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Dental Medicaid Transition to Managed Care: What Providers Should Know

WSDA has received many questions from members regarding the Dental Medicaid Program's transition to managed care. Please read for a summary of the transition and what providers should expect.

Why Is the Transition Happening?

In 2017, the Washington State Legislature passed a budget proviso requiring the Health Care Authority (HCA) to contract out the administration of Washington's dental Medicaid program. HCA must contract with at least two licensed health plans or managed health care plans, except in areas where only a single plan is available, to provide carved-out managed care dental services by January 1, 2019. For more information on the budget proviso, read here.

What Should Providers Expect?

At this time, there appear to be several interested companies that will bid on the contract, including an array of both dental and medical managed care entities (MCEs). Since the bidders are required to show they have an adequate network of providers in order to be considered for a contract, several bidders have been contacting providers, asking them to join their network.

Providers (even those who are not currently Medicaid providers) should expect to be contacted by several companies in the coming weeks. Here is what you need to know:

  • You may choose to contract with one or several MCEs.
  • You are able to negotiate the terms of your own contract(s).
  • To avoid potential antitrust concerns, you must negotiate on behalf of your individual practice and not as part of a group formed for negotiating purposes.
  • WSDA cannot provide recommendations regarding which MCEs to contract with.
  • Members are strongly encouraged to carefully read the contracts and raise any questions or concerns you may have with either the MCE directly or the HCA at hcamcprograms@hca.wa.gov before signing anything​.

The HCA ​has put together a list of FAQs regarding this process which you may read here.

How Can Providers Ask Questions & Provide Feedback?

Providers can learn more about the transition to managed care by joining the HCA for a provider-specific informational webinar on Friday, May 11 from 12:00-1:30 PM. 

Register Here
Providers will also have the chance to engage with potential bidders during the Pacific Northwest Dental Conference.

  • In the Exhibit Hall: Some of the potential bidders will have booths in the Exhibit Hall, offering providers a great chance to meet face-to-face to discuss any questions or concerns.
  • During a Q&A Forum: WSDA will host a Q&A Forum on Friday, June 22 from 1-3 PM at the Hyatt Regency Bellevue where providers will have another opportunity to ask questions and engage with potential bidders.

More Information & Questions

On May 3, the HCA released a request for proposal (RFP) which you may find on their website

Please make sure to regularly check the HCA's website and wsda.org for updates and further information related to the Dental Medicaid Program's transition to managed care. 

Should you have any questions for the Association, please do not hesitate to contact WSDA’s Director of Government Affairs Mellani McAleenan at mellani@wsda.org or WSDA’s Government Affairs Associate Emily Lovell at emily@wsda.org.

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