The Alaska Department of Health and Social Services will reinstate Alaska’s Medicaid adult preventive dental program (the Adult Enhanced Dental Program), retroactive to Oct. 1, 2019, when it was discontinued due to the State’s budget problems.
DHSS Commissioner Adam Crum’s decision was based on a lengthy discussion between his department and the Centers for Medicare and Medicaid Services (CMS). The reversal of the State’s position comes because Obamacare is requiring Alaska to reinstate the program.
247,000 unduplicated enrollees were in Medicaid in the last fiscal year, one third of the state population. Over 37,000 Alaska are adults in the expanded Medicaid program that came with Obamacare, covering those with higher incomes — over 200 percent of the poverty level. Children are part of a different program.
Funding for the preventive dental program for adults – $8.3 million of state general funds with a federal match of $18.7 million – is part of Gov. Mike Dunleavy’s FY2021 budget that was released Wednesday.
Adult enhanced dental services include preventive and restorative dental care such as cleanings, fillings and restorative work. Those services were originally scheduled to be discontinued July 1, 2019, but were extended through Sept. 30, 2019, to allow time for recipients to receive notice about the Medicaid change and plan their care.
After the program ended on Oct. 1, dental services continued to be available to Medicaid recipients in Alaska through Medicaid’s “emergency dental” program.
The federal agency advised the State of Alaska that while the program is optional for states, most of the dental services included in the program were obligated to continue under federal law, according to the essential benefits plan of the Affordable Care Act’s Medicaid expansion.
Under federal law, preventive dental care services must be covered by Medicaid when provided at federally qualified health centers that offer preventive dental care.
“After many months of discussions and a full review of all of the options, DHSS determined the best way to meet our obligation to Medicaid recipients and to maintain the fiscal integrity of the program was to reinstate the Adult Enhanced Dental Program,” said Commissioner Crum. “Initially we thought eliminating the program would be best but, because of the program’s complex rules and federal requirements, this was the more prudent option to benefit the health and well-being of Alaskans and our state’s fiscal sustainability.”
Southcentral President and Chief Executive Officer Katherine Gottlieb said, “This reinstatement of adult dental services to the budget ensures the importance of preventative care in maintaining health, avoiding unnecessary pain and saving many dollars in the long term.”
DHSS will review all denied claims and prior authorizations from Oct. 1 until now and will provide benefits to recipients according to the original Adult Enhanced Dental Program. The same annual limit of $1,150 for services that was part of the original program will continue to apply.
Health care providers will receive notice of this change through a remittance advice message from Medicaid next week, the department said. Medicaid recipients will receive letters next week notifying them the dental program will be restored.