Baucus, Grassley Look to Stop Medicaid Payments to Dental Clinics that Skirt Oversight Regulations

WASHINGTON –Senate Finance Committee Chairman Max Baucus (D-Mont.) and Senator Chuck Grassley (R-Iowa), Ranking Member of the Committee on the Judiciary, are calling on the Department of Health and Human Services (HHS) to ban dental clinics from participating in the Medicaid program if the dental clinics circumvent state laws designed to ensure only licensed dentists own dental practices as part of an effort to prevent substandard care.

The request by the senators comes in the wake of a year-long investigation into allegations of abusive treatment of children in clinics controlled by corporate investors rather than dentists.

The “Joint Staff Report on the Corporate Practice of Dentistry in the Medicaid Program” released by Senators Baucus and Grassley focuses on dental management companies organized as a corporation or limited liability company that works with dentists in multiple states.  The investigation found a failure to meet quality and compliance standards, including unnecessary treatment on children; improper administration of anesthesia; providing care without proper consent; and overcharging the Medicaid program.

According to the report, while many clinics technically meet state-level rules requiring their owners to be licensed dentists, the clinics nonetheless have placed control of their operations in the hands of corporate investors and the result is a system that “places profits above patient care.”  Twenty-two states and the District of Columbia ban corporate dentistry.

“Any company that subjected children to painful unnecessary dental procedures at taxpayer expense has no place in the Medicaid program,” Senator Baucus said. 

“The actions of some dental practices strain the Medicaid program while putting low-income children in vulnerable and even traumatic situations,” Grassley said.  “The problem is tied to a business model that contradicts state laws requiring dental practices to be dentist-owned as a measure of accountability both to patients and taxpayers.”

Senators Baucus and Grassley urged the Inspector General for HHS to take action to stop taxpayer reimbursement of dental management companies that operate in this manner because, “when states can’t hold owners accountable to maintain a professional standard of care, then clinics are more likely to fail to meet basic quality and compliance standards, putting the children who should be helped at risk,” according to the staff report.

The report also recommends Medicaid be allowed to reimburse mid-level dental providers, such as dental therapists.  Mid-level providers are in a position to provide much of the needed dental care at current Medicaid reimbursement rates. The senators noted that access to dental services is a concern and empowering mid-level providers is a common sense solution.

Senators Baucus and Grassley have a long record of working together on a bipartisan basis to oversee health care programs administered by the federal government.

The “Joint Staff Report on the Corporate Practice of Dentistry in the Medicaid Program” is available on the Finance Committee’s website here.

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