August 28, 2012
[Ed. Note: Dr. Mary Jennings represents the 11th District (Washington, Idaho, Alaska, Montana and Oregon) on the ADA Council on Government Affairs. They meet in Washington, DC, at the ADA office, twice a year. She is currently finishing her second year of a four-year term.
Our first meeting was tonight. We met the new Chief Dental Officer of The Centers for Medicaid and Medicare, Dr. Lynn Douglass Mouden. I am delighted to find that he is actually a dentist; the last few heads we met were not! The others took notes of our discussions, he actually discussed issues and answered questions. Dr Mouden has an extensive private practice, public health, and academic record. He is personable and has a real-life grasp of our issues. I am impressed! He started this position February 27th, and so is very new.
I was surprised to learn that his department is composed of five people. FIVE... for the whole federal program? Yes. He is the only dentist, and only full-time employee.
He has ambitious goals. He wants to expand virtually non-existent Medicare dental program. He is working on the Medicaid CMS oral health initiative form 416. Basically, that translates into encouraging states to increase percentage points on sealant and preventive visits for children.
One of the odd problems he faces is that there is only one way to penalize states for not following guidelines. That is to take away money. Taking away money only makes the problem worse so that is rarely done. Instead his "big stick" is to "encourage" state compliance.
But there is oh so much more on the horizon. The Affordable Care Act will expand Medicaid and serve more children. Since there is so little money, it is a formidable task. He is working to make it easier for dentists to enroll and get paid for their services. Some states have $534 fees to enroll per year along with 32 page applications. That, compounded with poor and slow payments, worsens that already horrible problem.
We asked questions about Medicaid fraud. About things like mobile vans that go around many states doing children's exams and then leaving town. The local dentists are unable to bill for exams et al., but feel compelled to do the exams and follow-up treatment anyway.
I could have spoken with him for hours! But we had to move on. There was a lively discussion on possibly taxing soda (we decided we could not pull that one off) and committee reports. We have another day and a half to go and we are starting early tomorrow. Wish me luck as we try to sort all this out!