The American Alliance for Dental Insurance Quality and the Massachusetts Dental Society released a letter concerning access to care problems in the Massachusetts Medicaid system.
The letter, backed by nine dental organizations, is centered around potential noncompliance by DentaQuest, MassHealth's third-party administrator, when it comes to care requirements for children on Medicaid, according to a May 20 news release.
The groups claim that DentaQuest using a distance-to-provider metric instead of a "care and services availability" metric leads to less coverage.
The noncompliance letter was led by Mouhab Rizkallah, DDS, president of AADIQ, and was sent Feb. 9, the release said.
DentaQuest provided the following statement to Becker's: "DentaQuest is proud of our record in the Commonwealth, and we prioritize access to care for all members. We have a 99%+ access rate as defined by the state and maintain a dedicated center of excellence to provide MassHealth members individualized assistance related to accessing care, such as changing providers or finding an alternate appointment.
"The letter in question was sent to MassHealth in February and did not prompt any action. The state determines how network adequacy is defined, measured and reported. What's more, the state's Department of Insurance sets the geo-standards for all carriers (medical and dental) statewide. DentaQuest is fully compliant with the contract requirements as defined today by the state and will ensure continued compliance should those requirements change in the future. For additional questions related to the distance-to-provider metric, please reach out directly to MassHealth or the DOI."