Jorge Landa: Why the dental carve-out works for Florida

The dentist and  patient agree that their teeth need to be repai
The COVID-19 pandemic has substantially reduced the utilization of health care services, including dental care.

As a dentist in Florida, I have experienced firsthand the challenges of meeting the dental needs of residents, especially vulnerable and special needs patients.

In the past four years, under Florida’s current stand-alone dental managed care program, access to care and quality of care have improved significantly. Recently, state officials have been exploring legislative proposals, including House Bill 7047, that would eliminate this dental “carve-out” program and reintegrate dental benefits back into the Managed Medical Assistance Program. This change would pose a major threat to children’s dental care in the state.

That is why I want to thank the Florida Legislature for recognizing the importance of keeping Medicaid dental services carved out from the medical Medicaid program.

Six years ago, the Legislature directed the state Agency for Health Care Administration to establish the dental benefit as a stand-alone managed care program, separate from other health benefits. The goal was to improve access to dental care, improve quality of care, and leave dental coverage in the stewardship of dental industry experts to provide and manage benefits. Three qualified stand-alone dental plans were contracted to provide dental services to Floridians, and these plans now provide comprehensive dental services to children and required dental benefits for adults. They have also stepped up to provide additional benefits for adults, at no added cost to the state.

The COVID-19 pandemic has substantially reduced the utilization of health care services, including dental care. While many hospitals, community clinics, and other health care facilities have had to cut back services or shift them to other facilities, under the stand-alone dental managed care program, the dental plans have been able to steer members with urgent needs to provider offices that can help. In addition, the dental plans have introduced innovative programs during the pandemic such as teledentistry and drive-thru and other community events, each of them improving outreach and education and providing needed care to their enrollees.

The truth is that parents are satisfied with the care their children have received through the stand-alone dental managed care program. Patient satisfaction surveys show that parents of child enrollees rate their dental care the highest of the three categories of ratings, at 88%, according to the staff analysis accompanying HB 7047.

The dental plans have built comprehensive statewide networks to ensure that all related dental care is available to those who need it, when they need it. This includes children with special needs and developmental disabilities, who have been served by a network of contracted offices that has expanded to over 1,000 offices across the state. That’s why the current carve-out system works for Florida.

For these and many other reasons, I applaud the Florida Legislature for retaining the current dental carve-out model as the bills move to the House and Senate floor.


Jorge Landa, DMD, is a board-certified pediatric dentist and chief of the Dental Department at Nicklaus Children’s Hospital,

Guest Author

One comment

  • RP

    March 2, 2022 at 10:45 am

    I am a member of a state-mandated dental plan and I can tell you, Dr. Landa, that you are completely and direly mistaken: care has not improved. The pool of dentists in these plans has decreased and the ones that remain are overbooked. Net result- basic care takes forever to get done.

    And this: because these plans are scrambling madly for doctors, behavior (discrimination, for example) that is illegal in private practice, is routinely overlooked by the plans.

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