Missouri’s Shortage of Rural Dental Care Providers Tied to Low Medicaid Reimbursement Rates

Missouri has only two publicly funded rural health centers that provide dental care, and the St. Louis Post-Dispatch reports that many low-income families enrolled in Medicaid "have a hard time finding places to get their teeth fixed." According to J.C. Standlee, legislative chair of the Missouri Dental Association, the state's low Medicaid reimbursement rates for dental care have prompted many dentists to stop treating new Medicaid patients. This year, state lawmakers approved a $7 million boost in reimbursement rates. However, Gov. Bob Holden (D) rejected about $4.5 million of the increase, which will only provide state dentists with about $57 for every $100 of Medicaid services that they provide. Standlee said that dentists require between "65 cents and 75 cents on the dollar" to cover overhead costs, adding that Missouri's low Medicaid reimbursement rates have left many dentists to ask, "Why am I paying more out of pocket than the state is willing to pay me?" State Budget Director Brian Long defended the decision to decrease the boost in Medicaid reimbursement rates for dentists, calling the increase "more than most Medicaid providers received." Meanwhile, activist groups, such as Grass Roots Organizing in Columbia, Mo., have threatened to file a lawsuit against the state to address the problem. Under federal law, states must have reimbursement rates "high enough to ensure" that Medicaid beneficiaries have "equal access to care." Jane Perkins, legal director of the National Health Law Program, said that advocacy groups have filed similar lawsuits in other states -- including New Hampshire, Connecticut, North Carolina, Texas and Massachusetts -- but added that the state's decision to boost reimbursement rates may "mitigate" legal claims (Bell, St. Louis Post-Dispatch, 7/22).