(The Center Square) — The Joint Budget Committee voted to extend DentaQuest’s contract for Medicaid dental services, aiming to maintain patient choice while ensuring accountability and service improvements.
As part of the contract, DentaQuest will be required to submit quarterly performance reviews to the committee.
The contract, covering nearly 771,000 Medicaid recipients, is critical for the state’s dental care network, particularly in underserved regions.
The committee questioned whether the company has adequately addressed gaps in service, especially in areas like northeast Louisiana, where residents still face limited access to dental care.
Despite assurances from DentaQuest and the Louisiana Department of Health, some lawmakers have expressed skepticism about the progress DentaQuest has made since a previous one-year extension.
According to Rep. Tony Bacala, R-Prairieville, DentaQuest has network inadequacy for general dentistry in over twenty parishes.
“Now, we’re suggesting that we’re going to accept mediocrity,” Bacala said.
Bacala cited the health department’s June 2024 report showing that DentaQuest’s provider network declined from 829 to 816 dentists over the year, while competitor MCNA retained 913 dentists, significantly more than DentaQuest.
The provider gap, some lawmakers argue, underscores ongoing issues in ensuring adequate care access across the state. In the September hearing, Bacala called DentaQuest a “bad actor” for its high rate of claim denials, which he argues dissuades dentists from participating.
According to DentaQuest representative Kevin Cunningham, these denials often occur because of improper documentation, not an outright denial of services.
Louisiana Department of Health Secretary Michael Harrington emphasized that denying DentaQuest’s extension would induce potential service disruptions for vulnerable populations as the state shifts to a single-source program, which Harrington said would take at least six months.
“We’re not satisfied where they are,” Harrington conceded. “But we do think that they’ve demonstrated enough of that progress to extend this for a year, now think about what it’s going to be like and try to transfer 771,000 to a different plan.”
Harrington said that time was needed to allow time for the development of a robust request for proposals to bring in the most qualified providers.
Health department officials argue that patient choice is essential to meeting federal Centers for Medicare & Medicaid Services guidelines, which require multiple options for Medicaid recipients.
Harrington and Medicaid Executive Director Kimberly Sullivan defended the extension by noting that while improvements have been made, both DentaQuest and MCNA Dental have faced compliance issues and similar penalties for service gaps.
Harrington noted that without choice, Louisiana could be forced to obtain a Center for Medicaid Services waiver, adding that multiple providers enhance patient care, hold companies accountable, and reduce risks.
“From an operational standpoint, it’s essential to have a choice,” Harrington said. “You may have one that’s doing really well right now, but that doesn’t mean six months from now, it’s going to be doing the same. And then you put both the state and residents at risk if you only have one, because where do you go from there?”
Sen. Gerald Boudreaux, D-Lafayette, expressed concerns about the impact on Medicaid recipients if DentaQuest’s contract were not renewed, while also acknowledging that low Medicaid reimbursement rates hinder dentist participation.
He assured lawmakers that the additional year would allow the health department to finalize an request for procurement with clearly defined performance metrics and outcome auditing.
This article was originally published at www.thecentersquare.com
