MedicaidPrior AuthMedium impact
Dental Bulletin 54: Waiving Dental Prior Authorization for Enrollees Transitioning to Fee-for-Service
MassHealth·MA · Dentistry·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
MassHealth is waiving all dental prior authorization requirements from January 1, 2026 through March 31, 2026 for Senior Care Options (SCO) members transitioning to Fee-for-Service due to new Medicare eligibility requirements. Providers can bill DentaQuest without prior authorization during this period but must maintain all documentation for potential audits.
Action Required
By January 1, 2026: Dental billing staff must identify SCO members transitioning to MassHealth FFS and submit claims to DentaQuest without prior authorization through March 31, 2026. Continue documenting medical necessity and retain all PA documentation for audits. Before February 2026 TPA transition, call BeneCare at (844) MH-DENTL to confirm member transition status. After March 31, 2026, resume normal PA requirements for these members.