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Dentists: Practitioner bill flawed

Senate committee chair would like to see a compromise

By Dave Ranney | March 09, 2011

The surest way to get Kansas dentists to treat more low-income children is to pay them more, according to five dentists who testified before the Senate Public Health and Welfare Committee today.

“My practice filed almost $50,000 in Medicaid claims last year,” said Paul Kittle, a pediatric dentist in Leavenworth. “We got back about $19,000.”

John Fales, a pediatric dentist in Olathe, said he recently received a form that showed that in 2010, Medicaid had paid his practice $153,000.

Mark Herzog, a dentist from Ellsworth.

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“We’d billed them for $390,000,” Fales said.

It’s unrealistic, the dentists said, to expect them and others in the profession to take on more Medicaid patients - all of them children – when their costs exceed their reimbursement.

Each of the five dentists testified against Senate Bill 192, which would expand the number of procedures that could be performed by specially trained dental hygienists without a dentist being present. The new class of licensed dental worker would be known as a Registered Dental Practitioner.

The bill’s supporters have said it is needed to offset a persistent shortage of dentists, especially in the state’s rural areas, and to ensure access to care for the poor and uninsured.

In Kansas, fewer than 20 percent of the state’s dentists take Medicaid.

The five dentists argued that allowing hygienists to become mid-level practitioners would endanger the public and do little to encourage low-income adults and children to take better care of their teeth.

Too often, Kittle said, low-income parents do not know how to care for their children’s teeth.

“The solution,” he said, “is education.”

For many, Kittle said, dental care is a “low priority” until they are in pain.

Kittle said that since Jan. 1, 38 percent of his Medicaid patients hadn’t kept their appointments.

Other dentists testifying against the bill were David Hamel, Maysville; Cindi Sherwood, Independence; and Mark Herzog, Ellsworth.

The committee heard testimony Tuesday from the bill's supporters, including dentists.

Afterward, the committee’s chairwoman, Sen. Vicki Schidt, R-Topeka, said she wished the bill’s supporters and proponents would settle their differences rather than expecting legislators to do it for them.

“What i know for sure is that both sides want the same end result – and that’s to provide good quality dental care to the citizens of Kansas,” Schmidt told KHI News Service.

“I just wish they would ‘funnel down’ their differences,” she said. “That always leads to better legislation.”

Schmidt said she did know when – or whether - the committee would vote on the bill.

“That’s something I’ll be discussing with the committee members,” she said.

A similar bill is stalled in the House Health and Human Services Committee.

Related coverage: Kansas' Oral Health Care Provider Shortage

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