AUGUSTA, Maine — Three bills now before the Legislature aim to expand access to dental care provided by dental hygienists who work without the oversight of a dentist.
Last year, lawmakers approved the licensing of independent-practice hygienists, as they are called. Maine is now the second state, after Colorado, to allow qualified hygienists to practice without the supervision of a dentist. There are now only about 15 hygienists licensed to practice independently, and only a handful actually doing so, according to the Maine Association of Dental Hygienists.
This week, lawmakers on the Legislature’s Health and Human Services Committee gave approval to a bill that would allow independent hygienists to bill MaineCare, the state’s Medicaid program for low-income and disabled people. With the committee’s “ought-to-pass” endorsement, that measure is expected to be aired in the House of Representatives next week.
The state Department of Health and Human Services, which administers the MaineCare program, is neither supporting nor opposing the measure.
A department spokeswoman said Friday that policymakers endorse the goal of increasing access to dental care. But the bill would cost the state an estimated $192,000 a year for each of the next two years, she said — money not included in Gov. John Baldacci’s bare-bones biennial budget now under scrutiny in the Legislature.
Similar legislation pending before the Insurance and Financial Services Committee would require private dental insurance companies that do business in Maine to reimburse independent hygienists. An estimated 450,000 Mainers have private dental coverage, said Kathleen Walker, a spokeswoman for Northeast Delta Dental. The company is the largest provider of private dental insurance in the nation and covers about 173,000 Mainers, she said. Northeast Delta Dental has not taken a position on the legislation.
Cathy Kasprak, president of the Maine Association of Dental Hygienists, said the issue of direct reimbursement is “very important” to independent practitioners.
“You can only work on a volunteer basis for so long,” she said. “Eventually, you have to pay the bills.”
A third bill, headed for the Business, Research and Economic Development Committee, would pave the way for hygienists to own and operate X-ray equipment. The Maine Dental Association, which has remained neutral on the issue of billing MaineCare and private insurance, opposes the X-ray measure.
“Hygienists are not trained to read X-rays; this crosses the line into diagnosis,” said dental association executive director Frances Miliano.
All three measures are sponsored by Rep. Pat Jones, D-Mount Vernon, a former dental hygienist who serves on the Health and Human Services Committee.
Dental hygienists are licensed to provide cleanings, sealants, fluoride treatments, education and referrals under the supervision of a licensed dentist. In order to practice independently under the law passed last year, they must demonstrate an advanced level of combined education and work experience.