Utah bill proposes expanding dental care coverage to adults under Medicaid
Senate Bill 19, a measure that would extend dental benefits under Medicaid to adults 21 years of age and older, advanced to the House after passage in the Senate by a vote of 19 to 0 with 10 abstentions Monday.
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Sponsored by Sen. Evan Vickers (R – Cedar City), the measure passed with bi-partisan support and has the backing of the Utah Dental Association (UDA).
Under current state law, only members who are pregnant, disabled, blind, age 65 or older, enrolled in Targeted Adult Medicaid (TAM) receiving treatment for substance use disorder, or children receiving Early Periodic Screening, Diagnostic and Treatment (EPSDT) have access to dental benefits through Medicaid.
In partnership with the Utah Department of Health and Human Services (DHHS), the University of Utah School of Dentistry (UUSOD) administers dental care to these individuals through the school’s clinics and affiliated providers in over 150 locations throughout the state.
“Back in 2008, the state eliminated all dental benefits for adults and the University of Utah School of Dentistry subsequently went to the legislature and said we’d like to partner and provide this care, and there are federal programs available that allow for that,” said James H. Bekker, Associate Dean for Professional and Community Partnerships at UUSOD.
“The School of Dentistry participates in creating that pathway. And so we opened up gradually to first the TAM patients that have substance abuse disorder and then we added to that blind and disabled patients. And then we added to that elderly. So it’s just been something that’s happened gradually and we’ve been able to do well.”
SB 19 would allow the state to pursue federal Medicaid waivers that extend dental care to all adults 21 years of age and over who are eligible for Medicaid. The bill, like previous ones that expanded dental coverage eligibility, contains a zero fiscal note because UUSOD pays the state’s portion to receive federal matching funds to provide care.
Should SB 19 pass, the number of Medicaid members eligible for dental coverage could grow from 70,000 to over 200,000, according to UUSOD estimates.
“This program allows [dentists] to see the patients and be compensated at a much better rate,” Bekker said. “It’s clear that with [currently eligible] Medicaid patients, that’s about 70,000 patients throughout the state, the School of Dentistry can’t possibly see all those patients at our clinics.
And so we have created an associated provider opportunity so any dentist in the state of Utah can become associated with the School of Dentistry and thereby treat these populations in their own office. They bill directly to Medicaid, they’re reimbursed directly [by] Medicaid. It’s just that association that they need with a state entity in order to be able to qualify.”
As the legislative liaison to the UDA and its past president, Bekker says dentists in the state are supporting the proposal.
General dentists had previously been reluctant to join the program and serve Medicaid patients because of low reimbursements rates, Becker noted. He has been working to change the perception that Medicaid does not pay adequately and recruit more dentists to participate and meet the potentially increased demand.
“We’re doing what we can to educate dentists out there to understand that it’s different than it was,” Bekker said. “The compensation rates are better and this is a wonderful opportunity to enhance your practice and provide care to underserved populations.”