Virginia Medicaid dental reimbursements get a boost for first time since 2005 – The Virginian-Pilot

Cindy Southern returned to Pulaski 22 years ago after following in her father’s footsteps as a dentist.

She insisted school-age children have access to dental care, especially those whose families were struggling to make ends meet when the big factories in the area began to close.

Many of these children were on Medicaid, and more than two decades later, Southern’s Pulaski practice still sees such recipients, although it is no longer just children who receive Medicaid-covered dental services. However, many Virginians face long waits for dental services, which are now covered by Medicaid, due to mismatched demand and providers.

The number of dentists accepting Medicaid patients has fallen to 1,888 from a peak of 2,031 in 2017, according to data provided March 29 by the Virginia Department of Medical Assistance Services.

Currently, 924,000 adults in Virginia are eligible for Medicaid dental care, and 158,237 have had procedures since the new benefits were introduced just over a year ago, according to data from the Virginia Dental Association.

Groups like the VDA have been organizing for years to bring Medicaid dental reimbursements more in line with dentists received from other insurance providers. This year, Medicaid reimbursements to dental providers will be adjusted for the first time since 2005, as groups hope the measure will help expand the number of providers as demand has increased. The budget increases the reimbursement rate by 30%.

“I hope that we’ll see more providers offering services because it’s definitely hard for people to find a dentist,” Southern said.

The change stems from this year’s state budget, which went into effect on Friday. According to the VDA, the financing amounts to 116 million US dollars from state and federal funds. The total two-year state budget is nearly $60 billion and includes various increases and cuts for various expenses.

For years, the VDA has been pushing for Medicaid reimbursements to be adjusted because, according to Ryan Dunn, CEO, they have been almost neglected since 2005.

The cost of maintaining a dental practice has risen over the years and has risen by around 60% since the pandemic began alone, according to Dunn.

“Honestly, that 30% doesn’t really get us anywhere, but it does get us closer to the goal,” he said.

According to Dunn, some procedures cost providers more to perform than they are reimbursed by Medicaid.

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Still, the adjustment is a step in the right direction, he and the other dentists said. Future and semi-annual reimbursement adjustments are required to maintain and expand the number of dental Medicaid providers, RON said.

“I don’t think we can go another 17 years without a raise,” he said.

Buckingham County dentist Walter Saxon Jr., who treats Medicaid patients, said there are options other than reimbursement adjustments that could bring more providers on board.

He said incentives that help pay off student debt could bring more young dentists into the group, while incentives that support retirement funds could encourage older dentists to see more Medicaid patients.

Southern and Dunn agreed.

Southern thanked lawmakers for passing the budget, which included the rate adjustment. She also told the Virginia Department of Medical Assistance Services for its efforts to find ways to attract more providers.

“They work really hard to make these programs work,” Southern said.

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