WASHINGTON — Two years after a 12-year-old Maryland boy died from an untreated tooth infection, low-income kids continue to face barriers to dental care despite state and federal efforts to improve access, government investigators said Wednesday.
"The bottom line: Children's access to Medicaid dental services has been improving but remains low," said Katherine Iritani, health care acting director at the Government Accountability Office.
State officials told the GAO that many children can't find dentists who accept Medicaid, and dental providers cite low reimbursement rates and patients skipping appointments as challenges to treating kids in the federal-state health insurance program for the poor.
At the time of 12-year-old Deamonte Driver's death in February 2007, only about a third of eligible children signed up for Medicaid received dental care under the program, according figures from the Health and Human Services Department's Centers for Medicare and Medicaid Services.
The GAO said in a report Wednesday that many states have reported moderate increases in poor children's access to dental services, but Iritani said there isn't enough data to say how many of the 30 million children signed up for Medicaid are actually seeing a dentist.
The GAO released a report as part of a House Oversight subcommittee hearing on the inadequacies of pediatric dental care among Medicaid enrollees.
The report said "continued attention and action is needed to ensure children's access to Medicaid dental services" despite steps by federal and state officials to address problems.
Federal Medicaid officials have done a focused review of 16 states and the District of Columbia where there have been shortcomings in dental care delivery. The officials have made recommendations to each.
Cindy Mann, director of the government's Center for Medicaid and State Operations, said the agency was committed to making sure the Medicaid program works for every child.
"It is a multipronged problem – and I don't say that to try and get around our responsibilities," Mann said. "I say that to say that we're rolling up our sleeves and it is not a simple solution."
The House committee's domestic policy subcommittee began looking into dental services for low-income children after the death of Driver, who was from Prince George's County, Md.
Driver, whose family's Medicaid coverage had lapsed, died after bacteria from an untreated tooth abscess spread to his brain. A routine tooth extraction may have saved him – but he couldn't get in quickly enough to see a Medicaid oral surgeon.
This is the subcommittee's fourth hearing on the topic since his death.
"We are not going to stand by and watch any more little kids die," said Rep. Dennis J. Kucinich, D-Ohio, the subcommittee's chairman.
The GAO recommended that the Centers for Medicare and Medicaid Services develop a plan for sharing promising practices among states and reviewing dental services in states with low access rates.
On the Net:
Government Accountability Office: http://www.gao.gov