Dentists cite low, slow KanCare reimbursements

(KSN File Photo)
(KSN File Photo)

TOPEKA, Kan. (AP) — Low reimbursement rates are preventing many dentists from accepting patients covered by Kansas’ managed care plan running Medicaid, with delays in getting paid also contributing to the problem, dentists say.

The reimbursement rate for KanCare patients is about 40 percent of his fee, Manhattan dentist E. Hamrick Swan Jr. told the Topeka Capital-Journal.

The low rates are partly responsible for a shortage of dentists in areas where many of the patients are covered by KanCare, he said.

“The Legislature has put it on dentists’ back to support these people,” he said. “They’re underserved because nobody can afford to make a living at 40 percent of their fee.”

Swan still takes KanCare patients, but said he will need to reduce how many new ones he accepts. In order for practices serving a large number of KanCare patients to survive, they need to have a majority of patients paying through private insurance, he said.

“If the percent of patients (covered by Medicaid) hits 40 or 50 percent, you’re having trouble,” he said. “It’s getting very difficult to meet all of my obligations.”

The switch to KanCare includes a requirement that rates couldn’t fall below their 2012 levels, said Aimee Rosenow, spokeswoman for Kansas Department of Health and Environment’s health programs.

The state spent $57.3 million on dental care for KanCare recipients in 2013, up from $50.7 million for Medicaid dental services in 2012, she said, adding that none of the rates were reduced before or after KanCare.

But they haven’t gone up very much, either, said Kevin Robertson, executive director of the Kansas Dental Association, especially when the costs to dentists of providing services continue to rise. Some dental offices are reporting trouble getting paid because the managed care organizations running KanCare want to preauthorize some procedures and sometimes refuse to pay part of the bill, he said.

East Topeka Dental Associates doesn’t take KanCare patients, office manager Jodi Hauschild said, but its two-day clinic in Holton can take a limited number.

Low reimbursement rates limit how many patients the Holton clinic can accept, she said, and the length of time to process KanCare claims also creates headaches because it often takes more than a month to get paid.

Despite that, dentists Benjamin Rutherford and Carrie Peterson accept some KanCare patients in Holton because so few other providers do, Hauschild said.

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