(The Center Square) — During a hearing on Friday, the House Joint Budget Committee expressed concerns over the inadequate dental insurance coverage provided by DentaQuest, a Louisiana-based dental insurance provider. The Department of Health had requested an extension of the state’s contract with DentaQuest, but the committee voted to defer the decision until October, citing the need for more comprehensive coverage data.
Committee members highlighted that many Louisiana residents are forced to travel between 60 to 75 miles to access dental services covered by DentaQuest. “We have dental shortage areas in Louisiana,” noted Kim Sullivan, director of Medicaid for the Louisiana Health Department. She emphasized the scarcity of both general and specialty dentists across the state, referring to these areas as “dental deserts.”
Rep. Charles Owen, R-Leesville, raised concerns about DentaQuest’s track record, recalling past promises that had not been fulfilled. “Military retirees were assured they would receive lifelong dental care, but the federal government later revoked that commitment. Now we face significant shortages, and our Medicaid population struggles to access essential services,” Owen stated.
Sullivan added that DentaQuest is responsible for ensuring an adequate network of providers to meet the needs of the Medicaid population. “They determine how many providers are necessary,” she said.
In November 2023, the state legislature renewed DentaQuest’s contract, yet lawmakers noted ongoing issues regarding insufficient coverage and oversight. Rep. Tony Bacala, R-Ascension, commented on previous complaints about network adequacy and a high rejection rate of claims. “Dentists have been reluctant to work with DentaQuest due to the frequent denial of claims,” Bacala explained.
Bacala recalled a DentaQuest representative’s promise to improve services, a representative who is no longer with the company. “People who enroll with DentaQuest are not receiving the services they are entitled to,” he said, labeling DentaQuest a “bad actor.”
In response, Kevin Cunningham, a representative from Southern Strategy, clarified, “The denial of a claim does not imply that a service wasn’t provided; it often indicates improper documentation.” He emphasized the need for accurate documentation at the time services are rendered to comply with federal and state requirements.
Bacala expressed frustration with DentaQuest’s claim rejection rates, which he argued contribute to a diminishing network of participating dentists. He pointed out that another state contractor, MCNA, had provided twice as many dental visits compared to DentaQuest.
Cunningham acknowledged challenges in securing oral surgeons willing to accept Medicaid in specific areas, but Bridget Edwards, DentaQuest’s director of client management, asserted that these issues have been addressed. Bacala pressed for tangible data to verify DentaQuest’s claims of improved coverage.
In defense of DentaQuest, Sullivan stated that the company has made strides in network adequacy and cited a July audit from the Louisiana Legislative Auditor, which found no outstanding noncompliance issues.
