NADP Urges Limit on Texas Dental Board’s Rulemaking
Access to Care for Medicaid Recipients could be Jeopardized
DALLAS – May 14, 2015 – The National Association of Dental Plans (NADP) has urged Texas lawmakers to take steps to prevent the Texas State Board of Dental Examiners (TSBDE) from passing rules that limit the effectiveness of dental support organizations (DSOs), as such action could jeopardize access to dental care for more than a million Texas Medicaid members.
Many of NADP’s member dental networks in Texas include dentists in practices supported by DSOs. This includes carriers providing dental services through the state’s Medicaid program.
According to the Texas Health and Human Services Commission (HHSC), 30 percent of Texas Medicaid members receive services through dentists supported by DSOs, which accounts for 20 percent of Medicaid claims. The TSBDE has repeatedly pursued rules that go beyond their statutory authority in attempts to restrict DSO-supported dentists’ use of non-clinical administrative services.
DSOs are critical to access in the state of Texas as they have the ability to see a large percent of the population in a timely manner. The number of Texans receiving Medicaid in 2013 was 4.67 million, with 30 percent receiving dental services through DSO-supported dentists. About 1.4 million Texans could be in danger of losing access to dental care if such rules were enacted.
Both child and adult Medicaid members with emergency dental care needs are often best served by DSO-supported practices that have a range of dental specialists available for dental treatment. DSO-supported practices are willing to assist with difficult cases when others are not. Several of the DSOs in NADP member carrier networks often fly specialists to other locations to provide treatment to Medicaid members where solo practitioners or small groups of local specialists are unwilling to participate in Medicaid.
In a letter to Texas lawmakers, NADP Executive Director Evelyn Ireland recommended that the dental board’s rulemaking “should be closely monitored to assure the critical support services that DSOs provide continue to be available to our member carriers in offering low cost, timely care to Medicaid recipients in Texas.”
“The DSO model of supporting practices that provide dental care to Medicaid-eligible Texans is critical,” said Ireland. “It is clear that significant access issues for Medicaid dental patients will occur if DSOs are shut out of the state or cease to operate because of unreasonable limitations by the State Board of Dental Examiners.”
Dental administrators for public programs face network challenges of providing critical emergency dental care for all Medicaid recipients in Texas and the full range of dental care for the most vulnerable children in Texas. Sustaining access to care for these populations would become increasingly difficult if DSOs were unable to provide necessary business support to dental practices in Texas.
National Association of Dental Plans (NADP), a Texas nonprofit corporation with headquarters in Dallas, Texas, is the “representative and recognized resource of the dental benefits industry.” NADP is the only national trade organization that includes the full spectrum of dental benefit companies operating in the United States. NADP’s members provide Dental HMO, Dental PPO, Dental Indemnity and Discount Dental products to more than 176 million Americans, more than 92 percent of all Americans with dental benefits through both private coverage provided through employers and public programs like Medicaid and CHIP.
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