Or. Admin. R. 410-123-1510 - [Effective9/27/2022]Additional Dental Care Benefits for Pregnant Individuals

Current through Register Vol. 61, No. 4, April 1, 2022

(1) This rule sets forth the access standards for dental care for pregnant individuals who receive Oregon Health Plan (OHP) benefits through the fee-for-service (FFS) delivery system.

(2) Pregnant clients shall be seen, treated in person or via teledentistry for an OHP-covered service within the following time frames:

(a) For emergency dental care: within 24 hours;

(b) For urgent dental care: within one week.

(c) For routine dental care: within four weeks, unless there is a documented special clinical reason that would make access longer than four weeks appropriate;

(d) For initial dental screening or examination: four weeks.

(3) Additional Dental Services are available to pregnant individuals if authorized as medically/Dentally Necessary due to the pregnancy. Additional services include:

(a) Additional prophylaxis, fluoride and periodontal services;

(b) Permanent crowns and resin-based composite crowns for anterior teeth;

(c) Prefabricated post and core;

(d) Root canals on first molars;

(e) Apexification/recalcification, pulpal regeneration;

(f) Alveoplasty not in conjunction with extractions.

(4) Nothing in this rule obligates a pregnant individual who receives dental care through the FFS delivery system to accept an offered appointment.

Notes

Or. Admin. R. 410-123-1510

DMAP 28-2016, f. & cert. ef. 6/28/2016; DMAP 50-2021, amend filed 12/24/2021, effective 1/1/2022; DMAP 13-2022, amend filed 02/09/2022, effective 2/9/2022

Statutory/Other Authority: ORS 413.042 & 414.065

Statutes/Other Implemented: ORS 414.065