Update on Medicaid

Dr. Carol Buffington and Richard Stevens continue to meet with Medicaid and managed care organizations – The Health Plan, Coventry, Unicare and Family Health – to resolve issues experienced by dentists.

At the recent meeting WVDA requested topical application of fluoride include children up to age 18.  WVDA provided clinical data to one of the MCOs who questioned this change after the meeting. This request is being considered.

After Dr. Buffington and Stevens expressed concern with missed appointments, Medicaid said they may add D9986 and D8887 for missed appointments for tracking purposes to help manage patients with multiple missed appointments.

WVDA also suggested Medicaid and MCOs review emergency room claims to determine the number of patients going to the ER for dental treatment, and the resulting costs which may be saved if the patient were treated by a dentist.

Dr. Buffington used a model to illustrate the restoration of two surfaces of a tooth, and explained why it is inappropriate to “bundle” payments for two or more restorations on the same tooth.   Scion is to review this request.

Dr. Buffington and Stevens requested Medicaid look at options to add various levels of adult dental services.


Dentists Input Is Requested:

The next meeting is scheduled for October 23.  Dentists are requested to report recommendations and problems they have with Medicaid to Dr. Buffington and Stevens so they presented them at that meeting.  Please provide specific examples.  Respond to [email protected]  or  [email protected]