State leaders struggling to raise dental Medicaid rates

There’s a push in the Nebraska Legislature to substantially increase Medicaid funding and raise the reimbursement rates, but so far it hasn’t succeeded.

Sen. Lynne Walz, Democrat from Fremont, introduced a bill in January that would increase dental services reimbursement under the Medical Assistance Act by 25%. The increase would cost roughly $6 million.

The proposed increase would raise reimbursements on average to match one of the state’s lowest private insurance plans, Ameritas, said David O’Doherty, Executive Director of the Nebraska Dental Association in an email.

Sophia Pankrats, a dental student at the University of Nebraska Medical Center’s College of Dentistry in Lincoln, testified in support of the bill in February. At the hearing, she said she hopes to practice in rural Nebraska, treating underserved children, but she is worried about balancing her student loans and the costs of owning a practice.

“I’m eager to see patients from my community that have the greatest needs and may not be able to care for themselves,” Pankrats testified to the Legislature’s Health and Human Services Committee. “However, with the current reimbursement … I’m concerned I will not be able to include them in my practice.”

The committee unanimously voted for LB 358, sending it to the full Legislature, but it has not yet been debated on the floor. The bill is on general file and can be brought up for debate during the 2024 session, a representative from Walz’s office said. 

In the 2023-2025 Biennium budget, all Medicaid reimbursement rates were increased by 3% for FY 2023-24, but Gov. Jim Pillen used a line item veto to remove a 2% rate increase for the second fiscal year. 

With the 3% rate adjustment, Nebraska Medicaid will still reimburse dentists at a rate that is lower on average both in-state private insurance and most neighboring states’ Medicaid rates.

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“The request for the [25%] fee increase would still make Medicaid our lowest payer, but at least it would allow us to … to see those kids, maybe keep more kids out of the operating room,” said Dr. Jessica Meeske, Hastings pediatric dentist, at the February hearing.

By Destiny Herbers

Destiny is a graduate of the Howard Center for Investigative Journalism at the University of Maryland, where she earned her master’s degree in journalism. She received her bachelor’s degree in communication from Alma College in Michigan, and spent summers interning in Sierra Leone and India. While at UMD, she covered NASA and Congress for the school’s Capital News Service, reporting everything from cheese served at state dinners to future missions to Mars. She contributed research to the Howard Center’s award-winning project, “Mega Billons,” an investigation of state lotteries, and was part of an ongoing Associated Press investigation into law enforcement practices. When she isn’t reporting, Destiny loves swing dancing and thrift shopping.

1 Comment

I was on Medicaid prior to 2017 when they actually started to cover dental. I have type 1 diabetes and multiple sclerosis. It was hard then to get approval for them to cover dental for me to go every three months but it seemed even harder to get coverage when they started to cover dental with MCNA dental. I think my dentist had to send in a prior authorization 3 times to get approval. It was harder than working with just the state.
Medicaid itself was a disaster to work with before changes were made when the expansion started. It has gotten so much better but in my opinion, still has its issues. Have more to write on this subject, but I’ll stop here. Thank you for bringing this to light. People don’t really care unless they’ve experienced it themselves.



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