MassHealth Kid's Dental Violates Law

This month US District Court Judge Rya Zobel ruled that Massachusetts officials are in violation of federal law in the running of the MassHealth dental program for low income children. The Court's decision held that MassHealth violated sections of the Medicaid Act that require prompt provision of services, adequate notice and treatment at reasonable intervals

The judge ordered the two sides "to develop a joint remedial program and judgment and report to the Court thereon by August 31, 2005. The court will schedule a hearing thereafter to determine the appropriate course of action."

The ruling, which ends a case that began in 2000, has the potential to affect as many as 500,000 children enrolled in MassHealth.

The advocacy coalition Health Care for All had argued in court that the state violated the civil rights of children by paying dentists too little, requiring them to do too much paperwork, and requiring that if they accept one MassHealth patient they must take every such patient seeking care. This lead to few dentists participating in the program; while about 5,000 dentists practice statewide, fewer than 800 treat MassHealth patients. Advocates argued that the result was unacceptable delays, with documented cases of children waiting months, even years for an appointment.

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.

-Adapted from “state must improve dental care for needy, judge rules” By Stephen Smith, The Boston Globe, 7/16/2005.

07/2005