Illinois Funds Preventive Dental Services for Adult Medicaid Recipients

Dentistry Today


The Illinois General Assembly has passed a budget that, for the first time, includes funding for dental prevention services for adult Medicaid recipients in Illinois. The funding will be added to the Illinois dental Medicaid program and will require better oversight of dental care provided by state contracted Managed Care Organizations (MCOs). When the new budget begins on July 1, all adults covered by Medicaid will be able to receive periodic exams and cleanings performed by a dentist enrolled in the program.

“The addition of preventive dental services for all adults is critical in improving oral health for these Illinois citizens. It gives dentists the opportunity to provide early interventions for not only dental disease but overall health as well. Diabetes, heart disease, and other systemic diseases are often better managed when oral health is maintained. I congratulate the legislators and Governor [Bruce] Rauner for supporting these long-needed changes,” said Barbara Mousel, DDS, president of the Illinois State Dental Society.

The legislation states that the Illinois Department of Healthcare and Family Services (HFS) will provide adult dental services including diagnostic, preventive, and restorative services as well as services needed to treat periodontal disease. It also states that the reimbursement to participating dentists will be at the levels required by the Memisovski vs Maram court decree for children’s prevention services.

HFS will be required to actively monitor the relationship between the contracted MCOs and their dental administrators, adopt appropriate dental metrics, and publish the results in the Illinois Medicaid Plan Report Card and Health Plan Comparison Tool. Also, HFS will begin to collect data on how the MCOs implement their care coordination plans for dental care for broad-based populations such as pregnant women and patients with diabetes.

Next, HFS will determine the specifics of the program and communicate these enhancements to the MCOs, plan enrollees, and dentists participating in the Illinois Medicaid program. The Illinois State Dental Society will continue to offer its assistance to HFS with providing a comprehensive dental program for all adults.

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