KDA Today

KDA Today

For Immediate Release

Date: Oct 21st, 2014
Contact: Dr. Garth Bobrowski
Phone: 800-292-1855
Email: info@kyda.org

Get passionate! This is Our Profession!

With so many complaints about the Medicaid MCOs, Dr. John Thompson has opened the door for the dentists of Kentucky and the KDA to get access to Secretary Audrey Haynes and Commissioner Larry Kissner, with Medicaid. The KDA TAC on Medicaid is in a gridlock with getting meaningful information from the dental MCOs.

A KDA Medicaid Workgroup was formed and is composed of Dr. Fred Howard, Dr. Susie Riley, Dr. Garth Bobrowski, Dr. Beverly Largent, Dr. Lee Mayer (UL), Dr. Raynor Mullins (UK), Dr. Fred Sharpe (Avesis) and Dr. Jerry Caudill (Avesis). Dr. John Thompson was the facilitator of a recent July meeting.

On Monday, July 28th, 2014 a meeting was set up with Secretary Haynes, Commissioner Kissner, senior Medicaid staff members, Dr. Stephanie Mayfield (Department of Public Health), Dr. Ken Rich, Dr. Julie McKee and others. At first we were expecting to meet for 45-60 minutes, but the meeting lasted two hours.

Four presentations were made from practicing Medicaid providers from across the state in varying Medicaid locales. The presenters were Fred Howard, Susie Riley, Garth Bobrowski and Beverly Largent. The presentations basically showed how the present system is becoming non-viable as a business entity and that RED TAPE AND PAPERWORK are major hindrances to becoming Medicaid providers.

There was good dialogue between the state and the presenters. The state looks at the POPULATIONS AND GLOBAL SITUATIONS with macroeconomics in mind. The dentists are looking at this as “our people” - the people with whom we go to church or meet at the grocery store and we look at it as the microeconomics of just keeping our businesses open and viable or we won't be able to see our Medicaid population at all. With Medicaid Dental Expansion, the dental offices that still see adult Medicaid patients are becoming overwhelmed with new patients, but are receiving a 10% cut in our already low reimbursement rates.

As reported by our lobbyist, Libby Milligan, at the Southeastern Dental Society meeting, the state is now making references about the KDA and our Medicaid Workgroup efforts with Medicaid at the Medicaid Managed Care Forums starting at Morehead State University. They are listening!!!!!!!!

In a recent discussion with a state politician, he asked, “Where are the dentists?” Our KDA has to get ahead of this PRIMARY CARE discussion, whether it be in dealing with insurance companies or Medicaid or private pay patients. We have to be at the table at every chance we get. We have to be there, not to fight, but to offer solutions to the problems that our patients and our dentists are having. As a side note, some dentists say, “I don't need to join the KDA because they are going to do my battles for me, anyway.” Well, that may be partially true, but hopefully, we do such a good job they will learn that we need their input and their support, now, more than ever. We need to emphasize that their membership is critical to be able to hire lobbyists, go to training meetings and meet with legislators one-on-one and in groups. We need to show them that there is strength in numbers. We dentists are stronger when we come out with one voice united under the KDA.

As we all know, ­ dentistry is a part of the health equation. Other medical provider groups are rapidly and intensely involved. These groups build their legislative base. They have meetings, so they are publicly, all on the same page with their thoughts and planning agendas. We have to unite dentistry and pull together all stakeholders. Dentistry is getting dragged into medicine and we are a part of medicine, but do we want to let the insurance companies, Medicaid, MCOs or other outside influences affect how we are to treat our patients? We have to get involved and plan our destiny or someone else will do it for us!

As late as July 16, 2014, there were presentations made by Commissioner Larry Kissner to the Interim Joint Committee on Health and Welfare (Primary Care, Medicaid, Impact Plus, Telehealth) in Owensboro, KY. At the meeting, various presenters discussed expanding the use of dental hygienists and looked at allowing dental therapists to operate in the state of Kentucky. The fact that this was even mentioned, shows that we, as dentists, need to be at the table and we have work ahead on educating officials in Frankfort, along with legislators, about the practice of dentistry in Kentucky, along with sharing “who we are”. It is vital that we are ahead of issues such as the dental therapist and we have to be heavily engaged in the whole process of getting to our bureaucrats and legislators. We have to find out what his/her thoughts are concerning this expansion and use of dental therapists and educate them on the practice of dentistry. That is one reason we need to recruit new KDA members and build a strong and sustainable KDA grassroots network. The KDA does not always know who has great contacts with their local or state legislators. The solution is simple; we (KDA) need a strong grassroots network and better communicators to share our (KDA) story of dentistry in Kentucky.

We have to educate the bureaucrats and legislators that our assistants and hygienists can already do many procedures (mostly under direct supervision of a dentist with laws already in place to handle this). WE DON’T NEED ANOTHER LEVEL OF PROVIDERS. Creating another level does not address the heart of the issue. Can we look at our existing laws and the way we run our offices to help access to care and make our jobs easier? We, as a group, have to be able to look at every access to care problem or perceived problem and analyze the situation to make sure that the citizens of Kentucky are getting the care they need at a reasonable fee. I will never forget one day when I was in dental school, one of our clinic professors made disparaging, downgrading remarks about a patient’s flipper. I knew the patient and generally his financial situation. I knew that was not the ‘best’ treatment, but the patient could not afford a regular partial denture or a bridge, let alone an implant/crown. That cheap flipper at least gave that patient self-esteem to go out in the public to work, attend church or socialize.

Our Medicaid workgroup has presented ideas to the state that might encourage more dentists to go into rural areas, such as a 25% increase in Medicaid reimbursement rates, loan forgiveness and decreased paperwork for all dentists and easier credentialing.

“Loose lips, sink ships!” someone told me that one time, concerning the KDA. Well, it is autumn and January 2015 is right around the corner with the starting of the next legislative session. We have to be PROACTIVE, NOT REACTIVE ABOUT EVERYTHING. We strive to be proactive with our patients’ oral health care…we need to practice what we preach. We have to give guidance now to our lobbying firm for our issues coming up. We may even need to look at our contract with our lobbying firm to decide at what level of future activity we need them to be. This should be seen as an investment going forward. Where do we stand on issues affecting dentistry? The goal is to brain storm, be proactive and be aware. Once again, sometimes I feel like we have too many mixed messages; our Executive Board must have a unified message for all groups involved. We must have e-file or white paper information on our talking points. When we go before our legislators, state regulators, state or federal bureaucrats, we can’t act like the “whiny kid”. We have to go before them professionally, with solutions in hand or at least be prepared to educate them properly.

There are two article series that I am looking forward to presenting to our members in KDA TODAY. Our new Executive Director, Richard Whitehouse, is an expert on human resources and he will be providing a series of articles relating to human resource management for the dental office. We are also going to focus on dealing with insurance contracts in upcoming issues of KDA TODAY.

Get passionate! This is our profession!

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