Several states are grappling with Medicaid funding challenges, while proposed Medicare changes are receiving pushback from dental organizations.
Four notable updates:
1. The American Dental Association urged CMS to retain oversight of Medicare Advantage supplemental benefits. The groups said that proposed changes for contract year 2027 could weaken transparency, lessen insurer accountability and reduce access to care.
2. Maine lawmakers are considering an emergency proposal to increase Medicaid reimbursement rates for pediatric dentists who perform work on patients under anesthesia. The bill would immediately increase the rates for medically necessary dental services requiring deep sedation or general anesthesia when those services are provided at an ASC.
3. Nearly 50% of Medi-Cal dentists say they would drop the program if the proposed cuts to provider rates take effect this year, according to a survey from the California Dental Association. Last year, Gov. Gavin Newsom proposed cutting Proposition 56 funding and redirecting the funds to address the state’s $12 million budget deficit, which would lead to the elimination of one third of funding for the Medi-Cal Dental program. The state legislature rejected the proposal, delaying any cuts until July 1. Dental leaders have continued to advocate for the preservation of this funding to support oral healthcare in the state.
4. Arkansas lawmakers must consider new options to boost support for its Medicaid dental program after CMS rejected several measures. The state legislature passed four bills during its last session aimed at supporting Medicaid dental care, two of which would have increased reimbursement rates for services provided to children and adults with special needs. CMS officials reportedly rejected the bills’ implementation and instead gave the state four different options to enhance dental care under Medicaid, including creating waivers for patients with special needs and creating an expanded limit for Medicaid recipients who receive dental care.
