Last winter, Director of Medicaid and Long-Term Care (MLTC), Kevin Bagley, announced that the Medicaid Program would undergo a new request for proposals (RFP) that would integrate dental with medical. Five companies bid on the contract and three were chosen. These include United Health Care, Nebraska Total Care, and Molina. Only Nebraska Total Care has announced their dental partner, who will be Envolve. The other two will be choosing their dental partners soon.
What does this mean for Nebraska dentists?
- MCNA will continue to be the dental Medicaid contractor until December 31st 2023.Beginning in January 2024, a dentist can choose if they wish to be a Medicaid provider for one or all three plans.
- The new plans in 2024 will be sending you information about their plan.This should include a provider credentialing application, provider contract, their fee schedule, and a provider manual.There may also be logistical information such as electronic claims processing forms or electronic funds transfer forms.
- The NDA has met with all three of the medical partners and new dental partner, Envolve, for Nebraska Total Care.We are working to assure that key things are included in their plans and that Nebraska dentists are included in their leadership.We will meet with the other two new dental partners when they are announced.
- As of July 1, 2022, MLTC did give dentists a 10% fee increase.In addition the PPE $5/patient visit will continue until April.Be sure you are adding this to your claim form.
- Beginning January 2024, the adult cap will go away.This is good news.Adults can be treatment planned and completed based on their needs and not a $750 annual cap.
Nebraska has never had an integrated dental plan with medical. The goals of this sort of a plan as compared to our current plan, (known as a “carve out” plan) is that the medical managed care plan will be at risk financially. They will take responsibility for the dental plan, which will be administered by a dental contractor with experience running dental Medicaid programs. In addition, while more funds will need to be invested to take on the pent up dental needs of the Medicaid population, ideally the goal is that many will get into good dental health and be able to maintain that level of health. Currently when patients go to the emergency department for dental pain, the medical side of Medicaid of billed. An integrated plan forces the medical and dental plans to work together.
The NDA will be looking at information coming from the plans as well and will continue to advocate for Nebraska dentists and their patients with Medicaid.
Dr. Jessica Meeske
EnvolveProviderAgreement