A decade ago, Dr. Roger Gausman was among a dozen dentists in Hutchinson who served children from poor families whose health insurance was provided though Medicaid, the publicly-funded medical program for low-income families and persons with disabilities.

But for reasons that include low Medicaid reimbursement rates to dentists for the services they provide, many dentists have dropped out of the program. Today, Dr. Gausman is one of only two dentists in Hutchinson providing services to children in the Medicaid program. And Gausman says the situation for children from families in the Medicaid program is repeated all across the state, putting a heavy strain on dentists who continue to serve children in the program.

"It's a problem everywhere," he said. "So many are not seeing children with Medicaid, we try to make up for the shortfall. But most of us have had to restrict our caseload. We can't take all Medicaid patients."

In an attempt to alleviate a severe access problem for families with children who receive dental services through Medicaid, the 1997 Kansas Legislature increased rates paid for dental services provided children in the program. The rate increase, which goes into effect July 1, is the first in the children's dental program in about 10 years.

Department of Social and Rehabilitation Services Secretary Rochelle Chronister said she hopes the increase, together with the simplification of children's dental reimbursement forms and codes, will bring Kansas dentists back into the program.

"We have had serious access problems for families because we have not had enough dentists participating in the program," said Chronister. "There are poor families in the state who have not been getting dental treatment for their children because they cannot find a dentist to provide services."

Over the past several years, the number of dentists providing treatment to children covered by Medicaid has dwindled. In some counties, no dentists are available to treat children who receive health care insurance through Medicaid. Of about 1,200 practicing dentists in the state, only about 400 provide services to children whose health insurance comes from the Medicaid program, according to figures from the Kansas Dental Association and SRS. Many of the dentists in the program see only a limited number of children who have insurance through Medicaid.

In Kansas, Medicaid covers most dental procedures for children who qualify for the program. Adult dental procedures are not covered by Medicaid except in medical emergencies.

Carl Schmitthenner, executive director of the Kansas Dental Association, said the rate increase and the work done to simplify reimbursement codes and forms are good first steps toward bringing more Kansas dentists back into the program. He indicated rates have been so low, it made it impossible for many dentists -- especially those in small offices -- to provide Medicaid services. He also said difficulties in billing for Medicaid services caused some dentists to quit the program.

"Hopefully, dentists will be more willing to participate," he said. "These are moves in the right direction."

Ann Koci, commissioner of Adult and Medical Services for SRS, said the agency has simplified forms and codes dentists needed to receive Medicaid reimbursement. The agency has recently begun using the American Dental Associations forms and codes in the Medicaid program.

"So now we have the same billing codes and forms that are used by all insurance companies," she said. "Along with the rate increase, we are hoping this also will help bring dentists back into the Medicaid program. They are very much needed if Kansas children are to receive dental treatment."

The rate increase will bring rates for Medicaid-funded dental procedures to the 50th percentile, meaning that half of dentists billing for the same procedure charge more and half charge less. Before this increase, some procedures billed through Medicaid were as low as the 30th percentile.

In total, the Kansas Legislature appropriated an additional $3.8 million for the children's dental program. Current expenditures for the program are $7.5 million. With the rate increase, expenditures next fiscal year will be about $11 million.

Page Last Updated: May 29, 2001