Health and Family Services Cabinet
Cabinet for Health and Family Services Announces Changes to Medicaid Dental Program
Higher Reimbursement Rates Expected to Attract Dentists, Serve More Children in Need
The Cabinet for Health and Family Services (CHFS) announced today that more Kentucky children will be able to receive much-needed dental services due to recent changes designed to improve the oral health of KyHealth Choices members.
Specifically, the changes focus on dental prevention and treatment for children by increasing the reimbursement fee for Medicaid child dental services by 30 percent. An additional oral examination visit for children and an orthodontic reimbursement have been added to the Medicaid package as well.
“Increase in oral disease is a major health problem for Kentuckians of all ages — but particularly among KyHealth Choices members. Even more troubling is the lack of dental care for the state's needy children,” Governor Ernie Fletcher said.
Last December, the Kentucky Youth Advocates organization released a study showing that about 338,000 children covered by Kentucky Medicaid did not see a dentist in the previous year. The study found that only 33 percent of children used dental care services covered by Medicaid, while almost half of our state's children from 2-4 years of age have untreated cavities.
The new changes are expected to attract more dentists to the Medicaid program and increase the number of children receiving services that are vital to their oral health. The changes have been accomplished through cost savings and internal restructuring within Medicaid's annual $55 million dental expenditures while preserving the adult dental benefit package.
“The changes to our dental program meet the overarching goals of our Medicaid transformation effort, KyHealth Choices – to stretch resources and improve the quality of care for members,” said CHFS Secretary Mark D. Birdwhistell. “We hope we have provided attractive incentives so that more dentists will begin providing services to our children.”
As part of the restructuring efforts, adults are now limited to one non-emergency visit per month unless waived by medical necessity and have a $2 co-payment per dental visit. These changes allowed the expansion of services available for children's dental health. Medicaid will continue to work on ways to enhance access to dental care for adults.
Next spring Medicaid will roll out the Kentucky Dental Choices program for adults. The member will choose a "home dentist" and that dentist will receive a small management fee per month for each adult he or she serves.
“One of the largest health problems facing the commonwealth is lack of access to dental care. Yet, so many childhood and adult dental problems could be averted through routine dental care and other preventive efforts,” said Secretary Birdwhistell. “We are committed to resolving this problem and believe, with these new changes to the Medicaid dental program, we are headed in the right direction.”
“We at the Kentucky Dental Association are excited about the changes based on the improvements in access we hope they will allow,” said Dr. Andy Elliott, president of the KDA and a practicing dentist in Martin, Ky. “We recognize the problems we are facing, especially with children, and we hope the changes will address that. We appreciate the administration’s recognition of these problems and their efforts to address these issues that we’ve been pointing out for the last several years.”
For more information about improvements to the dental program or Kentucky Medicaid, contact your current case manager or Medicaid Member Services at 1-800-635-2570.