To the editor:

We take pride in Minnesota and the services available to our citizens. Unfortunately, the ability to access dental care for Minnesotans on Medical Assistance (MA) is in jeopardy. Many Minnesotans often drive hours to receive care. Unable to access care in their communities, many utilize the hospital Emergency rooms as their dental home. Worse, many may be forced to defer care due to lack of access until they are in crisis.

Several factors have contributed to this crisis. Minnesota is the lowest in the nation for reimbursement for dental care. The State of Minnesota bases fees paid to dental providers on a 1989 fee schedule. What was reasonable 32 years ago is woefully inadequate in 2021.

Another issue that complicates delivery is transparency. Minnesota contracts with several managed care organizations (MCOs) to administer MA. While this should promote better care delivery, the result is a complicated system administratively for providers and limited access for patients. Due to the proprietary nature of the contracts with the MCOs, the state lack visibility into how dollars are spent on patient care.

The Minnesota Legislature is currently debating a restructuring of the dental Medicaid system in Minnesota. The house has proposed increasing the reimbursement from 1989 rates to a proportion of 2018 rates. To aid with transparency, Minnesota would move to a single dental administrator for their dental programs.

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We are at a critical point where either significant improvement needs to be made, or the current system will continue its course to collapse.

Jim Nickman, DDS, MS

President, Minnesota Dental Association

Lino Lakes, MN