From ADA
CHICAGO – Beginning June 10, eligible Medicaid or Children’s Health Insurance Program dental providers can apply to receive funding from the U.S. Department of Health and Human Services’ Provider Relief Fund Payment Portal, the department announced June 9.
Approximately 39% of dentists participate in Medicaid or CHIP, according to the ADA Health Policy Institute. The Provider Relief Fund Payment Portal will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their payment, which “will be at least 2 percent” of the provider’s reported gross revenue.
To be eligible for the Provider Relief Fund, dentists must not have received payments from an earlier $50 billion distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for health care-related services between Jan. 1, 2018 to May 31 of this year. The amount of relief a provider receives will be determined after the data is submitted and will be based on the number of Medicaid patients the provider serves, HHS said.
The Provider Relief Fund was established by the Coronavirus Aid, Relief and Economic Security Act — known as the CARES Act — which directed $175 billion in relief funds to hospitals and other health care providers, particularly those impacted by the COVID-19 pandemic.
“Health care providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” HHS Sec. Alex Azar said.
Securing these funds for dentists has been a key issue for the ADA since the CARES Act became law on March 27.
“In mid-April, both ADA and HHS leadership began working on how this fund could best provide relief to dentists. Soon after our initial talks, HHS confirmed dentists would be included and today I am happy to report many dentists will see some relief from this fund,” ADA President Chad P. Gehani said in a June 9 Issues Alert to members.
In the last two months, the Association has had several discussions with HHS and also sent an April 17 coalition letter with other dental stakeholders to HHS Secretary Alex Azar to make sure dentists were prioritized.
In that letter the ADA told Sec. Azar that dentists took on “significant financial risk due to postponing nonessential procedures and visits” during the pandemic. The letter also noted that dentists were among the first providers to recommend postponing all non-urgent procedures at the onset of the crisis.
PROVIDER REACTIONS
“I’m very excited to hear that HHS is providing some relief for dentists who see patients that rely on Medicaid,” said Dr. Jessica Meeske, a pediatric dentist who estimates 60% of her Nebraska-based practice is children who rely on Medicaid. “We definitely are committed to these children in our community and partnering with their parents to be sure they are free from dental disease, pain, and infection. Participating in Medicaid can be a tough business due to challenges many of the patient families have and the lower reimbursement.”
Dr. Charles Czerepak, a Chicago-area pediatric dentist, was thrilled to hear dentists would be receiving some relief.
“For the Medicaid lifelines, every little bit helps,” said Dr. Czerepak, whose hospital-based practice sees dental Medicaid patients who also have medical needs. “Medicaid is a hard arena anyway. Right now, with the increased concern during COVID-19, anything you can give that population of dedicated dentists is welcome. Treating Medicaid patients is more an advocation than profession. You have to be dedicated and work hard to get these kids in and to survive as a dentist.”
As states start to open up, many providers are also focused on obtaining ample amounts of personal protective equipment and reconfiguring their offices in order to see patients in the safest manner possible.
Dr. Meeske, vice chair of the ADA Council on Advocacy for Access and Prevention, added that the Nebraska Medicaid program, its dental contractor, MCNA, and fellow state dental Medicaid provider dentists have worked together during the pandemic to assure that these patients continue to receive needed dental care. They’ve also worked hard to acquire PPE.
“Knowing that federal relief may be coming to states and to dentists will help our practices continue to see these children and encourage other dentists to stay in the program,” she said. “I feel strongly that these kids and low-income adults, particularly those with special health care needs, deserve a dental home with a dentist that is close to home.”
Dr. Czerepak, a member of CAAP’s Medicaid Provider Advisory Committee, said he appreciated the Association’s advocacy efforts on the issue.
“The ADA has held its end of the bargain. They wrote letters and used our government advocacy system to help the kids that need us the most by helping them get access to care,” he said. “The core group of Medicaid providers, the ones who see 90 percent of the patients are a dedicated group of people who should be acknowledged for their work. They are a resource for all of us in oral health and I tip my hat to all of them. We want to show these kids growing up [in the pandemic] that oral health is important.”
The last few months have been a whirlwind for Dr. Meeske, but she said things are beginning to return to normal. Last week a woman brought in her two young daughters for early appointments ahead of a very special occasion: their mother’s wedding.
“What a joyous day it was for us. The girls were in perfect oral health,” Dr. Meeske said. “We wished them off to the wedding, all three in their beautiful dresses and happy smiles. It felt good knowing this mom made oral health a priority. I don’t know anyone who visits the dentist and gets married the same day by choice.”
The June 9 announcement is the first of many the Association expects to receive from HHS. The department has also indicated it will be allocating additional relief funds at a future date for dentists who practice outside of Medicaid and CHIP.