House panel gets update on dental carve out law

Dental care

A recent study by the Office of Program Policy Analysis & Government Accountability into how effective managed care plans are at providing dental care appeared to be inconclusive, agency officials said this week.

OPPAGA was tasked with looking into how effectively managed care plans are at providing dental care under a contentious 2016 law.

The law, among other things, carved out dental care from the list of minimum benefits offered under the state’s Medicaid managed care plans. It required the Agency for Health Care Administration to implement a prepaid dental health program for children and adults beginning enrollment by March 1, 2019, unless the Legislature acts during the 2017 Legislative Session to require the statewide plans to cover it again.

 Mary Alice Nye, a staff director at OPPAGA, told the House Health & Human Services Committee her team could not come to a “definitive conclusion” about which was a more effective way to provide the service.

Nye said it was difficult to draw a conclusion because there wasn’t a lot of available data for comparison. There were only two full years available for OPPAGA to use for comparison.

According to the OPPAGA report, nearly 24 percent of eligible children received preventative dental services in fiscal 2013. That increased to 31 percent in fiscal 2015.

“I think what we are hearing is that move to statewide medical managed care and including dental is working for the state of Florida and for the children in Medicaid,” said Audrey Brown, the president and CEO of Florida Association of Health Plans, which opposed the 2016 legislation.

Nye said of the 28 states similar to Florida, 14 include dental services as part of comprehensive managed care, four use a pre-paid managed dental program, and 10 use a fee-for-service system. Seven states are currently in transition, with four choosing to carve dental services in. Two states, she said, are carving dental out. One is still weighing its options.

“I think we definitely need a more in depth analysis if we’re going to change the system,” said Rep. Gayle Harrell. “The outcomes are extremely important.”

Jenna Buzzacco-Foerster



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