Black dentists from across the state met in Nashville for a legislative briefing session Tuesday afternoon. State Rep. Larry Miller, chairman of the Tennessee Black Caucus of State Legislators, and Rep. Joe Armstrong, president of the National Black Caucus of State Legislators, convened the legislative session to get information on the oral health crisis of children in Tennessee. George Curry, editor-in-chief of the National Newspaper Publishers Association News Service moderated a panel discussion that included Doctors Robin Daniel, Denise Mustafil-Martin and Kent Melbourne.
The State of Tennessee contracts with DentaQuest to provide dental care under its Medicaid program. Many African American dentists are alleging that DentaQuest has purposefully removed dentists who saw high numbers of TennCare patients to discourage them from getting treatment in order to receive an $8 million dollar bonus for reducing costs.
This alleged reduction caused a disproportionate amount of African American dentists to be removed from the program.
“About 22% of all dentists take Medicaid, but if you look at Black dentist, it is 62%. So when you start kicking Black dentists off, you end up with about half of the Black kids in Tennessee not having access to dental care. And it’s not just the Black kids, but kids growing up in rural areas,” said moderator Curry.
“I’m here because kids in Tennessee are getting less and less dental care, and Black dentists are being kicked off the roll with no appeals process.”
According to the National Dental Association, only four percent of dentists in Tennessee are African American. Of that, 62% see kids on Medicaid in predominantly Black and minority communities.
Robin Daniel, past president of the National Dental Association, asserts: “If only four percent are African American, and you remove them from the Medicaid provider list, you dilute the Black community to a point of under access. This is what is happening in areas such as north Nashville, Antioch, and Memphis.”
The doctors assert that the State of Tennessee provides Dentaquest an incentive not to see kids enrolled in Medicaid and that “at a time when American is expanding healthcare, Tennessee is contracting the access of dental care of kids.”
“If disease prevalence hasn’t decreased, and patient population hasn’t decrease, then why have the number of claims paid for active disease drastically decreased and the number of providers decreased,” said Denise Mustafil-Martin, a periodontist from Memphis.
“The obvious answer is that we have a company that is administering a program that is focusing on decreasing their bottom line so they can increase personal wealth.”
Scientists have found links between periodontal disease and a number of other problems, including: Heart disease, diabetes, dementia, rheumatoid arthritis, and premature birth.
Experts believe that oral bacteria can escape into the bloodstream and injure major organs.
Such was the case with 12-year-old Maryland boy, Deamonte Driver. Driver died in 1997 after bacteria from an abscessed tooth traveled to his brain.
“In Tennessee, what we have are multiple cases [that can become a] Diamante driver,” said Mustafil-Martin as she passed out pictures of patients she saw, who were denied treatment by DentaQuest. “If we compare this year with the immediate past year, the claims paid for active diseases are significantly reduced.
Dentaquest is trying to make more money by not treating the children of the poor who are enrolled in TennCare. Their contract outlines the fact that if they come in under budget, in addition to their 38million dollar contract, they will get a bonus of $8 million.”
Dentaquest responded to these accusations in a statement, saying: “DentaQuest’s first priority is providing access to high-quality dental care for the 750,000 children who receive dental benefits through TennCare. In line with our agreement with the state, we invited and contracted with Tennessee dentists to create a new network to meet the state’s requirements for access, while also ensuring maximum quality and efficiency in how members receive, and providers deliver, dental care. We are confident that the dentists participating in this new TennCare dental network will help us to achieve this goal.”
The State of Tennessee also responded with the following: “The Bureau of TennCare entered into a partial risk sharing contract with DentaQuest in October 2013.
Under the terms of this business arrangement, the dental benefits manager is incentivized to assure that children have access to needed preventive and treatment services and that care is delivered as economically as possible. Shared savings are contingent upon DentaQuest demonstrating success in areas, access and cost. It should be noted that not only does the contract create the potential for the dental benefits manager to share in savings, it also creates the potential for the dental benefits manager to share in a financial loss and/or incur other financial penalties if access to care, quality or budgetary benchmarks are not reached.”