Medicaid Dentists Need to Speak Up at HHSC Rate Hearing, November 12

It is a common misconception that your voice does not matter in big government.  Unfortunately, it is that misconception that allows big governments to continue in a state of blissful unawareness about the need for change in their policies and actions. Your voice is important.

Officials lack knowledge and experience of providers

The truth of the matter is that policymakers and administrative officials lack direct experience with the day-to-day realities of running a dental practice in Texas, especially one that serves Medicaid patients.  They only look at statistics on a printed page, the comparisons of Medicaid fee schedules with other states on a computer screen, listen to briefs and conversations with agency colleagues, and that is all they know.

As an example, back in 2012, at the start of the legislative battle over the orthodontic debacle, Dr. Juan D. Villarreal, TDMR’s founder, started visiting in person a number of legislators in the Capitol about the fraud allegations against Medicaid dentists, including himself.

The one comment from those individuals that impressed him was that they had never heard the dentists’ side of the story.  They had only seen the allegations in the media and what their agency bureaucrats had told them, which, to cover their backsides, blamed the dentists.  These visits were vital to helping to change the scene around.

Dentists also testified at legislative hearings on behalf of SB1803, which added due process protections in dealings with OIG, and this legislation passed the Senate 31-0 and the House 119-20, with Gov. Perry signing it into law.

There is power in participation and getting involved.

Use this hearing to educate officials

Although this is not a legislative hearing but a public hearing held by HHSC on November 12, if there is overwhelming participation by Medicaid dentists either by submitting comments about the review to HHSC or testifying virtually or in person in front of HHSC executives or providing written testimony, something more is bound to happen than if no one did, which is what happened two years ago.

By participating in the hearing through comments or written testimony, Medicaid dentists can bridge the knowledge gap by providing HHSC policymakers with firsthand insights into the true costs and challenges of delivering quality dental care under this proposed reimbursement structure.

Here’s why voicing these real-world challenges is essential:

1. 1. Highlighting Cost Pressures: Dental practices face rising expenses in nearly every area—materials, sterilization supplies, advanced technology, and staff wages. These costs have increased sharply over recent years, while Medicaid reimbursement rates have not kept pace. Sharing real data about these expenses helps policymakers understand why static or minimal increases in Medicaid rates fail to cover the cost of care, creating a financial strain on practices and limiting access for Medicaid patients.
   2. Explaining the Impact on Service Quality: When reimbursement rates don’t align with the actual costs, practices are often forced to make difficult choices. This might mean reducing service availability, delaying equipment upgrades, or even reducing appointment availability. By explaining these downstream impacts, dentists can underscore how low reimbursement rates can reduce patient access to care and compromise service quality—ultimately affecting the health outcomes Medicaid aims to support.
   3. Illustrating the Challenge of Attracting and Retaining Skilled Staff: Recruiting and retaining qualified dental professionals—assistants, hygienists, and administrative staff—is essential to running a high-quality practice. However, competitive wages are hard to offer when reimbursement rates are low. Dentists can use this platform to illustrate the staffing challenges they face, explaining how limited resources make it difficult to maintain a skilled team, which directly impacts patient care.
   4. Providing Data on Medicaid Patient Needs: Medicaid patients often have unique and complex oral health needs that require more intensive or specialized care. Dentists who work closely with this population can bring these realities to light, explaining the specific demands and how low reimbursement rates can limit their ability to meet those needs effectively. This can help HHSC understand why an increased rate structure is critical for the quality and comprehensiveness of Medicaid dental services.
   5. Advocating for Real Solutions: Dentists not only highlight issues but also offer potential solutions and realistic adjustments that can make a meaningful difference. This insight from those “on the ground” is invaluable, as it offers practical recommendations that may not be apparent to policymakers.

How to participate

From the document below:

Direct Testimony

The Texas Health and Human Services Commission (HHSC) will conduct a hearing to receive public comment on proposed Medicaid payment rates detailed in this document on November 12, 2024, at 9:00 a.m. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements. HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communicationsevents/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website.

This hearing will be conducted both in-person and as an online event. Members of the public may attend the rate hearing in person, which will be held in the Public Hearing Rooms 1.401, 1.402, 1.403 and 1.404 in the North Austin Complex, 4601 W Guadalupe St, Austin, Texas.

Please register for HHSC Public Rate Hearing for Medicaid Reimbursement Rates on November 12, 2024 9:00 AM CST at:

https://attendee.gotowebinar.com/register/5854419373469218647

Webinar ID
433-069-979

Comments and written testimony

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. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance Department, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance Department at (512) 730-7475; or by e-mail to PFDAcuteCare@hhs.texas.gov. In addition, written comments will be accepted by overnight mail or hand delivery to Texas Health and Human Services Commission, Attention: Provider Finance Department, Mail Code H-400, North Austin Complex, 4601 W Guadalupe St, Austin, Texas 78751