Dental benefits provider DentaQuest is limiting the number of additional dentists in its Medicaid network in Texas, according to an Oct. 14 report by Texas Dentists for Medicaid Reform.
Here are seven things to know:
1. As of Oct. 15, DentaQuest is accepting additional Medicaid network applications from general and pediatric dentists on an as-needed basis only.
2. The company stated in a letter that it currently has an adequate network of dentists to meet the needs of its Medicaid patients.
3. The changes affect 72 counties in Texas, which represent 74% of the state's population and 79% of the state's children on Medicaid.
4. Additional dentists may only be added to an existing provider's Medicaid roster if they are replacing a dentist who left the practice within 30 calendar days.
5. DentaQuest will not accept any Medicaid applications from new providers or groups unless the company determines that there is an identified need.
6. Providers who are already part of the Medicaid network may not add any new practices or locations in the 72 counties unless DentaQuest determines that there is a need for it.
7. In September, the Louisiana state legislature delayed the renewal of its Medicaid contract with DentaQuest amid coverage concerns.
DentaQuest provided the following statement to Becker's:
Preserving access to quality oral healthcare for Texans who rely on Medicaid is our top priority. DentaQuest maintains the largest Medicaid dental network and the most dental access points in the state. We continue to expand the network in regions where more dental care access is needed for our Medicaid members.
It is our duty as good stewards of Texas’ Medicaid dollars to regularly review and adjust our dental program to optimize performance within available program funding, which has been stretched following the end of the Public Health Emergency and the eligibility redetermination process.
As a result, beginning October 15 we are pausing the addition of new general and pediatric dentists only in targeted counties. We have a robust network of quality general and pediatric dentists who can meet the ongoing needs of the Medicaid community in these areas. Of course there are exceptions, such as replacing dentists at existing network locations who may leave the practice. We have made the Texas Health and Human Services Commission aware of our network management activity.
There are no changes to any of DentaQuest’s other networks in Texas, including Texas CHIP.
DentaQuest is proud of our Medicaid program in Texas, where we have consistently delivered high provider and member satisfaction as well as the highest quality scores of all Texas Medicaid dental administrators. We value the partnerships we have built during the last 12 years. We are honored to work alongside Texas dental providers in pursuit of our common goal of improving the oral health of all Texans.