After over a decade, Hawaii to restore adult Medicaid dental benefits – State of Reform

Med-QUEST Division Administrator Judy Mohr Peterson, PhD, had an exciting announcement for members of the Med-QUEST Healthcare Advisory Committee (MHAC) at its meeting on June 22nd: after over 10 years, full Medicaid dental benefits are returning for Hawaii adults. 

 

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Due to the financial strain of the Great Recession of 2009, the Department of Human Services was unable to continue providing dental care for individuals over the age of 21 on Medicaid in Hawaii. Only emergency and child dental services have been covered since then. 

With the passage of the FY 2023 Executive Supplemental Budget this past legislative session, Med-QUEST received over $25 million in total funds to expand services, including restoring full dental benefits for adults. 

“We have about 266,000 adults [on Medicaid], so it’s quite a few people we’re covering now,” Peterson said. “We’re very excited about this. This is an opportunity to be able to implement these services. Folks have gone without comprehensive dental benefits for over 10 years now.”

According to Peterson, the benefits will include basic preventative services such a teeth cleaning, X-rays, and exams. Basic restoration procedures for chewing functions, fillings, and crowns will be covered as well. 

Med-QUEST is aiming for coverage to begin in January 2023, but Peterson noted much work lay ahead for the administration, notably receiving federal CMS approval. Med-QUEST sent a pre-submission draft on June 6th, and is waiting for feedback. 

“We’re trying to submit them to CMS so that they are generic enough, should have the opportunity to change or to add additional services,  we will be able to do that, but at the same time [make them] specific enough for CMS approval purposes.” Peterson said. 

While this change would apply to all Medicaid providers, some have already worked to bridge the gap in dental care services. In 2020, AlohaCare partnered with Hawaii Dental Service (HDS) to provide basic dental coverage for Medicaid adults at no additional cost to the member. 

Peterson said Med-QUEST is currently negotiating with HDS to expand the dental service contract statewide. She also said the administration is working to recruit more dental providers, and encouraged MHAC members to refer prospective dentists to Med-QUEST.



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