Medicaid dental reimbursement increase considered

Members of the Health and Human Services Committee heard testimony Feb. 16 on a bill that seeks to increase access to dental services for Nebraska Medicaid recipients.

LB358, sponsored by Fremont Sen. Lynne Walz, would increase the reimbursement rate for dental services provided under Medicaid by 25 percent. Walz said the increase would better support providers who choose to care for some of Nebraska’s most vulnerable residents.

“People on Medicaid are already struggling to get by day to day, but compounding factors like poor dental health make life even harder,” she said.

Walz said early childhood tooth decay, one of the most chronic illnesses in the U.S., has been connected to educational and behavioral issues and can lead to disabilities. She also noted that poor dental health in adults can cause employment issues, mental health problems and impaired speech and can lead to other health issues, including heart attack, stroke or dementia.

Nebraska Dental Association vice president and pediatric dentist, Jessica Meeske, testified in support of LB358. Meeske said her practice has cared for kids on Medicaid for over 40 years, but is being forced to reconsider that commitment due to reimbursement rates.

“The number of people with Medicaid is going up and the number of dentists willing to see them is going down,” Meeske said. “Only 12 percent of adults with Medicaid in 2022 received any dental visit — preventative or emergency.”

Sophia Pankratz, a third-year dental student, also spoke in support of the bill. Her program has limited the number of Medicaid patients seen because the cost of care is significantly higher than the reimbursement rate, she said. Treating Medicaid patients enhances clinical training and teaches dental students how best to support patients with barriers to health care, Pankratz said.

“This not only impacts student opportunities to treat patients and gain valuable experience,” she said, “it also limits our ability to care for underserved Nebraskans.”

Also testifying in favor of LB358 was Corinne Van Osdel, an Omaha dentist who primarily provides care to medically compromised patients and individuals with special needs.

Van Osdel and her two colleagues are the only dentists within a three-hour drive of Omaha who provide operating room care to special needs patients on Medicaid, she said. The waitlist for a patient to be examined and provided traditional care is one year, she said, but for patients who need care in an operating room, that wait can be up to four years.

“We do not know how severe a special needs patient’s dental disease is until we are able to get them into the operating room,” Van Osdel said, “in four years this can become catastrophic.”

Arc of Nebraska representative Edison McDonald also spoke in support, noting the impact the bill would have on individuals with intellectual and developmental disabilities.

“In Nebraska, 41 percent of individuals with an intellectual or developmental disability do not receive regular dental care,” he said. “This is frequently one of the most difficult services for our members to find.”

No one testified in opposition to LB358 and the committee took no immediate action.