State Must Improve Dental Care for Needy, Judge Rules
Jul. 16–A federal judge yesterday ruled in favor of poor families seeking better dental care for their children, ordering the administration of Governor Mitt Romney to improve its system for providing coverage to the needy.
US District Court Judge Rya W. Zobel did not impose a particular remedy, instead ordering the state and legal representatives of the families to come up with ways to change the system by Aug. 31.
The ruling, which ends a case that began in 2000, has the potential to affect as many as 500,000 children enrolled in MassHealth Medicaid.
The advocacy coalition Health Care for All had argued in court that the state violated the civil rights of children by not adopting changes that would make it easier for them to have their teeth cleaned and their cavities filled. As a result, advocates have documented cases in which children of the poor wait months, even years, for an appointment.
The delays, families and dentists argued, are the consequence of a state system that pays dentists too little, requires them to do too much paperwork, and demands that if they accept one MassHealth patient they must take every such patient seeking care. While about 5,000 dentists practice statewide, fewer than 800 treat MassHealth patients.
In her ruling, Zobel stated that evidence from the children’s advocates “persuasively demonstrates that MassHealth established reimbursement levels so low that private dentists could not afford to treat enrollees who, thus, either received dental care only after much delay or not at all.”
Further, the judge found that the Romney administration had “violated sections of the Medicaid Act that require prompt provision of services, adequate notice, and treatment at reasonable intervals.”
Healthcare advocates hailed the ruling and said they looked forward to developing cures for the ailing dental system with state health authorities.
“We’re pleased that Judge Zobel recognized that dental care received by children in MassHealth is inadequate and violates federal law,” said John McDonough, executive director of Health Care for All. “The Commonwealth now has an obligation to fix the mess.”
Dick Powers, a spokesman for Romney on health affairs, said the governor’s lawyers were still reviewing the ruling, but added that the administration plans to sit down with the health advocates.
Powers said one concern had already been addressed. A measure in the state budget approved for the next fiscal year eliminates the rule that prevented dentists from capping how many MassHealth patients they will accept.
Advocates said one of their first priorities would be to encourage the state to promptly improve the running of the plan and to hire dentists to manage it.
It took Sharleen Campbell of Kingston two years to find a dentist for her two daughters and one son, all MassHealth recipients. “Awesome,” she said of the ruling. “The kids deserve it . . . They needed someone to stand up for them.”
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