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PUBLICATIONS
ADA
Reports
- State
innovations to improve access to oral health care for
low income children: A compendium update. 2005.
This compendium identifies and summarizes successful
state interventions to improve access to oral health
services for children enrolled in
Medicaid or the State Children’s Health Insurance Program (SCHIP).
State summaries are divided into two main sections: (1) Medicaid/SCHIP
oral health care for children and (2) state oral health care innovations.
Information about each of the interventions is presented in the following
categories: (1) administrative policies and procedures; (2) work force
resources; (3) education, communication, and patient care facilitation;
and (4) financing and reimbursement.
- Crall, J. and
Schneider, D., with American Dental Association (Ed.). Increasing
access to Medicaid dental services for children through
collaborative partnerships. 2004.
This brief discusses barriers to access to oral health services for
children enrolled in Medicaid and presents a rationale for increasing
access through collaborative partnerships. The brief identifies three
areas of concern associated with Medicaid dental programs that discourage
dentist participation and limit access to care. Also provided are examples
from several states that have engaged in significant efforts to improve
access to oral health services for individuals covered by Medicaid.
- Crall,
J. and Schneider, D., with American Dental Association
(Ed.). Medicaid
program administration. 2004.
This brief discusses the way Medicaid dental programs are administered
and how simplifying the administration procedures could help increase
access to oral health care for Medicaid enrollees. The brief focuses
on how states administer Medicaid dental programs. Topics include single-vendor
contracting, state reconsideration of managed care strategies, and
state efforts to reduce administrative burdens. Single-vendor programs
in Michigan and Tennessee are described. A list of notable Medicaid
dental program administrative innovations is also included.
- Crall, J. and
Schneider, D., with American Dental Association (Ed.). Enhancing
dental Medicaid outreach and care coordination. 2004.
This brief discusses ways to increase awareness of the importance of
oral health and to improve care coordination for Medicaid participants,
thereby decreasing the rate of no-show appointments and increasing
compliance with oral health instructions. The brief focuses on innovative
strategies and approaches that some states are using. Topics include
consumer outreach, locating Medicaid dental providers, obtaining oral
health screenings and referrals, case management and support services,
reducing the number of missed appointments, and coordinating oral health
care for young children and pregnant women. Brief case studies of several
state programs are presented.
- Crall, J.
and Schneider, D., with American Dental Association (Ed.). Medicaid
reimbursement: Using marketplace principles to increase
access to dental services. 2004.
This brief discusses Medicaid reimbursement rates
for oral health services and how these rates, which
often fall well below dentists’ fees,
contribute to dentists’ reluctance to participate in Medicaid.
Topics include problems with current state Medicaid reimbursement rates;
using percentile analysis to establish marketbased Medicaid reimbursement
rates; and state-bystate, regional, and national comparisons of Medicaid
payment rates and market-based fees.
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California HealthCare Foundation
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Children's
Dental Health Project — Medicaid and SCHIP Publications
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CMS
Forms and Publications
- Schneider,
D., Hayes, K. L. and Crall, J. J. The
CMS Form-416 report: Understanding its use in assessing
dental care utilization in Medicaid's Early Periodic
Screening, Diagnostic and Treatment (EPSDT) Service for children.
National Oral Health Policy Center, 2005.
This
technical issue brief provides an overview of Medicaid
and the Early
and Periodic Screening, Diagnostic and Treatment
(EPSDT) program;
Medicaid-eligible children's ability to access oral
health services; data on children's utlization of oral
health services in Medicaid;
and the Centers for Medicare and Medicaid (CMS) Services
Form-416 report, which is the most common source of such
data. The
brief provides background
on EPSDT and discusses EPSDT statutory enhancements,
reporting of EPSDT oral health services utilization (CMS
Form-416),
rates of oral health
services utilization derived from revised CMS Form-416
data, uses of EPSDT oral health utilization data, cautions
in using
Form-416 data
and derived utilization rates, and proposals for
additional adjustments to Form-416 data.
- Medicaid and SCHIP Quality Spring Teleconference
On April 3, 2008, the CMS Center for Medicaid & State
Operations, Division of Quality, Evaluations and Health Outcomes,
conducted a national audio-conference on pediatric oral health.
There were presentations on innovative payment practices,
state approaches to increasing provider participation and
access to dental services, and state approaches to dental
performance/quality improvement measures. Click
here for handout materials from the call.
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Congressional Testimony
- Concerns Remain about Sufficiency
of Data for Oversight of Children's Dental Services--Testimony
Before the Subcommittee on Domestic Policy, Committee
on Oversight and Government Reform, House of Representatives --
GAO Report # GAO-07-826T
- "Insuring Bright Futures: Improving
Access to Dental Care and Providing a Healthy Start for
Children." Testimony before the US House of Representatives,
Committee on Energy and Commerce, Subcommittee on Health;
March 27, 2007.
Archived Video Webcast of Hearing available at http://boss.streamos.com/download/energycommerce/032707.he.hrg.dental.wmv.
- Jack M. Chapman, MD, President, Health
Access Initiative
- Christine Farrell, RDH, MPA, Medicaid
Policy Specialist, Medical Services Administration,
Michigan Department of Community Health
- Stephen Corbin, DDS, MPH, Senior
Vice President for Constituent Services and Support,
Special Olympics International
- Burton L. Edelstein, DDS, MPH, Board
Chair, Children’s Dental Health Project, Washington
DC, Professor of Dentistry and Health Policy, Columbia
University
- Chris Koyanagi, Policy Director,
Bazelon Center for Mental Health Law
- David M. Krol, MD, MPH, FAAP, Chair,
Department of Pediatrics, University of Toledo College
of Medicine
- Nicholas G. Mosca, DDS, University
of Mississippi, School of Dentistry
- Kathleen Roth, DDS, President, American
Dental Association
- Raymond C. Scheppach, PhD, Executive
Director, National Governors Association
- Oversight
Adequacy of the Pediatric Dental Program for Medicaid Eligible
Children. Testimony before the US
House of Representatives, Committee on Oversight and Government
Reform, Subcommittee on Domestic Policy; May 2, 2007. Links
include:
- Chairman
Kucinich's opening statement and testimony from Frederick
Clark, Dennis Smith, Norman Tinanoff,
Allen Finkelstein, Jane Perkins, Susan Tucker, Laurie
Norris, and James Cosgrove.
- Video
of the hearing.
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Deficit
Reduction Act of 2005 Information
- Tritz,
K., Tilson, S., Stone, J., Peterson, C., O'Sullivan,
J., et al. (2006). Side-by-Side
Comparison of Medicare, Medicaid, and SCHIP Provisions
in the Deficit Reduction Act of 2005. Washington,
DC: Congressional Research Service.
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EPSDT
Periodicity Schedules submit
your state's schedule
- MSDA
letter to state Medicaid directors
This
letter was developed by the board of MSDA, in response
to a letter that AAPD sent to state Medicaid directors
regarding EPSDT and the dental periodicity schedule.
- EPSDT
Periodicity Schedules and Their Relation to Pediatric
Oral Health Standards in Head Start and Early Head Start
This
technical brief discusses the relationship between Early
Head Start (EHS) and Head Start (HS) and Medicaid's Early
and Periodic Screeing, Diagnostic and Treatment (EPSDT)
program.
The brief, which includes an executive summary, discusses
(1) oral health services in HS and EHS programs, (2)
the role of
Medicaid and its relationship to HS, (3) EHS/HS performance
standards for oral health services, (4) linkages to EPSDT
and the need for suitable dental periodicity schedules,
and (5)
periodicity considerations for EHS/HS oral health services.
Strategic recommendations are included.
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Medicaid
Dental Expenditures Compared to Total Medicaid Expenditures,
2005 (Data from CMS-64 forms)
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Medicaid
Dental Program Reports submit
your state's report
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National Academy for State Health Policy
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National Oral Health Policy Center
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Office of the Inspector General, Department of Health
and Human Services
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State
Medicaid Policy
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