Newsday

Dentists seeking higher Medicaid reimbursement rate to serve the poor
March 9, 2005, 1:32 AM EST

HARTFORD, Conn. -- Dentists are calling for higher Medicaid reimbursement
rates to ease what some say is an oral health care crisis in Connecticut affecting more than 300,000 poor adults and children.

Fewer than 100 of 2,500 dentists in the state are willing to provide care for substantial numbers of patients on Medicaid, according to the Connecticut Oral Health Initiative.

Dr. Michael Goodman, a Newington dentist, said fewer than 10 pediatric dentists in Connecticut see poor children, leading to delayed treatment, days lost in school and more teeth lost later in life. "Dentistry has failed children," he said.

Goodman helped the Connecticut Oral Health Initiative launch a new Web
site Tuesday in Hartford. The site, http://www.ctoralhealth.org, provides
advice on dental care and will update dentists on legislative proposals that
would affect their practices.

Poor children from as far away as Willimantic and Putnam have been going
to Goodman's Newington office to receive care. But Goodman says he now only treats those in the most pain, because seeing too many Medicaid recipients would harm his business.

"If there is a small hole in a tooth and a big hole, you fix the big hole," Goodman said. "But you know those small holes will be big ones in a year."

Medicaid reimbursements, which haven't been increased for children since
1993 and for adults since 1989, now cover only about 60 percent of dentists' cost to do most procedures, dentists say.

If there is no increase in the reimbursement rates, dentists say there will be fewer providers to serve the poor, including some 200,000 children on Medicaid.

Robert Slate, executive director of the nonprofit Oral Health Initiative, said he hopes the Web site will increase awareness of what he calls a crisis in dental health care.

Dental health advocates want to persuade more dentists to accept poor patients by getting the state to increase reimbursement rates to dentists to
about 75 percent of fees normally charged. The joint state-federal Medicaid
program pays about 30 percent to 35 percent of fees normally charged by
Connecticut dentists, Slate said.

The proposal would likely face a difficult future in the legislature, where officials are dealing with a $1.2 billion deficit and a spending cap. Some lawmakers are somewhat optimistic that such a plan could be approved.

"I think we might be able to find ways to do this," said Sen. Toni Harp, D-New Haven, co-chairwoman of the Appropriations Committee.

The courts may step in if lawmakers don't.

Legal aid advocates have sued the state for failing to provide dental services for the poor. A request for a summary judgment has been in federal court in Hartford since 2003, said Jamey Bell, an attorney for Greater Hartford Legal Aid Inc.

Bell said the state would be allowed to circumvent the spending cap if there is a court ruling in favor of Medicaid recipients.

Gov. M. Jodi Rell has proposed some initiatives, including $2 million to pay for dental equipment at community health centers in urban areas. Copyright © 2005, The Associated Press