State finally admits concealing its mistake about dental Medicaid services

It took more than three months, but the state health department has finally admitted that it concealed its mistake in announcing that Medicaid dental coverage had ended July 1, only to learn later from the federal government that the state had failed to follow the Medicaid rules requiring advance notice. The program continued until Oct. 1.

As I wrote here Aug. 23, the state failed to give advance notice of the change, required under federal law, which made it illegal to end the program July 1. But state officials kept this quiet, which led to misleading and inaccurate news reports about the reason for the extension.

The false impression was left with many Alaskans that dental coverage was temporarily continued out of concern for patients whose treatment had been interrupted.

As the Anchorage Daily News wrote the weekend of Aug. 24-25, Donna Steward, deputy commissioner of the health department, "said the extension is intended to help Alaskans who had begun dental treatments before July 1 and not yet finished them at the time of the veto but added that all Medicaid beneficiaries can take advantage of the extension."

The Associated Press rewrite of that story said, “The extension is aimed at helping Alaska residents who began dental treatments before July 1 that were not completed at the time of the veto.”

In fact, the extension had nothing to do with concern for Medicaid dental patients or treatments that began before July 1.

More troubling than the misleading claim from the health department was this document released Aug. 19 by the governor’s office that concealed what was happening and did not make it clear to legislators, the press or the public that the July 1 cancellation had already been reversed, but had not been disclosed.

“Dental work involving crowns and dentures that began prior to July 1, but has not been completed, will be covered until complete,” the Office of Management and Budget said in a statement that added to the confusion.

Anchorage Rep. Andy Josephson and Sen. Elvi Gray-Jackson wrote health commissioner Adam Crum Sept. 16. with a series of pointed questions about the timing and the thinking behind the end of dental coverage.

“How and when did the administration determine that the Adult Preventative Dental Program could not be eliminated by July 1, 2019?” they asked.

In an unimpressive Oct. 3 reply to Josephson and Gray-Jackson, Crum said that on July 17, the federal Medicaid office contacted the state about the required 10-day notice to recipients of dental coverage that had not been given by the state.

“As a result, the department extended the adult enhanced dental program,” Crum wrote. But two paragraphs earlier in the same letter, Crum wrote that the state was told “in early August” that it had not followed the rules and had to extend the program.

Crum’s department waited until Aug. 26 to reveal that the program remained available, without explaining the reversal. This means that patients who should have been getting treatment were allowed to believe that they did not qualify. Dentists were also kept in the dark.

After the Aug. 26 announcement, the department did not do much to notify Medicaid patients and providers of its error or publicize that the program continued until the end of September.

The lack of candor from the state on the mishandling of the dental program cancellation is indicative of a pattern of bungling that continues as the Dunleavy administration has provided the public with no plan on the consequences of its actions on Medicaid.

The Legislature should override the governor’s veto of this program, which was largely funded by the federal government. The $8 million veto, a foolish action, means the loss of perhaps $19 million in federal money that paid for dental services for people in need.