On Friday, June 28, Governor Dunleavy announced over $440 million in cuts to the State of Alaska FY20 operating budget, including over $83 million in cuts to Medicaid services. The Medicaid reductions fully eliminated adult dental coverage ($27 million), reduced over $6 million in behavioral health programs, and cut $50 million in health coverage. This was in addition to the Legislature’s already implemented cut of $70 million.
These deep cuts will mean the cost of travel for adult dental and certain behavioral health services for customers in our service area will no longer be covered by Medicaid. This will effectively deny access to healthcare for many YK Delta residents who live in our 50 villages, that are tens to hundreds of miles away from the Bethel hospital. Over the next year, as the Department of Health & Social Services begins the process of implementing these cuts, YKHC customers will likely find that there are numerous other services no longer covered by Medicaid. Sadly, at this time, there is no way to determine what rate or service has been cut.
On Monday, July 8, the Alaska Legislature is preparing to begin a second special session and is able to override the Governor’s vetoes if they can obtain 45 votes (out of 60 votes) in a joint session of the House and Senate. I encourage you to voice your opinion to the governor and your legislators. You can easily send a message to your elected officials at the following link: https://www.akleg.gov/poms/message.asp
Read YKHC’s official statement on this issue here.
What this means for providers and staff who request travel
For adults age 22 and older, Medicaid will no longer reimburse for periodic or comprehensive exams, cleanings of any kind, fluoride varnish, fillings, crowns, bridges, and root canals. We are unsure at this time if Medicaid will be paying for adult dentures. Medicaid will continue to pay for problem-focused limited exams, extractions, biopsies, and facial fractures. In short, this means that unless an adult has a dental emergency, they will not be eligible for Medicaid travel under a dental prior authorization. As of now, the dental clinic will continue to see patients regardless of ability to pay/reimbursement for exams, cleanings and fillings. However, no travel can be made for these patients. As far as YKHC is aware, nothing has changed for Medicaid recipients ages 21 and under.
Proper documentation for emergent dental travel is vital. YKHC is still authorized to approve services deemed emergent by Medicaid rules. Those procedures can be found in this document, beginning on page 5. When submitting a travel request for an adult with an emergent dental need, providers should provide thorough documentation proving medical necessity for the procedure. Staff with questions about appropriate documentation can call YKHC’s Medicaid Travel team at ext. 6625.
There is a lot of information still unknown. YKHC leadership is staying in contact with the State of Alaska and will update staff as more details are available.