UPDATE: September 1, HHS announced this morning that it has put on hold the proposed rate changes per legislative sources.
Original story: August 1, 2017
TDMR has received a copy of an email from the Texas Academy of Pediatric Dentistry asking members to contact Texas Health and Human Services over a proposed decrease in Medicaid dental rates. They warn in the email that “many very critically important codes are being slashed.”
Public hearing on Tuesday, August 8 in Austin
Next Tuesday, August 8 in Austin, HHS is holding a public meeting regarding “Proposed Medicaid Payment Rates for the Medicaid Biennial Calendar Fee Review” at which the new fee structure is to be discussed for many specialties including dental. The meeting will be held at the Health and Human Services Commission, Brown-Heatly Building, Public Hearing Room, 4900 North Lamar Blvd. Austin, TX 78751 at 1:30 pm. Attachments showing the rate structure changes for all can be downloaded from the HHS website. A spreadsheet relating to dental rates is shown below.
Effective rate decrease said to be 6%
A dentist following the issue told TDMR that the overall rate cut appears to be about 6% after several codes that are rare but have rate increases are eliminated.
TAPD wants members to make their views known
TAPD is exhorting members to email HHS their comments if they cannot attend the meeting.
Here are the entire contents of the TAPD email:
Dear Colleagues,
As many of you are aware a Medicaid dental rate hearing is taking place August 8th. As you will see, many very critically important codes are being slashed. There are 2 ways to participate. Please choose one.
A very effective way to respond is in writing. You can send, via email, written comment but be VERY specific why certain codes should not be reduced, because we can offer insight like no body else can.
You can also sign up to speak at the rate hearing and speak about how the rate changes make no sense and will affect access to preventive services to the most vulnerable population in Texas plus other insight you gain from reviewing the new fee schedule.
Thanks for doing this. Please share the information with all colleagues.
When they tried to lower the ASC facility fee for dental anesthesia, there was a great amount of non support and they decided to study the issues further before taking action.
Here’s the contact info for the meeting:
Written comments regarding the proposed payment rate adjustments will be accepted in lieu of, or in addition to, oral testimony until 5 p.m. the day of the hearing, August 8.
Written comments may be sent by U.S. mail to:
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030
by fax to Rate Analysis at (512) 730-7475
or by e-mail to RADAcuteCare@hhsc.state.tx.us.
In addition, written comments will be accepted by overnight mail or hand delivery to:
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400; Brown-Heatly Building
4900 North Lamar
Austin, Texas 78751
Sincerely,
TAPD
Proposed Rates to take effect October 1, 2017
Wow. This is huge. They are trying to pass this off quietly, it is a loud issue. It is monstrous. This may be sold as 6%, but it is more realistically a 20% hit to practices treating children. For the average practicing dentist who treats Medicaid kids look out. Look at common procedures like 1-3 surface anterior restorations, recall exams, FDH (36% hit huge) bite wings, fmx’s, Pano’s, RCT,s(almost 30% hit), any type of surgical extractions (Full bony’s 30% hit), conscious sedations, adult SSC’s. Almost every common procedure outside of posterior fillings is absolutely taking a pounding. We need all hands on deck to fight this. We need the Texas Dental Association to fight this. The program was designed for kids, now a significant piece of the funding is lining the DMO’s pockets. These appear to be recommendations from HHSC, but this is from the DMO’s to the state.
What is current status for October
See the update at the top. It’s on hold.
What and when will a decision be made on these fees?
That is how MCO\’s adjust the budget. and become the best save money people to the eyes of Medicaid and health human service.
Now we have the health and human service secretary having to leave his office because miss use of the government moneys . A good example of whom really is abusing with the tax moneys.