DHS to end Medicaid managed care dental program, return to fee-for-service

by Talk Business & Politics staff ([email protected]) 589 views 

The Arkansas Department of Human Services (DHS) announced Monday (June 3) that it will end its Medicaid managed care dental program and return beneficiaries who qualify for dental coverage to the Medicaid fee-for-service program beginning later this year.

DHS expects to launch this program on Nov. 1, 2024, and efforts to support this change are being prioritized immediately, it said.

The dental managed care program within Arkansas Medicaid has been in effect since Jan. 1, 2018, and as of this month serves 572,047 beneficiaries.

“After careful consideration of dental service utilization, the total program expenditures, and the work underway to ensure a holistic, efficient, and sustainable Medicaid delivery system for all Arkansans, DHS has determined that fee-for-service for Medicaid dental services is both the best and most cost-effective option at this time,” DHS Secretary Kristi Putnam said. “This change shifts management of the program to the DHS Division of Medical Services (DMS), where we will operate it efficiently and effectively. This transition makes better sense for Arkansas patients, dentists, and taxpayers.”

Sen. Missy Irvin, R-Mountain View, chair of the Senate Public Health Committee, said she agreed with the DHS decision.

“I believe DHS made the appropriate decision after evaluating the delivery system, contracts and drop in utilization. Ultimately, it’s about making sure the qualified Arkansans who are being served can get the quality care they need, and for the state to utilize the most efficient and effective delivery system to provide that service. The goal is to improve the dental health of Arkansans. Clearly they have evaluated the system with that goal in mind and made a decision to return to paying dentists directly for the care they provide,” Sen. Irvin said.

In a letter sent on Friday, DHS formally notified the Centers for Medicare and Medicaid Services of the plan to sunset the program and to switch back to Medicaid fee-for-service for dental services instead.

The letter also includes a month-by-month transition plan for activities leading up to the targeted November 1 start date. DHS notified both companies that currently operate the managed care dental program — Delta Dental of Arkansas and Managed Care of North America (MCNA) — of the plan Monday.

“Our staff will work closely with providers, partners, and other stakeholders to make this transition seamless and assure that care remains readily available for beneficiaries leading up to November 1 and beyond,” Putnam said.

With this shift, beneficiaries served by the managed care dental program will continue to be eligible for dental services. However, DHS will administer the program instead of Delta Dental and MCNA. In the months leading up to November 1, beneficiaries can expect to continue receiving dental services through Delta Dental and MCNA, DHS said.