August 12, 2013
One day before the Florida AHCA released the memo, a dentist from the state wrote a response to the American Dental Association’s article “Dentist workforce size not a major factor in access for underserved.” (This article was also a response to a Pew Study on the two dentist shortages that prevent access to dental care for children.) The Florida dentist, Frank A. Catalanotto, DMD, argued, “[T]he primary factor shaping access to low-income residents is the number of dentists within a state who participate in Medicaid.”
As if on cue, the Florida AHCA released the memo, which states:
- More children had a dental visit because of the Prepaid Dental Health Plan (PDHP) Program.
They say that annual dental visits have increased since the inception of the program in 2004.
- Prepaid and managed care dental systems have increased care.
The PDHP Program in Miami-Dade county outperformed fee-for-service care for FY 2011-12 and was expanded to cover the entire state in December 2012.
- Fully staffed network of dentists.
PDHP plans have more dentists in their networks than the fee-for-service programs do.
- Emergency care is never required to be prior authorized.
Dental providers can provide emergency care to patients without worrying about reimbursement. If they are worried, there is an expedited authorization process in which a dentist can receive authorization over the phone.
- Expanding dental care for children.
Effective July 1, 2013, all Medicaid children eligible for PDHPs were enrolled in either DentaQuest or MCNA Dental.
- Expectations of care moving forward.
Florida will continue to increase the provision of dental services for children “as defined by CMS measures and HEDIS scores.”
Read the memo here: AHCA.MyFlorida.com