Nebraska leaders trying, thus far failing, to raise dental Medicaid rates

There's a push in the Nebraska Legislature to substantially increase Medicaid funding and raise dental reimbursement rates, but so far it hasn't succeeded.

Sen. Lynne Walz, a Democrat from Fremont, introduced a bill in January that would increase dental services reimbursement under the Medical Assistance Act by 25%. The increase would cost roughly $6 million.

The proposed increase would raise reimbursements on average to match one of the state's lowest paying private insurance plans, Ameritas, said David O'Doherty, Executive Director of the Nebraska Dental Association, in an email.

Sophia Pankrats, a dental student at the University of Nebraska Medical Center's College of Dentistry in Lincoln, testified in support of the bill in February. At the hearing, she said she hopes to practice in rural Nebraska, treating underserved children, but she is worried about balancing her student loans and the costs of owning a practice.

"I'm eager to see patients from my community that have the greatest needs and may not be able to care for themselves," Pankrats testified to the Legislature's Health and Human Services Committee. "However, with the current reimbursement ... I'm concerned I will not be able to include them in my practice."

The committee unanimously voted for LB358, sending it to the full Legislature, but it has not yet been debated on the floor. The bill is on general file and can be brought up for debate during the 2024 session, a representative from Walz's office said.

In the 2023-2025 biennium budget, all Medicaid reimbursement rates were increased by 3% for FY2023-24, but Gov. Jim Pillen used a line item veto to remove a 2% rate increase for the second fiscal year.

With the 3% rate adjustment, Nebraska Medicaid will still reimburse dentists at a rate that is lower on average than both in-state private insurance and most neighboring states' Medicaid rates.

"The request for the (25%) fee increase would still make Medicaid our lowest payer, but at least it would allow us to ... to see those kids, maybe keep more kids out of the operating room," said Jessica Meeske, a Hastings pediatric dentist, at the February hearing.

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