Fla. dental managed-care rollout for kids stalled

The Florida Agency for Health Care Administration (AHCA) has delayed a statewide rollout of Medicaid dental services to children through a managed-care system, according to a news-press.com story.

The agency announced the decision after lawmakers approved budget language saying that dentists in most of the state could still be paid for each service they provide instead of being required to participate in a type of managed care known as "prepaid dental plans," according to the story.

In 2004, Florida began a prepaid-dental pilot in Miami-Dade County, and lawmakers in 2010 directed AHCA to develop a statewide program. The Prepaid Dental Health Program (PDHP) began operations in January in five counties (Indian River, St. Lucie, Martin, Palm Beach, and Okeechobee) and was on track to expand to other parts of the state between April 1 and June 1.

The Florida Dental Association (FDA) reported that Medicaid dental providers had encountered numerous challenges with managed-care plans, including one area dentist, who represents the FDA on a statewide Medicaid advisory panel at AHCA, who raised concerns about the burden of obtaining the required authorizations from managed-care plans to perform procedures, according to the news-press.com story.

Except in Miami-Dade, lawmakers said AHCA could not limit dental services to the pre-paid plans and must allow dentists to be paid as fee-for-service. In an email to news-press.com, AHCA spokeswoman Michelle Dahnke said lawmakers did not eliminate the prepaid-dental program; they only required that fee-for-service payments still be allowed.

Expansion into other counties across the state has been delayed to allow time for AHCA to determine whether enough dentists will participate in prepaid plans. If adequate provider networks exist, expansion of the managed-care system will move forward.

The state would use two prepaid companies, MCNA Dental Plans and DentaQuest.

Medicaid managed-care plans in some parts of the state already offer dental coverage, including Broward, Duval, Baker, Clay and Nassau counties, according to the story, which also reported that the state is seeking federal approval to require beneficiaries throughout the state to get their health care through HMOs and other types of managed-care plans. Those plans would be required to provide dental coverage to the bulk of Medicaid beneficiaries.