MEDICAID FEE INCREASE HAVING POSITIVE IMPACT ON PATIENTS, DENTISTS

New Ohio dental Medicaid fees went into effect on Jan. 1. The new fees come to an average of a 93% increase over the previous fees, which had not seen any significant increase in over 20 years.

“The new reimbursement rates are having a positive effect across the board,” said Dr. Jennifer Kale, chair of the ODA Medicaid Working Group. “Many dentists are taking a hard look at signing up as Medicaid providers or taking on additional Medicaid patients thanks to the fee increase. This is good news when it comes to improving access to care for patients in need. Additionally, we’re hearing reports that some dental insurance companies are considering raising their rates to remain competitive with the new Medicaid fee schedule. This will benefit all dentists across Ohio.”

The ODA’s advocacy team and grassroots dentists had been actively advocating for a substantial increase in the state’s funding of Ohio’s dental Medicaid program over the past several years. In July 2023, the Ohio General Assembly passed the state’s budget for 2024 and 2025, which included an increase in dental Medicaid funding.

All of the funding increase that was approved in the state budget will be directed towards patient care in the form of increased fees and not plan administration.

According to the ODA membership survey, participation in Medicaid had dropped from 30% in 1994 to 18% in 2023. Of those who do not participate in Medicaid or Medicaid managed care, 86% said it was because of low reimbursements.

“With this significant increase in Medicaid reimbursements, it is our hope that more dentists will sign up to be Medicaid providers to help improve access to care,” said Dr. Manny Chopra, ODA president. “Thanks to the ODA’s aggressive advocacy efforts, we are able to see a significant change in Medicaid reimbursement levels that will make a tangible impact on dental practices and patients in Ohio.”

The Health Policy Institute of Ohio reports that “Ohio Medicaid provides healthcare coverage for about 3.55 million Ohioans with low incomes, most of whom are children, older adults, people with disabilities and low-income adults who could not otherwise afford private or employer-sponsored health insurance.” The U.S. Census Bureau’s July 2022 estimates indicated that over 11,750,000 people live in Ohio.

For more information and to sign up to become a Medicaid provider, visit https://medicaid.ohio.gov/resources-forproviders/managed-care/become-a-provider.