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1995 SESSION

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LD6791384
HOUSE JOINT RESOLUTION NO. 476 Offered January 18, 1995 Requesting the Secretary of Health and Human Resources to study Medicaid eligibility for orthodontic care. ---------- Patrons--Nixon, Baker, Cox, Crouch, Hamilton and Orrock; Senator: Martin ---------- Referred to Committee on Rules ----------

WHEREAS, the Commonwealth of Virginia spent $1.2 million on Medicaid payments for orthodontic care in fiscal year 1993; and

WHEREAS, the Department of Medical Assistance Services establishes policy determining eligibility for such care; and

WHEREAS, the current criteria are based on a rating system developed Dr. J.A. Salzman in 1968; and

WHEREAS, the Salzman index contains factors that are inappropriate, arbitrarily weighted, unreliable and/or are not reproducible; and

WHEREAS, the Salzman index is wholly quantitative, thereby excluding consideration of important qualitative factors normally associated with orthodontic care; and

WHEREAS, use of the Salzman index results in the denial of eligibility to persons with severe functional orthodontic needs, but approval for persons with mostly cosmetic needs; and

WHEREAS, it should be the objective of the Commonwealth to implement the most equitable and efficient system of eligibility possible; now, therefore, be it

RESOLVED by the House of Delegates, the Senate concurring, That the Secretary of Health and Human Resources be requested to study and implement appropriate administrative actions required to alter the Commonwealth’s current policy of Medicaid eligibility for orthodontic care to include quantitative and qualitative criteria and that such criteria be heavily weighted toward functional need. Any altered policy shall require that evaluations be provided by private sector Doctors of Dentistry who agree not to accept Medicaid patients for orthodontic care; and, be it

RESOLVED FURTHER, That the Secretary of Health and Human Resources report her findings and actions to the 1996 Session of the General Assembly by December 1, 1995, as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.