A public hearing will be held Thursday at the DPHHS building in
If adopted as-is, coverage will end for dentures, crowns and bridges for adults. Comprehensive orthodontic treatment will only be available to children up through age 20 grappling with specific conditions, such as cleft palate or a severe overbite.
"These budget cuts will mostly impact elderly and disabled adults in very critical ways," said
But the change in the rule-making will also make it "more restrictive, more difficult for children who have need of orthodontic treatment to be qualified," he said.
The decrease in services comes as a result of budget cuts adopted by Gov.
Cuts to dental services total
Another
Under federal law, states must provide dental care to children enrolled in Medicaid and the
Probably about two-thirds of dentists in
"At times they may limit the number of patients they can see," Hermion said. "The fee scheduled is less than their cost of that care they're providing."
Dr.
"Each one is just a little bit different," he said. "
With his Medicaid patients up until now, Townsend has been able to choose the procedure that best meets his patients' need, whether that be a filling, a crown or a root canal.
"You don't want to do a root canal or crown and leave teeth with decay," he said. "You try to help the patient and save as many teeth as you can."
If the proposed rule changes are adopted, his options will include filling cavities or pulling teeth. Not being able to provide dentures "is the one that's really tough," Townsend said.
"Without dentures, they age faster, their face gets sunken in and they look very different," he said. "It's a big change and it can compound the difficulty for someone trying to turn their life around."
Another aspect to the dental cuts is the possible 2.99 percent cut to the overall rate dentists are paid for their Medicaid care.
"My worry is there will be less providers that can afford to treat the kids," Townsend said.
Treating children helps them avoid major dental problems later, he said. Decreasing the rate could limit their access to care.
Rather than dictating the procedures dentists can do, Townsend would rather be given dollar amounts per patient.
"Then the patient and the dentist could decide on the treatment together," he said.
Dr.
Even though care is limited for people 21 and older, "disproportionately, the older, fragile population will feel it the most," Gillette said.
Denying the opportunity to wear dentures is especially difficult for elderly patients in nursing homes who have fewer joys in life. Eating is one of them, and taking away their ability to eat a meal "of pot roast and cake is really inhumane," she said.
"We should have dignity, and not having dentures takes away their human dignity," Gillette said.
As people age, a number of factors come into play. Their mouths don't produce as much saliva, which allows a person to rinse away germs.
Also, a lot of taste preferences go away, except for a craving for sweets. And a patient struggling with arthritis, Parkinson's or dementia may have trouble cleaning their teeth.
"This population gets the most outrageous tooth decay you can imagine," Gillette said. "And it's difficult for them to go through intense dentistry."
With the rule changes, DPHHS took away a couple of key codes dentists use to manage cavities in this population. Dentists have easy techniques to reverse cavities that don't require shots or extractions.
Not only is it easier on patients, but the cost is much lower, Gillette said.
The alternative is for them to go the hospital and undergo dental anesthesiology while cavities are filled.
"Literally there is no more expensive way, and yet that is what the department is proposing," Gillette said. "It's pretty clear they never asked anybody with dental knowledge what codes should stay and what codes should go."
Gillette said dentists in the state have had a very positive relationship with DPHHS over the years. It came as a surprise to her that dentists weren't asked for their input.
She has been in touch with health department staff about the issues that most concern her. Her goal is to help make the rule changes less painful for patients.
___
(c)2018 Billings Gazette (Billings, Mont.)
Visit the Billings Gazette (Billings, Mont.) at www.billingsgazette.com
Distributed by Tribune Content Agency, LLC.
Japan Marine, Aviation and Transit Insurance 2020: Market Size, Growth and Forecast Analytics – ResearchAndMarkets.com
Croatia Health Insurance Market Analysis 2012-2017 and Forecasts to 2021 – ResearchAndMarkets.com
Advisor News
Annuity News
Health/Employee Benefits
Life Insurance