Gov. Andy Beshear has again proposed regulations to expand dental, vision and hearing Medicaid benefits for Kentucky adults, after the legislature ended the expansion by finding earlier regulations deficient.

Each new regulation says why it is “substantially different” from the one rejected by the legislature. Most of the reasons have to do with changes in the services offered under the original and new regulations. This language was necessary because the bill that quashed Beshear’s expansion of dental, vision and hearing services for Medicaid adults requires any new regulation to be “substantially different.”

The bill had an emergency clause, so it became law as soon as the legislature overrode Beshear’s veto. But it also told the Medicaid program to reimburse health-care providers “for services rendered or initiated prior to the effective date of this act,” which was March 29.

The proposal is open for public comment through the end of May.

Each of the new regulations addressing expanded dental, vision and hearing services for adults covered by Medicaid starts by giving reasons they are needed, including concern that failure to implement these services, which have gained federal approval, could result in the loss of federal funds.

They say the regulations are needed to pay providers for these services, and as a way to ensure that appropriate services are being offered in appropriate settings, instead of emergency rooms.

Stewart also noted that it is especially important for people to get dental care from an appropriate provider because dental pain in the emergency room is a gateway “to addiction to pain medication.”

“Offering better and more comprehensive dental services is a way to stop that,” Stewart said. “So literally, it’s a way to save lives and save suffering.”

The regulations say these services will help more than 900,000 Medicaid recipients in Kentucky who are 21 and older return to the workplace.

The governor’s veto of Senate Bill 65 said that in its first two months the dental expansion had served “more than 1,000 Kentuckians in all 120 counties” with “nearly 3,330 dental services, including from a dentist in Clay County, who . . . has provided four sets of dentures for patients and has 44 more sets of dentures in progress.” Clay County is the home of Senate President Robert Stivers, R-Manchester.

Beshear added, “Nearly 7,000 Kentuckians have received vision services under these regulations, with nearly 43,000 services provided. And 40 Kentuckians have received hearing services with these regulations in place.”

Stewart said that having access to dentures and hearing aids will make the biggest difference because many of the managed care organizations already offer glasses as an extra benefit, but not the others. As an example, she noted that many domestic-violence survivors and crime victims have lost teeth and need access to dentures.

“And that really affected their recovery and their ability to feel great about themselves,” she said. “And also, every time they open their mouths to smile, they have memories of being abused. . . . There are so many populations for where this is a really big deal.”

The cabinet had not responded to a request for comment last week when this story was first reported. Nor had state Sen. Stephen West, R-Paris, the sponsor of Senate Bill 65.

This story is republished from Kentucky Health News.