The ADA agrees with Dr. Rucker that the Medicaid reimbursement rates for private practicing dentists in most states are exceedingly low and serve as a disincentive to participation in the program. In fact, helping constituent dental societies increase the rates, which are established by the states, is a very important element of the Association’s access initiative.
To date, several states, including Michigan, have been successful in increasing reimbursements and eliminating other barriers to participation by dentists. The Association is working at the national level to rewrite the definition of a Health Professional Shortage Area, which helps determine where Community Health Centers, including all FQHCs, are placed.
In addition, ADA-supported legislation signed into law last October authorizes federal grants for states that enhance their Medicaid oral health programs. While generally Community Health Centers receive a higher level of reimbursement for Medicaid services than private practitioners, their first priority must be serving indigent patients. There are also opportunities for private practice dentists to contract with Community Health Centers and negotiate a reimbursement level acceptable to the individual dentist and receive payment even if the patient fails to show.
