West Virginia Seeks To Increase Medicaid Reimbursement Rates For Dentists

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Dentistry
Article Date: 15 Jan 2009 - 3:00 PDT

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The West Virginia Medicaid Fund Advisory Council last week unanimously approved a plan to ask CMS for permission to raise Medicaid reimbursement rates for dentists for the first time in eight years, the Charleston Gazette reports.

According to the Gazette, the amount of the increases and which services will be covered is still being negotiated. West Virginia's Medicaid program covers some dental care for children younger than age 19 and emergency tooth extractions for adults ages 19 and older. The West Virginia Dental Association has suggested that dentists be reimbursed for additional services provided to infants and toddlers to encourage early dental health. Association executive director Richard Stevens said, "Not all fees are going to be increased," adding, "Our suggestion is to increase the fees where the need is the greatest. I consider our recommendations to be financially responsible."

According to the Gazette, the move is "expected to increase the number of low-income West Virginians who receive dental treatment" because the rate increase likely will result in more dentists accepting additional Medicaid beneficiaries as patients. In addition, the rate increases likely will reduce state expenditures in the long term because fewer beneficiaries who have delayed dental care will seek treatment in emergency departments, according to dentists and state Medicaid officials. Stevens said, "There will be improved access for patients," adding, "A person can have a dangerous abscess, and they can go to the emergency room, but all they're going to get is a prescription for an antibiotic and pain medication."

State Medicaid officials expect CMS to approve the request within the next two months. Shannon Landrum, a state Medicaid spokesperson, said, "This will allow us to modify our state Medicaid plan," adding, "We don't want our dentists losing money when they treat Medicaid patients" (Eyre, Charleston Gazette, 1/11).

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