State invents bogus claim to explain temporary extension of Medicaid dental plan

A state official has given a bogus explanation to the Anchorage Daily News about the screw-up with Gov. Mike Dunleavy’s plan to eliminate adult dental coverage for Medicaid recipients in Alaska.

Dunleavy claimed that the program ended July 1, but dentists and people on Medicaid were not told that the state was prohibited from ending it July 1 by law. It has been resurrected to continue until Oct. 1, though it’s not clear how it will be paid for because Dunleavy vetoed all of the money for the service, which was two-thirds funded by the feds.

I wouldn’t be surprised if this becomes part of the recall campaign against Dunleavy, an effort that already includes an allegation of incompetence about mishandling Medicaid.

It is possible that state officials did not know they were prohibited from ending the program July 1. I’ve been told that the regulation requiring advance notice is common knowledge among Alaska health care experts who deal with Medicaid.

It is now clear that this document released by the governor and his Office of Management and Budget Aug. 19 contained deceptive and misleading language that concealed the status of the program from the public and the press.

Instead of admitting that the program did not end July 1, the governor’s office tried to confuse the matter by saying, “Beginning October 1, adult Medicaid recipients will be eligible for limited dental benefits covering emergency dental services.”

The governor and his temporary budget director also claimed that “Dental work involving crowns and dentures that began prior to July 1, but has not been completed, will be covered until complete.”

They should have said that work that begins prior to Oct. 1 will be covered if completed by Oct. 31.

The Legislature voted twice this year to keep adult dental Medicaid services, but Dunleavy didn’t listen. He vetoed nearly $19 million in federal money and about $8 million in state money. In a sensible world, the Legislature would vote to override this decision at the upcoming special session Dunleavy has promised to argue about the Permanent Fund Dividend.

The Daily News writes this about Donna Steward, the deputy commissioner of the health department: “Steward 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 extension is “not intended to help Alaskans who had begun dental treatments before July 1.” The extension is intended to correct a mistake that health commissioner Adam Crum and his department should have known about.

How and why did this happen? And why has the Dunleavy administration refused to inform the public about its error? The state website still falsely claims the program no longer exists and that only emergency services are available. The state handbook for Medicaid recipients also claims the program is gone.

The governor needs to provide an honest explanation and say how he is going to pay for the extension. The Anchorage Daily News needs another story.

On Monday, some details about the temporary extension were distributed, but the state did not publicize what is happening or why.

Every dentist in the state, as a public service, should make room in September for as many Medicaid patients as possible. Having good teeth is a requirement for getting almost any job.

This is a new fiscal year, so recipients qualify for up to $1,150 of preventative coverage, if it starts in September.

The existence of this program saves money and lives. Without it, the state will have to provide more expensive emergency Medicaid dental services to those who let their teeth get so bad it becomes a personal health crisis. Delaying dental care leads to far more expensive and damaging health problems.

The document released Monday says that requests by providers that were submitted on or after July 1 “and were denied because the program was unfunded will be reconsidered; do not resubmit previously denied service authorizations.”

Medicaid is a vital program for 217,000 Alaskans. The evidence so far is that the Dunleavy administration is operating without a plan and without a clue. Combined with cuts by the Legislature, the state is trying to reduce Medicaid spending by nearly 25 percent right now, though the governor has offered no guidance on exactly how and has failed to communicate his intentions to Alaskans.

The most likely result of the Medicaid chaos will be a request early next year for a giant supplemental budget to deal with this element of the Dunleavy disaster, meaning that much of the so-called cuts will turn out to not exist. If the services are provided, the state has to pay the providers.

The cavity in the dental budget is a small part of the problem. Buried deep in the ADN account was this paragraph, which directly contradicts the state claim that this extension is all about helping people: “When it comes to dental coverage in particular, the governor’s Office of Management and Budget indicated funding would end July 1. But doing so requires approval from the federal Centers for Medicare and Medicaid Services, and that permission wasn’t requested until after the new fiscal year began. Service can’t end in the middle of a quarter, so that means dental coverage until the end of September, even though it hasn’t been budgeted.”