Reports of denied dental care mount after Bevin's Medicaid cuts

Deborah Yetter
Courier Journal

Dentist Bill Collins treats a patient at the Red Bird Mission clinic in Eastern Kentucky in 2017 as dental assistant Kayla Collett looks on.

Two advocacy groups on Thursday called on the administration of Gov. Matt Bevin to ensure children and pregnant women are not affected by the state's abrupt decision to  cut dental and vision benefits to nearly a half-million Kentuckians.

The Kentucky Oral Health Coalition said in a statement it has received about a half-dozen reports directly from dentists that the cuts were resulting in "denial of routine dental care of eligible children and pregnant women."

"Though these populations were supposed to be protected from coverage changes, errors have meant that children who show up for a dental visit have been turned away with unmet dental needs unnecessarily," the statement said.

Terry Brooks, executive director of Kentucky Youth Advocates, said his organization also had received reports of denials of such care from "numerous dental providers across the state."

Kentucky Youth Advocates provides staff for the oral health group, a coalition of dental health providers and advocates.

The Courier Journal on Tuesday night reported that some dentists said they had to turn away children and pregnant women after they were mistakenly showing up in the state's computer system as having no dental coverage — even though they were supposed to be exempt from the cuts.

Doug Hogan, a spokesman for the Cabinet for Health and Family Services, blamed the Courier Journal on Thursday for the confusion surrounding the program it calls Kentucky HEALTH.

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"Unfortunately, recent irresponsible, unsubstantiated reporting by The Courier-Journal has contributed to misinformation about Kentucky HEALTH amongst the public," he wrote in an email to the Courier Journal.

Hogan also took issue with statements by the advocacy organizations.

"These statements by advocacy/interest groups and others are perpetuating misinformation, and causing confusion among individuals calling to check on eligibility for themselves and/or their children," he said.

Hogan said the cabinet's policy exempting pregnant women and children has not changed and blamed the problems on health care providers who "have misinterpreted computer screen eligibility information and turned away some patients."

But Dr. Bill Collins, a Pikeville dentist who also practices at the Redbird Mission in Clay County, said when he checked Medicaid eligibility for patients, he found multiple errors for children as well as a pregnant patient, listing them as either having no dental coverage or being enrolled in the "My Rewards" dental program for able-bodied adults, which was set aside by the court order.

Under the "My Rewards" plan, adults would lose basic dental coverage but could earn points toward buying dental services through activities such as volunteering or taking online classes.

Collins said one of his patients was a disabled, 11-year-old boy who the Medicaid computer system said was covered by "My Rewards." Medicaid staff he called couldn't explain it, Collins said.

Collins said he said he has experienced the same problems with patient eligibility at both of his clinics.

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He said when he called the state Medicaid Department this week trying to determine whether the patients had dental coverage, a worker told him he couldn't say — or say whether he would get paid for dental services for those patients.

Collins dismissed the cabinet's claim that providers aren't interpreting computer information correctly.

"They're playing games," Collins said.

Meanwhile, the abrupt nature of the cuts has sparked concern from both the Kentucky Dental Association and the Kentucky Optometric Association.

The state's dentists are "disappointed by the removal of dental benefits" but will continue to work with patients for better dental health and to work with the Bevin administration to "restore those benefits as soon as possible," Executive Director Richard Whitehouse said in a statement. 

The optometrists' group said it was surprised by the cuts and is "disappointed that substantial changes were made in this manner."

Dentists across the state have reported confusion and frustration among patients from the cuts, which followed a judge's order last week striking down Bevin's plan to overhaul the Kentucky's Medicaid program. 

 "I think there's just a lot of uncertainty," said Jennifer Hasch, manager of dental services for the Shawnee Christian Healthcare Center in Louisville. "Patients are really confused. It was so abrupt there's a lot of fear from people about whether it affects their dental coverage."

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Many patients didn't realize they'd  lost coverage until they showed up for appointments this week, they said.

"Obviously, patients are not very happy when that happens," Owensboro dentist Matt Johnson said. "I wouldn’t be, either."

The state announced the cuts after a federal judge on June 29 rejected Bevin's new plan for Medicaid that included work requirements and premiums, largely for the "able-bodied" adults among about 500,000 people added to Medicaid under an expansion authorized by the Affordable Care Act.

After the judge rejected that plan, the state announced it was ending vision and dental coverage for about 460,000 people.

Advocates say they may challenge the cuts on the grounds the state did not give sufficient notice of the cuts and time for public comment, as required by Medicaid rules.

Deborah Yetter: 502-582-4228; dyetter@courierjournal.com; Twitter: @d_yetter. Support strong local journalism by subscribing today: courier-journal.com/deborahy.