Dr. Garner Morgan used to be reimbursed about $9 for a child’s sealant through Maryland’s medical assistance program — less than a quarter of what he was paid through regular insurance plans.
“In the past it was almost a charity deal,” said Morgan, past president of the Maryland State Dental Association.
The paltry reimbursement rates were little incentive for dentists to accept Medicaid patients, just one of many problems leading to declining oral health among children in Medicaid, said Morgan and other officials.
Maryland has taken steps to boost access to oral health care, including increasing the reimbursement rates beginning in July.
Dental disease continues to plague American children in Medicare, according to a U.S. Government Accountability Office report released this week.
One in three children in Medicaid had untreated tooth decay between 1999 and 2004, and one in nine had untreated tooth decay in three or more teeth, the report found. A third of children in Medicaid had seen a dentist in the year before the survey, compared with half of children with private insurance.
In Maryland, the death this past year of 12-year-old Deamonte Driver from an untreated abscess that spread to his brain was a wake-up call for lawmakers, dentists and families. Driver’s mother has said she couldn’t afford treatments because her Medicaid coverage had lapsed.
In August, Gov. Martin O’Malley announced a $1.2 million grant to develop oral health prevention plans and improve access to dental sealant programs.
Changes to the state’s dental programs will occur during a three-year period, thanks to a $42 million state and federal infusion, said Dr. Marc Nuger, president of the Maryland State Dental Association.
This year, fees for preventative procedures such as exams and routine extractions were increased, and future changes include merging to a far less complicated single-payer system, Nuger said.
Dental association officials have started educating dentists on the changes and serving low-income children, who often have more complex needs, he said.
“Our goal is to get a group of general dentists more comfortable and willing to take on more kids,” Nuger said.
Morgan, one of a few dentists in St. Mary’s County offering care to Medicaid patients, said he hopes the increased reimbursement rates will encourage other dentists to share the burden.
“It’s a start,” he said. “And it’s where you need to start.”
