Dentists applaud changes
in QUEST fees

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By Helen Altonn
haltonn@starbulletin.com

Effective Oct. 1, the dental part of the state's QUEST program is moving from managed care back to a traditional fee-for-service schedule, with increased reimbursements for dentists treating Medicaid patients.

The final dental fee schedule is being worked out with input from private dentists and will be mailed to dentists, said Dr. Mark Greer, chief of the state Dental Health Division. In the past, he said, the Legislature set the reimbursement rate, which has been the same since 1991, at about 40 percent of what dentists charge.

"Traditionally that created a lot of problems," Greer said. "We could never adjust or negotiate fees. As a result, dentists overall were very frustrated working with Medicaid."

However, a change in the fee structure was authorized by the last Legislature, he said.

Greer said he believes the new rates for dental services will reimburse at least 75 percent of the dentists' costs. "The community will benefit and I expect we will gain a lot of dentists (in the Medicaid program)."

The move is more welcome news for the local dental community, which last week also learned that The Queen's Medical Center's Dental Clinic will not be closed June 30 as planned.

Dr. Angela Chin, who has a private practice in Aiea and heads Queen's Dental Division, said retention of the dental clinic "is a huge win for everyone ... to ensure we have hospital-based services for people who cannot be treated in an office."

Queen's had announced it was closing the 40-year-old clinic because of revenue losses. The decision was reversed after Gov. Ben Cayetano said $200,000 will be provided to keep the program going until June 2003.

Meanwhile, the clinic will be included in the Health Department's Dental Health Division budget for steady state funding.

"From a community perspective, $200,000 is a very good public investment to assure that program is there and the most needy disabled folks have some place to go," Greer said.

Also, it's the trauma service for anyone whose mouth is smashed in an accident, he said, noting other hospitals refer dental cases to Queen's.

"If the (dental) residents were not in a position to respond to these things, there would be a lot of fumbling, a lot of people not having trauma dealt with immediately," Greer said.

About 44 dentists volunteered services to the clinic last year and waged a strong behind-the-scenes campaign to keep it alive.

The dentists reduced a $350,000 operating loss to $200,000 this fiscal year and developed a business plan to increase efficiency and savings.

The clinic has two dental residents and a third may be added, Chin said.

The volunteer dentists and residents treated nearly 4,000 poor and seriously ill people in the past fiscal year and more patients are expected with higher Medicaid reimbursements, she said.

Greer said, "We expect reimbursements through the state and federal government through Medicaid will probably triple."