Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but Gaps Remain. Report to Congressional Requesters. GAO-09-723.
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Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for 30 million low-income children--but, like many children in Medicaid, he experienced difficulty finding a dentist who would treat him. At the federal level, the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), oversees Medicaid. In this report, Government Accountability Office (GAO) examined: (1) state strategies to monitor and improve access to dental care for children in Medicaid; and (2) CMS actions since 2007 to improve oversight of Medicaid dental services for children. GAO surveyed all state Medicaid programs and interviewed state and federal officials, and dental researchers and associations. GAO recommends that CMS develop a plan to review dental services in states with low utilization rates, ensure that states found to have inadequate managed care provider networks strengthen their networks, develop additional guidance, and identify ways to improve sharing of promising practices among states. CMS generally concurred with GAO's recommendations. Seven appendixes are included: (1) Methods Used by State Medicaid Programs to Monitor the Statewide Provision of Dental Care to Children; (2) Statewide Utilization Goals for the Provision of Dental Care to Children in State Medicaid Programs; (3) Access Standards Set by the 21 States That Provide Dental Services through Managed Care Organizations (MCOs); (4) Extent to Which Managed Care Organizations (MCO) Meet State Standards and State Verification of MCO Networks; (5) CMS Promising Practices and State Reported Best Practices; (6) Comments from the Department of Health and Human Services; and (7) GAO Contact and Staff Acknowledgments. (Contains 8 tables, 1 figure and 37 footnotes.)
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|Date:||Sep 1, 2009|
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