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House passes resolution aimed at better serving Medicaid population

November 29, 2018

By Michelle Manchir

Creating better working relationships between state dental associations and their respective state dental Medicaid agencies is the goal of a resolution passed in October by the ADA House of Delegates.

Photo of Dr. Whitman
Dr. Whitman
Res. 69H-2018 encourages state dental associations, working with state Medicaid agencies, to create a dental peer review committee made up of licensed Medicaid providers to offer expert consultation on issues brought to them by the state agency or third-party payers.

"This creates an opportunity to resolve issues through investigation and education, rather than just monetary penalties as often occurs presently," said Dr. Sidney Whitman, chair of the ADA Council on Advocacy for Access and Prevention's Medicaid Provider Advocacy Committee.

The resolution builds on previously passed Medicaid-related House resolutions.

In 2015, the House passed Res. 85H, which called for state dental associations to work with state Medicaid agencies to have a dentist within their state dental Medicaid program, who is a member of organized dentistry. It also encouraged state dental associations to participate in establishing or continuing existing Medicaid dental advisory committees to provide consultation and guidance to the state Medicaid agency.

Another resolution, passed in 2017, 33H, encouraged state dental associations and Medicaid agencies to ensure all Medicaid dental audits are conducted by dentists who have similar educational backgrounds and credentials as the dentists being audited. It also called for the dental auditors to be licensed within the state in which the audit is being conducted, as there are often specific regulations and circumstances that make each state unique.

These resolutions have helped some states improve the oral health of Medicaid-eligible individuals, said Dr. Whitman.

"Our goal is to serve this population," Dr. Whitman said. "We are trying to remove barriers for those willing to provide quality care."

Dentists interested in becoming Medicaid providers, or those who already are and would like guidance, can reference an ADA-developed reference guide and toolkit that includes information about Medicaid compliance, audits, recordkeeping, reducing barriers and more.  

Visit the Medicaid Provider Reference Guide & Advocacy Toolkit webpage for more information.