Medicaid in Florida

From: Joel M. Eichen (joeleichen_at_yahoo.com)
Date: 02/06/05 

Date: Sun, 06 Feb 2005 16:48:47 -0500

The link is on Flap's Blog site.

Joel

**

Rotten Teeth, Rotten Politics, Part II
Local 10 Investigated Privatization Of Dental Care

POSTED: 5:27 pm EST February 4, 2005
UPDATED: 5:51 pm EST February 4, 2005

MIAMI -- In Part I of our Problem Solver Investigation "Rotten Teeth,
Rotten Politics?" reporter Jilda Unruh showed you how some of
Miami-Dade County's poorest children are having to scavenge for dental
care.

Critics said this dental debacle is being repeated over and over in
Miami-Dade County as a result of a dramatic change in the way the
state provides for dental care in the county.

It's been seven months since Gov. Jeb Bush and the Florida Legislature
privatized the dental Medicaid program for children in Miami-Dade
County -- Medicaid coverage for children like Medicaid mom Sylvia
Latimer's two girls.

Latimer, talking about her youngest daughter, said, "I know she gets
headaches, sometimes really bad headaches."

Latimer told Jilda that her daughter's mouth doesn't close properly
because of an underbite. In December, Latimer told Jilda she had been
trying since July to get her kids a dental appointment.

Jilda: "How many dentists did you call for an appointment under the
ADI (Atlantic Dental, Inc.) plan?"

Latimer: "I don't know. Anywhere between 30 and 40."

So why are Latimer and other Medicaid families with whom Local 10
spoke having such a hard time seeing a dentist? They said the problems
began in July when the state gave a private company called Atlantic
Dental, Inc. a contract worth around $18 million a year to manage
Miami-Dade's dental Medicaid program for kids.

Latimer said, "The way it was, you were a human. The way it is, you
are not."

The way it worked before ADI, and the way it still works in the rest
of the state, is that dentists provide treatment and get paid by the
state a fee for their service.

Now, ADI is responsible for paying those dentists, many of whom have
stopped serving poor children because they say ADI will pay then only
$4 per child per month. They describe it as a money-losing
proposition.

Dr. John Tabak is a past president of the South Florida Dental
Association.

Tabak said, "If I have my day filled with children who I'm getting $4
a month to see, no way can I pay the rent and the staff and the
materials on that kind of money."

How or why ADI got the contract is the stuff of speculation both in
Tallahassee and in Miami-Dade County.

"I think it's purely political," Tabak said. "He's a major political
contributor."

Tabak is talking about Mike Fernandez. Over the last couple of years
Fernandez and his many health insurance companies have been the
subject of many published and Internet reports detailing numerous
political contributions.

Local 10 wanted to talk to Fernandez. He lives in a Coral Gables
mansion so secure that as close as we could get to it was flying Sky10
overhead.

Instead of Fernandez, the company arranged for us to speak with Leila
Chang, ADI's president and CEO.

She said, "I think there's criticism because with any new program
there's criticism because it's not happening the way it used to be."

"If anyone has any issues, I welcome them to call us and tell us
specifically what their issue is and I can assure you that issue will
be taken care of," Chang said.

State Rep. Rene Garcia chairs the Health Care Regulations Committee in
the House. He bought into the privatized experiment, because he said
the state was promised a cost savings.

"You've brought a serious situation to my attention," Garcia said.

But Garcia said, "What we're trying to do is contain the cost of
Medicaid."

Then Jilda showed Garcia ADI's contract, and asked how the state is
saving money by paying almost $3 million more a year to ADI than it
spent in 2003 on dental Medicaid claims in Miami-Dade County.

"I'm shocked to see that this," Garcia said. "If it's true, it's
something that is just wrong. It shouldn't be. We shouldn't accept
this."

ADI representatives said Local 10's interpretation of the $4 per
month, per child payment is misleading. The company said it does pay
dentists for many additional procedures.

Coming up Monday at 6 p.m. on Local 10 News, find out what else we
discovered about this privatized program when we picked up a provider
handbook and started dialing for dentists.

Copyright 2005 by Local10.com. All rights reserved. This material may
not be published, broadcast, rewritten or redistributed.

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