Best Practices in Medicaid and CHIP Oral Health Programs
Mark Casey, DDS, MPH and Lynn Mouden, DDS, MPH

Robert L. Birdwell, DDS, MSDA President

This opening keynote address will set the stage for the two day Symposium. State Medicaid and CHIP programs are continuously faced with the challenge of meeting federal, legislative mandates to provide or arrange for the provision of EPSDT services; including any medically necessary healthcare service to beneficiaries, while at the same time adhering to requirements for balanced state budgets. Participants will gain insight from a national expert on the factors that influence these challenges and the anticipated changes Medicaid and CHIP programs will endure as Healthcare Reform takes shape.

This session will provide basic knowledge regarding key federal legislation which brought about the Medicaid and CHIP programs. The history of these programs, significant changes and current legislation as they relate to state program infrastructure and policy will be discussed. Current service and payer models affecting private providers, as well as the safety-net, public health, medical, dental and dental hygiene schools and programs will be presented. Emerging issues and legislation affecting policy, programs and oral healthcare services will be discussed. A “snap shot” perspective regarding the various federal legislative proposals being considered by Congress regarding the Medicaid and CHIP programs and how they might impact state programs and policy will be discussed. Perspectives on Healthcare Reform and the Affordable Care Act (PPACA) will be highlighted.

This session will focus on the current challenges and difficu lt decisions state programs face as result of state budget shortfalls. Proposed policy changes as a result of Healthcare Reform and their impact will also be highlighted. Questions for consideration during Session 6 Tuesday morning breakout will be proposed.

Greg Folse, DDS

This session will spotlight federal and state Medicaid policies and programs related to the delivery of oral healthcare services in school-based settings. Specific Medicaid issues related to mobile, portable and teledentistry will be discussed. Strategies for meeting the 2010 CMS oral health goals will be highlighted.

James Thommes, DDS; David Kilber DMD; and Martha Dellapenna, RDH, MEd

Program integrity has become a top level priority for state Medicaid programs. This session will bring together an expert panel in areas of dental program oversight. Monitoring provider behavior, the necessity of adequate information systems in detecting fraudulent activities and the overall importance of proper provider payment and accountability for Medicaid dental services will be discussed.

Tuesday, June 28, 2011

No one group can do it all. Federal agencies and state programs are forging new partnerships to help reduce the burden of dental disease and increase access to care. This session will highlight programs and initiatives currently underway at the federal and state levels.

During this session, attendees will separate into groups by “discipline”. A group facilitator will guide participants in a discussion regarding key Medicaid issues, policies and or program models that directly affect each discipline/group. The groups will be charged with identifying program and/or policy gaps and recommendations for improvements as they relate to their discipline.

During this session, participants will re-convene and group facilitators will report stakeholder discussions to the full assembly. Additional questions and comments will then be solicited from the audience.

States use Medicaid and CHIP dental claim data to assess access and program administration. This session will begin with a brief overview of those data systems currently in place, followed by a federal perspective of their utility and any potential changes. This session will focus on the changes in the system and how those changes will impact Medicaid and CHIP programs and their constituencies.

Changes and improvements in the system will depend upon the extent to which Medicaid and CHIP dental programs effectively collaborate, cooperate and communicate with their respective constituencies. This session will wrap up the Symposium by creating a concrete list of actionable items for Medicaid and CHIP dental programs and their partners to consider.