State mishandling of Medicaid dental coverage continues

As of Tuesday, the dental care coverage for Medicaid patients in Alaska ends because Gov. Mike Duynleavy vetoed about $8 million in state funds for the program, which was largely funded by the federal government.

Dunleavy’s decision means that about $19 million in federal funds that would have paid for dental care for poor people will be forfeited.

The administration has mishandled this situation for months and continues to do so.

The governor and his staff have said that some dental care for Medicaid patients will be available at some of the 27 clinics in Alaska that are federally qualified health centers.

But here’s the problem.

On Sept. 4, the state published a notice saying that as of Oct 1. certain dental services “may be available” at the clinics, but “these services may not be the same as the services that are currently available under the Adult Enhanced Dental Program.

To add to the confusion, the health centers say federal law and the state Medicaid plan require that the state continue to provide Medicaid coverage for dentistry services they offer.

It seems that it should be an easy matter for the state to clarify what it intends to cover starting Tuesday.

But state health commissioner Adam Crum hasn’t done that, which puts the health centers and their patients in a bad spot.

“By identifying but not taking a position on this issue—which implicates patient and provider rights—the department has created a tremendous amount of anxiety and uncertainty,” Nancy Merriman, executive director of the Alaska Primary Care Association, wrote to Crum Thursday.

She asked Crum that the state should make a clear statement about what exact dental services it deems acceptable for Medicaid patients treated at the health centers.

On Aug. 29, she wrote to state officials about exactly what would transpire and summarized an Aug. 21 phone conversation with various health officials in which the coverage question had been cleared up with a verbal commitment from the state. The health centers, patients and providers had already been notified.

On the next day, Crum replied to Merriman and disputed that any commitment had been made on the group phone call: “We do not agree that Alaska will cover all Enhanced Adult Dental Services as they currently exist on and after October 1, 2019.”

Ok. What services will Crum’s department accept? Nothing has been published.

That Crum has failed to answer that simple question is in keeping with the continual bungling that has marked the operation of Medicaid during his time as commissioner. It all stems from the governor’s effort to cut Medicaid spending without bothering to plan.