A new report from the American Dental Association’s Council on Advocacy for Access and Prevention found that only seven states are meeting network adequacy standards for Medicaid.
The ADA council recently conducted a survey of Medicaid networks and analyzed CMS’ enforcement of provisions under the Medicaid Act which state that payments should be sufficient to enlist enough providers.
The report concluded that CMS has not enforced compliance, attributing this to different interpretations of the law between presidential administrations and managed care organizations, according to a Sept. 4 news release.
Council Chair Jessica Robertson, DMD, said increased reimbursements and reduced administrative burden can incentivize more providers to participate in Medicaid, allowing more beneficiaries to access treatment.
“This report demonstrates that these remedies are often not pursued by states to fix network adequacy as there is a lack of enforcement at the federal level,” Dr. Robertson said.
The report includes several recommendations for the ADA to advocate for improved network standards. These include establishing new network adequacy standards and advocating for CMS’ adoption of these standards.
Becker’s has contacted CMS for comment and will update this article if more information becomes available.
