing couldn't accept insurance or MaineCare."

Maine is the second state, following Colorado, to allow dental hygienists to set up independent practices, Jones said. Colorado already has laws in place that require insurance companies to cover these practitioners.

The bill was submitted by the Maine Dental Hygienists' Association (MDHA).

"It will be a step toward helping access to oral health care in Maine," said Catherine Kasprak, R.D.H., president of the MDHA, in an e-mail interview with DrBicuspid.com. She added that it will also encourage more hygienists to become an IPDH.

Pending passage in the legislature, "An Act to Expand Access to Oral Health Care" will go into effect January 1, 2010.

The Maine Dental Association has not taken a position on this legislation.

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