State prepares for Medicaid dental procurement

Health Care Concept. Doctor holding a jigsaw puzzle with MEDICAI
There appears to be an emphasis on ways to improve dental care for people with intellectual and developmental disabilities.

Florida Medicaid officials released a request for information (RFI) seeking input from potential vendors as it prepares to put its Medicaid Prepaid Dental Program out to bid.

Responses to the four-page RFI are due by 5 p.m. May 30.

The agency must start the procurement process this year for the six-year dental contracts, which will take effect sometime in 2024.

The document solicits information on innovative ideas and best practices to improve Florida’s dental care services for Medicaid beneficiaries.

There appears to be an emphasis on ways to improve dental care services to people with intellectual and developmental disabilities enrolled in the Medicaid waiver program called iBudget.

For instance, the RFI seeks ways to: improve the integration of dental and primary care services for iBudget enrollees; and to identify different options for integrating sedation dentistry into dental services for iBudget enrollees.

The RFI also requested information on identifying certification(s) and accreditation(s) that allow for the safe and high-quality provision of dental care for individuals with intellectual and developmental disabilities; and educating future dentists about providing dental services for individuals with intellectual and developmental disabilities.

The RFI also asks for ways to:

—Utilize value-based payment (VBP) designs to simultaneously increase quality and reduce costs;

—Improve integration of dental and primary care services for children, adolescents, pregnant women, and the elderly;

—Provide enhanced orthodontia services;

—Innovate delivery methods for the dental care model, including care bundling, that empower recipients in making more informed health care decisions.

—Improve providers’ and recipients’ experiences with the prepaid dental program; and

—Achieve cost savings throughout the prepaid dental program.

Three prepaid dental plans currently have contracts with the state to provide dental care to Medicaid beneficiaries.

There was a legislative dogfight during the 2022 Session over Medicaid dental services and whether they should continue to be administered through a separate managed care program or be combined with the statewide Medicaid Managed Care Program, which also encompasses managed medical assistance, long term care, and specialty care.

The fight pitted the insurance industry, which wanted the program rolled into the larger managed care program, against dentists, who wanted the program to remain bifurcated. Ultimately, the Legislature agreed to keep them separate.

In April, the Agency for Health Care Administration published an ITN for the statewide Medicaid Managed Care Program.

Interested parties have until May 30 to submit written questions to the state about the ITN.

AHCA has not replied to Florida Politics’ requests for the questions or the names of the companies that submitted the questions.

The statewide Medicaid Managed Care Program contracts are worth tens of billions of dollars to the companies that submit winnings bids. Companies that don’t secure contracts with the state are essentially locked out of Florida’s Medicaid market.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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