Expansion of Medicaid Dental Benefit

In August, 2018, The Legal Aid Society and Willkie Farr & Gallagher filed Ciaramella v. Zucker (18-cv-06945) to challenge the New York State Department of Health’s rules preventing Medicaid coverage for replacement dentures within 8 years from initial placement and the ban on Medicaid coverage for dental implants.  In response, DOH implemented changes to the dental manual to cover dental implants when medically necessary and to change the rules for replacement dentures. These changes, described here went into effect on November 12, 2018.

The case was amended to include a challenge the revised rules for Medicaid coverage for dental implants, replacement dentures and to add a challenge to Medicaid coverage rules for root canal and crowns.

On May 1, 2023, a motion for preliminary approval for a settlement agreement was filed. This Know Your Rights document provides basic information about the settlement.