Introductory provision
paragraph 1 of this regulation are given supplementary regulations to the
Act (2008:145) on State dental care.
The words and terms used in the regulation has the same
meaning as in the Act.
Eligible dental measures and reference rates
section 2 of the dental and pharmaceutical benefits agency must notify
regulations on
1. What are the dental measures that may be eligible for reimbursement
under the Act (2008:145) on State dental care and under
what conditions may be reimbursed for these measures
(eligible dental care measures), as well as
2. the reference prices for the eligible
Dental operations. Regulation (2008:844).
paragraph 3 of the Dental procedures in which amalgams have been used as the material is
not reimbursable.
General dental premiums
paragraph 4 of the General dental contribution left with 150 kronor a year.
Of the patients who fill the lowest in 20 years and no more than 29 years or
not less than 75 years in the year in which the earliest dental
used, provided grant with 300 dollars a year.
Especially dental premiums
4 a of the Particular Dental grants may be used for payment
by reimbursable preventive dental measures
If the patient
1. is dry mouth due to prolonged drug therapy,
2. is dry mouth due to radiotherapy in ear, nose,
mouth or throat region,
3. have Sjogren's syndrome,
4. have chronic obstructive pulmonary disease and have been prescribed
oxygen therapy or nutritional drink,
5. has cystic fibrosis,
6. have ulcerative colitis,
7. have Crohn's disease,
8. have intestinal weight,
9. have burns on the teeth and anorexia nervosa,
bulimia nervosa or gastroesophageal reflux disease,
10. have svårinställd diabetes,
11. is undergoing dialysis treatment,
12. is immunosupprimerad due to drug therapy,
or
13. have undergone an organ transplant.
Unless there are special reasons, the patient should be accompanied by a certificate
or other evidence that he or she has such
illness or disabilities referred to in the first
paragraph. Regulation (2011:1184).
4 b of the Special dental contribution is left with a maximum of 600 USD per
half of the year. Regulation (2011:1184).
4 c § the National Board may announce further provisions
If
1. the diseases and disabilities that are specified in section 4 (a)
first subparagraph, and
2. the supporting documents referred to in paragraph 4 (a).
Regulation (2011:1184).
Subscription dentistry
4 d section a contract for the subscription dentistry pursuant to Chapter 2. section 2 of the Act
(2008:145) on State dental care need not include
dental care as a result of occupational injury or accident.
Regulation (2012:784).
Dental health care
paragraph 5 of the dental and pharmaceutical benefits agency must notify
regulations on
1. the amount of the patient's total dental care costs
under a compensation period shall exceed to
dental health care to be provided, as well as
2. what proportion of the total costs
excess of the amount provided for in paragraph 1 that dental reimbursement shall
left. Regulation (2008:844).
section 6, if the prosthetic treatment needs to be done and the new
treatment
1. in accordance with the regulations adopted pursuant to section 2 of 1 is not
eligible, and
2. performed by another health care provider than the one that carried out the
treatment needs to be done if,
get insurance agency pay compensation to caregivers who
Repeat the treatment with an amount equal to the amount
may be demanded back or deducted from a different claim under
Chapter 4. the second subparagraph of paragraph 3 of law (2008:145) on State
dental care.
The remuneration referred to in the first subparagraph may not, however, exceed the
the lowest of the following amounts:
-healthcare provider's price for making the treatment for it
current patient, and
-the reference price to do the treatment.
If the new treatment is more extensive or otherwise
consists of other eligible dental measures than
the treatment needs to be done about, the dental health care
be provided for the costs of these measures as referred
in Chapter 2. paragraph 4 of the law on State dental care. Costs may
not, however, be estimated higher than an amount equal to the difference
between the cost of the new treatment and the cost of
the treatment needs to be done. The calculation of the
the costs of the measures included in the treatments should be performed
on the basis of the reference prices for these actions, however,
maximum caregiver Award for the current patient.
Regulation (2011:83).
section 7 compensation is not payable for a dental operation that has
carried out without a prior examination has been made where such
required. However, this does not apply if the action has been of such
character to that of dental or medical reasons been
necessary to implement without waiting for a
prior authorisation or if there existed special reasons
to begin operation prior to a preliminary examination has been made.
Healthcare provider's responsibility to the patient
section 8 of the health care provider must provide price lists with information on
1. the healthcare provider's prices and reference prices for the
eligible dental care provider actions
perform,
2. what guarantees that the caregiver is leaving for their jobs,
as well as the
3. the patient's right to request written information on
the materials used in prosthetic work and other
treatments aimed at permanently replace lost
tissue.
section 9 If the healthcare provider suggests a dental operation that is not
eligible health care provider shall inform the patient
whether there are any other measure that may be eligible for
State dental care.
section 10 if a patient needs to be treated on more than one occasion,
the caregiver should give the patient a preliminary written
price quote over the total cost of treatment.
If the patient needs a more extensive processing, shall
the caregiver also give the patient a written treatment plan.
The treatment plan shall include information on
1. the diagnosis has been made,
2. the proposed treatment and the reasons for this,
3. possible alternative treatment suggestions,
4. whether dental measures are eligible,
as well as the
5. the healthcare provider's rates, reference rates and resolution codes
Dental operations.
section 11 On the receipt that the patient receives over payment, the
the health care provider type
1. its price for each performed dental operation for the current
the patient,
2. reference price and resolution code for each executed
Dental action, as well as
3. where applicable, the compensation granted under the Act
(2008:145) on State dental care.
If dental work has been included in the treatment, to
the receipt shall be attached a copy of the dossier that the dental
laboratory left over the cost of the dental
the work.
12 § After each survey that is not solely intended
single teeth or a single problem, the caregiver
establish a research protocol. The Protocol must be submitted
to the patient immediately after the survey.
paragraph 13 of the health care provider shall, unless there are special reasons, after
survey and treatment offer the patient to get
a notice to a new investigation in the appropriate time.
section 14 of the health insurance fund shall, at the request of a health care provider
provide data pursuant to Chapter 4. section 1 of the Act
(2008:145) on State dental care if
1. whether the patient is covered by the right to State
dental care,
2. patient's utilization of dental benefits,
3. the patient's total costs for
eligible dental measures
completed during the replacement period,
4. what date ongoing replacement period started to run,
5. the date the last completed
eligible dental operation completed successfully,
6. presence of subscription agreement pursuant to Chapter 2, dental care
section 2 of the Act on State dental care and any
case, the subscription period for the agreement, and the dental
covered by it, and
7. decisions in cases where prior authorisation according to Chapter 4.
5 a of the Act on State dental care.
The data may relate only to patients that the caregiver is
in terms of treating or has treated.
Regulation (2011:1184).
Healthcare provider's obligation to
section 15 of the health care provider should establish a basis for follow-up and
statistics as well as for calculation of State dental care for
all eligible dental measures
the health care provider has performed on a patient. The dossier shall be submitted
to the social insurance office within two weeks of the respective
Dental operation has completed.
The dossier shall contain the
1. the treating dentist or tandhygienists name and
social security number,
2. the patient's name and social security number,
3. the date when the operation was completed,
4. authorisation and resolution code for the action
reimbursable in each case,
5. authorisation and resolution code for the actually performed
the measure, if this is not allowable in the
individual case,
6. tooth number and tooth position,
7. the caregiver Award for action taken for the current
the patient, and
8. the basis for the request for compensation in the form of special
dental benefits.
In connection with the request for compensation in the form of General
dental care provider shall also provide information to
The National Board if the patient's number of remaining respective
intact teeth.
The obligation also applies to such dental care covered
of a current subscription agreement. Regulation (2012:785).
section 16 When a subscription agreement pursuant to Chapter 2, dental care section 2 of the
Act (2008:145) on State dental care has been concluded, or
expired prematurely, do the caregiver within two weeks
from the time the contract was concluded or expired leave
statement to the insurance fund.
When a contract has been concluded shall be provided
1. subscription period,
2. the dental services covered by the agreement, and
3. the fee for the subscription.
Submission of information
section 17 of the Dossier in accordance with paragraph 15, first and second subparagraphs, information
According to the third paragraph of section 15 and section 16 as well as the application for
prior authorisation and application for compensation under the Act
(2008:145) on State dental care must be provided by electronic
Road.
Social insurance may provide for the cases in which
information may be provided by other means.
The connection to the Swedish social insurance agency's electronic system for
State dental care
section 18 application for connection to the Swedish social insurance agency
electronic systems for State dental care should be made by
the health care provider. The application must be in writing and submitted to the
The social insurance agency.
To get connected to the electronic system,
the caregiver must be a licensed dentist or dental hygienist
or, through employment or otherwise, recourse to such
staff. Health care providers in particular undertaken activities to further
be approved for F-tax to be attached to the system.
Regulation (2011:1469).
section 19 of the insurance fund may decide that accession to the
electronic system for State dental care shall cease where
the health care provider
1. request in writing to the Association shall cease,
2. has ceased to pursue dentistry,
3. no longer meets the requirements set out in section 18 of the other
subparagraph, or
4. has not started operations within six months of the
the Swedish social insurance agency announced the decision on accession.
Insurance obligation
19 a of to dental and pharmaceutical benefits the work should
able to carry out their activities in the areas of the State
Dental assistance, social insurance to leave
data on:
1. serial number of patient's number and,
case coordination number,
2. the patient's sex and age, condition and action code
for the action, the tooth number and tooth position, date
When the operation was completed and, where appropriate, if the patient
been referred for action to the dentist with proof of
specialist expertise,
3. the patient's replacement time, start and finish dates, and
use of dental benefits,
4. the caregiver Award for action taken for the current
the patient and if the treating dentist has evidence about
specialist expertise,
5. where appropriate, in accordance with the subscription agreement dentistry 2
Cape. section 2 of the Act (2008:145) on State dental care,
subscription period and if performed dental services covered by
such an agreement as well as the fee for the subscription,
6. reference price per action taken, the amount the patient
has a State dental care, patient's price per visit,
allowable amount per visit, provider's price for
visit, accumulated allowable amount under
benefit period and correction amount, if appropriate,
7. dental reception geographical location relating to the County and
kind of care provider: public, private or other, or in
where applicable, if the operation was carried out in another EU/EEA
country,
8. serial number of the provider's registration number, and
dental clinic,
9. date when the provider's claim against the State arises, date
When the provider's claim against the State is regulated, the date when the case
registered or changed in the database in the insurance fund, and
10. serial number of administrative tasks that case number,
line numbers from the database of the Swedish social insurance agency, case type and
case status.
Each social security number, coordination number, routing number and
Dental reception number, before the data referred to in the first
the paragraph is left out to be encrypted in such a way that
identification is not possible.
The data may be disclosed to the media for automated
treatment. Regulation (2012:784).
Other appropriations
section 20 of the health insurance fund may provide for
1. application for and the calculation and payment of compensation
under the Act (2008:145) on State dental care,
2. subscription dentistry,
3. notification of new replacement period under Chapter 2. paragraph 4 of the law on
State dental care and if after such period shall begin
run,
4. connection to the Swedish social insurance agency's electronic system for
State dental care,
5. the healthcare provider's obligation under Chapter 3. paragraph 3 of the first
law on State dental care,
6. the application for prior authorisation,
7. price lists pursuant to section 8,
8. treatment plans according to section 10, as well as
9. the Protocol according to section 12.
Insurance agency may announce further provisions concerning
the enforcement of the law on State dental care and of
This regulation.
section 21 of the National Board may provide for the caregiver
obligation under Chapter 3. the second subparagraph of paragraph 3 of the law
(2008:145) on State dental care.
section 22 of the dental and pharmaceutical benefits agency must notify
regulations about when prior examination shall be carried out in other cases
than those referred to in Chapter 4. 5-6 of the Act (2008:145) on State
dental care. Regulation (2011:1184).
Transitional provisions
2008:193
1. This Regulation shall enter into force on 1 July 2008, when
Ordinance (1998:1337) if dental tariff shall cease to
apply.
2. For dental measures that have been initiated before the entry into force
for older replacement provisions.
2008:844
This Regulation shall enter into force on 1 december 2008. The
repealed annexes and paragraph 5 of its older version, however,
still for those dental measures have commenced before
end of december 2008.
Annex I repealed Regulation (2008:844).
Annex 2 is repealed by Regulation (2008:844).
