Dental Could Be Carved Out Of Managed Care Under Bill Signed By Scott

Mar 24, 2016

Credit Daniel Oines / flickr.com

Changes could soon be on the way when it comes to how the state administers dental services in its Medicaid Managed Care program.  Dental care could be re-established as an independent service in the state’s Medicaid program.

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House Bill 819 calls for a study on dental care access in Medicaid Managed care. The state would have to decide by 2017 whether to keep the system as it is now, or allow dental to revert back to an independently administered program. The reversion would come in 2019.  Right now, dental is part of the overall benefits more than three million Floridians enrolled in Medicaid managed care receive. But prior to the changeover, dental was separately insured, and incoming Senate President Joe Negron believes it should be again.

“The state’s that have the highest utilization rates, states like Texas and Connecticut, have an independent system," he said. Those are also state's that pay their Medicaid dental providers more.

Florida’s historically low reimbursement rates have led many dentists to drop out of Medicaid making it hard for people to get care. The study is aimed at determining whether managed care has improved access to those services.

Supporters say the move grows out of concerns insurers are taking too much money in fees, and dentists are not being fully reimbursed for their services, and the Florida Dental Association has claimed  more providers participated in Medicaid before it was turned over to insurers to run in managed care. The association's  Jo Anne Hart says more work will also have to be done.

“Right now we have this opportunity to get some data, and once we look at the data and review it, we can take those next steps."

Both Negron and Hart say those next steps could include boosting Florida's dental reimbursement rates, still among the lowest in the nation.

The hope is the study will provide answers to several questions:

How many are regularly treating Medicaid patients? How many are taking new Medicaid patients? What dental care services are children are receiving and what is the impact on dental health? And there's a big one: How much is being spent on actual services? 

The bill was opposed by the Florida Association of Health Plans which warned adults could lose services if dental was carved out of managed care. That carve out would happen by 2019 if the legislature doesn’t act.