IL SR0365

Illinois State Dental Society expresses concerns about gaps in dental care data and monitoring by managed care organizations (MCOs) serving two million Medicaid enrollees

Current MCO contracts require quality assurance plans and utilization reporting for dental services, but these requirements are not being met

DHFS uses 20 HEDIS quality measurements to monitor MCO performance, but none of these metrics evaluate the quality of dental care provided to Medicaid enrollees

Resolution urges Governor Rauner to direct the Department of Healthcare and Family Services to amend the request for proposal to separate dental care into stand-alone dental administrators rather than including it under MCOs

Requests that adult preventive dental services be included and reimbursed at reasonable rates in the new dental RFP to improve care quality, increase utilization, and reduce tooth and gum decay among Medicaid recipients