The Florida Agency for Health Care Administration on Friday delayed a statewide move to provide Medicaid dental services to children through a managed-care system, reports Jim Saunders of the News Service of Florida.
AHCA announced the decision after lawmakers last week approved budget language that made clear that dentists in most of the state could still be paid for each service they provide — instead of being required to take part in a type of managed care known as “prepaid dental plans.”
Florida in 2004 began operating a prepaid-dental pilot in Miami-Dade County, and lawmakers in 2010 directed AHCA to develop a statewide program. That program began in January in a five-county area stretching from Indian River to Palm Beach counties and was scheduled to expand to other parts of the state between April 1 and June 1.
Dentists have raised concerns about the change, with the Florida Dental Association releasing a statement Friday saying it had “heard from many Medicaid dental providers who have encountered numerous challenges” with managed-care plans.
Earlier this week dentist Robert Payne, who represents the association on a statewide Medicaid advisory panel at AHCA, complained about the burden of getting required authorizations from managed-care plans to do procedures.
“The FDA supports the provisions in the state budget that (allow) Medicaid dental providers the option of contracting directly with the state or a managed-care dental plan,” association President Cesar R. Sabates said in the statement Friday. “The FDA encourages the governor’s support as he considers the budget.”
Lawmakers included the change in budget fine print and in an “implementing” bill that helps carry out budget decisions. Except in Miami-Dade, lawmakers said AHCA could not limit dental services to the pre-paid plans and must allow dentists to be paid for each procedure they provide, a traditional system known as fee-for-service.
AHCA spokeswoman Michelle Dahnke said in an e-mail that lawmakers did not eliminate the prepaid-dental program — only required that fee-for-service payments still be allowed.
She said expansion into other counties across the state has been delayed to allow time for AHCA to determine whether enough dentists will participate in prepaid plans. If adequate provider networks exist, expansion of the managed-care system will move forward.
The state would use two prepaid companies, MCNA Dental Plans and DentaQuest, according to information on the AHCA website.
Aside from the prepaid program, Medicaid managed-care plans in some parts of the state already offer dental coverage. That includes plans in Broward, Duval, Baker, Clay and Nassau counties, where a pilot program requires most beneficiaries to get the full range of health services through managed care.
Also, the state is seeking federal approval to require beneficiaries throughout the state to get their health care through HMOs and other types of managed-care plans. Those plans would be required to provide dental coverage to the bulk of Medicaid beneficiaries.