WASHINGTON – Maryland’s Medicaid program pays dentists much less than they usually charge for the 15 most-common procedures, a practice that has led to inadequate dental care for low-income children, the American Dental Association said Wednesday.
The ADA report said the Maryland situation reflects a national trend that has left millions of poor kids with bad teeth.
“Within 10 miles of where I stand, there are thousands of children who don’t get regular dental care,” said ADA President Eugene Sekiguchi at a Washington news conference Wednesday.
“Let’s pick a day, draw a line, say that from that moment forward, every child born in this country will enter a continuum of oral health care, will visit a dentist by their first birthday and return on a regular schedule,” Sekiguchi said, while a screen beside him showed a photograph of a young boy whose teeth had been worn down to stumps from tooth decay.
Sekiguchi praised seven states — Delaware, Alabama, Georgia, Indiana, Michigan, South Carolina and Tennessee — for setting up systems in which at least 75 percent of dentists get reimbursed what they usually charge. He said that is the standard every state needs to live up to.
By contrast, the report said that no more than 9 percent of Maryland dentists are reimbursed at the rate that dentists in the South Atlantic region usually charge their patients for the 15 procedures.
An earlier ADA report said that only about 18 percent of children enrolled in Medicaid received some sort of dental health service in Maryland during 2001.
Officials with the Maryland Department of Health and Mental Hygiene declined to answer questions about the dental payments Wednesday.
But Dr. Howard Bailit, director of the Health Policy and Primary Care Research Center at the University of Connecticut, said Maryland is like many states whose dentists on average get only “30 to 50 percent of what they get from regular patients.”
“If you talk to the Medicaid directors around the country, they fully understand that they are paying a minor percentage of what dentists normally make,” Bailit said.
To improve the dental health of children from low-income families, Medicaid programs need to increase their payments, Bailit said.
The report agreed, saying access to dentists who accept Medicaid is a big factor in improving the dental health of children.
But the report also said dentists often do not even bother charging Medicaid patients the full amount, because they know they will not be reimbursed for it. The effect is that Medicaid programs continue to be underfunded.
Rep. Mike Simpson, R-Idaho, a former dentist who was at the news conference, said that federal and state governments constantly overlook the importance of funding oral health-care programs because dental diseases are not usually fatal.
“Dentistry is always the last thing to be added and the first thing to be cut,” he said.
But bad teeth, Simpson said, can make it harder for kids to get jobs when they grow up, effectively keeping them at the low-income level.
“People who have nice smiles get better jobs,” he said.
-30- CNS 03-24-04