Michigan continues to expand Medicaid dental coverage – State of Reform

Over the past few months, the Michigan Department of Health and Human Services (MDHHS) has implemented a variety of changes to its Medicaid dental policy. On April 1, MDHHS continued its expansion of covered dental services by adding deep teeth cleanings, sealants, root canal treatments, crowns and care to keep gums healthy as part of Medicaid benefits.

It comes after the department increased provider reimbursement rates at the average commercial rate, expanded dental sealant coverage for those under 21, and implemented a new reimbursement methodology for dental services on January 1. In October, the MDHHS submitted an overhaul proposal to the legislature, then began the implementation process in December after the legislature approved the overhaul.

These many changes stem from the contribution of stakeholders, Healthy Michigan Plan and Pregnant Women Dental ProgramsAnd an MDHHS report from November 2022 noting that there are disparities in access to Michigan dental care. However, Vincent Benivegna, president of the Michigan Dental Association (MDA), told State of Reform that this has been in the works for several years.

He said this venture began about a year and a half ago when he testified before the Michigan House and Senate Appropriations Committees. He asked the legislature to allocate funds to support Medicaid and adult hospital issues.

Benivegna called for more funds to help Medicaid patients as it became increasingly difficult to get them into hospitals and dental practices as facilities would lose money based on Michigan’s Medicaid reimbursement rates. .

“Hospitals only received $200 per patient per facility reimbursement fee, and the same amount for anesthesia,” Benivegna said. “Hospitals were telling us it costs (normally) $2,000 per patient for facility fees and the anesthesiologist would say the same. So (hospitals) were telling us that they were losing money taking our patients.

Benivegna said those Medicaid dental reimbursement rates haven’t increased in about 30 years.

“Dentists were losing money seeing Medicaid patients,” Benivegna said. “That’s why very few dentists in Michigan took Medicaid. They just couldn’t afford it. They could take a small part of it, but they could not make it a large part or a substantial part of their practice.

MDHHS reports that it will invest $85.1 million to increase reimbursement rates and $30 million in redesigned benefits so recipients don’t lose services. The department says the funding was appropriated in the FY23 budget and represents a mix of federal Medicaid dollars and the state matching needed to secure those funds (approximately 65% ​​federal funding and 35% general state funding).

About two million adults on Medicaid in Michigan could benefit from this change, the MDHHS said. The number of Medicaid dental patients is also expected to be reduced over the next year as new Medicaid determinations take place.

“This positive change recognizes the strong correlation between oral and physical health outcomes,” MDHHS director Elizabeth Hertel said in a statement. “With better services and closer coordination of care, we can maximize opportunities to create healthy outcomes for recipients of all ages while increasing the number of providers so Michigan residents can get care where and when they need it. need it.”

MDHHS expects the change to be beneficial, as they have received positive feedback from their recent provision of technical assistance to providers who wanted to become Medicaid providers.

“I’m super happy this is happening,” Benivegna said. “It’s a huge benefit to the oral health of Michigan residents. Twenty-five percent are on Medicaid, and that’s a lot of residents that this (policy) is going to affect. Anything that improves the oral health of our population is great.

MDHHS said it is working with MDA, the Michigan Oral Health Coalition and Medicaid health plans to ensure broad awareness of these changes. Benivegna said he was making sure his organization played its part.

“We are currently hosting a webinar to update our members on the medical changes,” Benivegna said. “We’re going to have a booth at our annual session this year in Grand Rapids, which is the first week of May, and we can help people sign up. This will be published in our newspaper, in our e-news and in all our communications. Also, as president, I do component tours, and I give talks and updates, and one of the things I let people know about are Medicaid updates.