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Spokane, Washington  Est. May 19, 1883

Many Idaho Dentists Limiting Medicaid Patients Federal-State Program Doesn’t Cover Even Half The Cost For Poor Patients

Associated Press

Dr. David Heninger considers the Medicaid patient in his dental chair a free service because the state will reimburse him for less than half his costs.

“I don’t think that there are any questions that when we see a Medicaid patient, we typically lose money,” the Idaho Falls dentist said. “In my perspective, it’s like service to the community. It’s like doing time.”

The federal-state program that provides health care for the poor, elderly and disabled pays less than half of a dentist’s regular fees, about 44 percent, said Jerry Davis, Idaho State Dental Association director.

Many Idaho dentists are so frustrated with the low reimbursement that they have stopped taking Medicaid patients. Medicaid officials in Boise estimate three out of four dentists statewide have done so.

Heninger limits the number of Medicaid patients he takes each month to about 100, he said, because otherwise there would be an insufficient amount of money coming in.

Dr. Keith Couch, another Idaho Falls dentist, refers Medicaid patients to other dentists in town. He said he served many when he began his practice, but has stopped.

“Personally, I’m not taking them because I’ve paid my dues,” he said. “I admire other dentists for doing that. I just kind of burned out. I feel the state needs to get together and fix it.”

It is not a new problem. For years, just a small fraction of the state’s Medicaid budget has been set aside for dentists, about 1.5 percent, said Mike Norris, an Idaho Falls man who is contacting legislators about improving the situation.

Medicaid patients do not have as much of a problem getting medical care, Davis said. Physicians generally do not lose as much as dentists do, he said.

Idaho dentists currently offer about $5 million a year in free or discounted dentistry to the poor, he said.

But if they say no, the 83,000 residents who qualify for the program will go without dental care, said DeeAnne Moore, the state Medicaid administrator.

Federal law prohibits dentists from making Medicaid patients help pay for the part of their care that the program does not cover.

Moore said state officials are looking at limiting the dental care adult recipients receive, Moore said. That would pay dentists more. Dental services for children are mandatory, while adult care is optional.

Moore said the Legislature would have to approve any changes.