Down to the Wire

Thursday, June 28, 2007
By Daniel D'Ambrosio

With budget negotiations going down to the wire - and past it - Marty Milkovic of the Connecticut Oral Health Initiative was watching intently to make sure $20 million slated for increased fees to dentists treating poor children survived the deal-making.

Rep. Denise Merrill, D-Mansfield, co-chairman of the appropriations committee said the money was "safely ensconsed" in the appropriations bill..

"Believe me we will hang on to that increase long after we've given other things up," Merrill said..

Turns out they did..

"The $20 million survived," said Merrill last week..

Milkovic was delighted, along with others, including Greater Hartford Legal Aid attorney Jamey Bell, who has spent seven years on a lawsuit to force the state to pay reasonable fees for dental work on children enrolled in HUSKY A, the state's Medicaid program.

"We're extremely pleased the legislature recognized the need and fought for funding to increase the abysmally low reimbursement rates in the HUSKY A dental program," Bell said. "We're also hopeful this money will enable the parties to resolve the litigation."

Bell and many others have been pushing for the money to raise the HUSKY A reimbursement rate into the 70th percentile. The current rate is in the 10th percentile, meaning 90 percent of the dentists in the state would charge more for any given procedure.

As the Advocate reported in an April 12 cover story, only about 100 of the state's 2,900 dentists take on Medicaid kids, two-thirds of whom receive no dental care at all, according to the Connecticut Health Foundation. About 250,000 Connecticut kids are enrolled in HUSKY A - one-quarter of all the children in the state.

Merrill has been skeptical that even with increased reimbursements dentists would begin welcoming poor children into their offices. But she said she was reassured when the former president of the Connecticut State Dental Association, Dr. Jack Mooney, guaranteed if the Medicaid reimbursement rate was raised to the 70th percentile, the state's dentists would step up to the plate.

Carol Dingeldey, executive director of CSDA, said some 400 dentists have already committed themselves to taking HUSKY A patients if the reimbursement rate is increased.

The only thing now standing in the way of a victory party for HUSKY A advocates is the so-called "implementer" language for the budget, which details exactly how the $20 million will be spent. If that language directs the Department of Social Services to spend the money exclusively on rate increases for dental work on children covered by Medicaid most observers believe the fee schedule will make it into the 70th percentile.

"We would love to see the 70th percentile for all of the procedures the kids need," Dingledey said. "It's the flouride treatments, varnishes, cleanings, filling, some root canal therapy and stainless steel crowns - the things most important to make sure kids are healthy and happy."