Medicaid dental benefits cap delayed
The
Members will be subject to the cap on services through
There are 301,348 members in the Dental Wellness Plan, said
"This delay will allow a sufficient amount of time for the Iowa Medicaid Enterprise to identify and test program requirements for the dental carriers," Highland said. "These requirements will ensure the member's dental plan has the most current annual benefit maximum claims calculation to share with providers."
The benefit maximum previously was set to begin
The limit does not include preventive, diagnostic or emergency dental services, as well as anesthesia in conjunction with oral surgery and fabrication of dentures, according to the previous
The cap would not include services such as annual checkups, cleanings, X-rays and fluoride treatments.
This decision comes nearly a month after the
"
The state's only dental college called it quits at the beginning of this month due to concerns over recent changes to the dental program, including the
"The management of the Dental Wellness Plan program has become so complicated that we no longer have the ability or resources to effectively oversee additional Dental Wellness Plan patients," said
It was similar concerns that led Dr.
Grimes opted to stop seeing those patients after he said state health officials lowered the reimbursement rates for services such as cleanings and exams, which wellness plan patients must have to meet their coverage requirements.
"It was just one of those things where we were going to be non-profitable," Grimes said.
Some dental professionals in the Corridor still accept the state insurance, including Dr.
Peek said he didn't go to dentistry school and subsequent specialty training to become an expert "and only accept people who can afford (it)."
However, he acknowledges the challenges he and others in his profession face obtaining authorization or reimbursements from insurance companies for certain procedures.
"We're figuring out these new red tapes, but they're not making it any easy," Peek said.
For more information on the Dental Wellness Plan, go to dhs.iowa.gov/dental-wellness-plan.
l Comments: (319) 368-8536; [email protected]
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