Full Medicaid Pricing (FMP) Program Initiative for Dentists
FAQ Regarding FMP Program
The LDA has been working for some time now with the LSU School of Dentistry (LSUSD), the University of Louisiana Lafayette (ULL) and the Louisiana Department of Health (LDH) on what is known as a “Full Medicaid Pricing” (FMP) program to enhance payments for Medicaid dental services. This should soon result in many dentists in Louisiana who are enrolled as Medicaid providers being eligible for supplemental payments based on the volume of Medicaid services for which they have been reimbursed. The Louisiana dental FMP program will be the first of its kind in the nation!
The LOIs constitute non-binding expressions of interest. However, they are essential to determining how many practices are interested in participating in order to initiate the process that will make funds available. And, it should be pointed out that the more dentists that participate, the more total funds that will be available. This is not a situation in which there is a finite pool of money, and the more dentists that participate, the smaller the share allotted to each practice. It is actually to everyone’s benefit the more dentists that participate, as more dentists means more total funds available. So, please share this information and copies of the LOI with any Medicaid dentists you know.
It’s still too early to predict by exactly how much Medicaid dental reimbursement will be enhanced, but we are confident the actual amount will have a very significant positive impact. The overall amount involved is potentially many millions of dollars. You will be advised more specifically about the dollar amounts as more information becomes available.
If you are already a provider or just signed up, please click here to let the LDA know so that we can maintain updated records.
For the most recent updates and information from the Department of Health and Hospitals, visit the Louisiana Medicaid Web site at www.lamedicaid.com.
The five Healthy Louisiana plans are:
- Aetna Better Health
- Healthy Blue (formerly Amerigroup Real Solutions)
- Amerihealth Caritas Louisiana
- Louisiana Healthcare Connections
- UnitedHealthcare Community Plan
HOW TO CONTRACT WITH MCNA DENTAL (Louisiana's dental benefit program manager)
In 2014, MCNA Dental was selected by the Louisiana Department of Health and Hospitals to administer its Medicaid and CHIP dental programs statewide. MCNA would like to invite all Louisiana dentists to join the MCNA network of dentists. For your convenience, the documents that must be completed and submitted for credentialing are available on our website http://www.mcnala.net/
• Credentialing Application (Please submit one application per dentist)
• W-9 Form
• Direct Deposit EFT Form
HOW TO CONTRACT WITH BAYOU HEALTH (Louisiana's medical Medicaid program managers, updated 1/17/19)
All five Bayou Health plans offer a limited dental benefit in addition to the current Medicaid Dental Benefit managed by MCNA.
Amerigroup, AmeriHealth Caritas of Louisiana (ACLA), and Aetna all contract with DentaQuest to manage the dental benefit. Information relative to credentialing and benefits offered can be found on the Dentist Page link at www.dentaquest.com/Louisiana or by contacting the credentialing hotline at 1-800-233-1468.
United Healthcare Community Plan of Louisiana (UHC) ask interested dental providers to contact the United Healthcare Dental Provider Services line at 1-844-275-8751.
ELECTRONIC HEALTH RECORDS (EHR)
The American Recovery and Reinvestment Act of 2009 (Recovery Act) includes the Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act," which established programs under Medicare and Medicaid to provide incentive payments for the "meaningful use" of certified electronic health records (EHR) technology.
There is *no federal deadline* for adoption of Electronic Health Records (EHRs) by dentists who do not submit claims to Medicare. However, Medicare eligible professionals will have a payment adjustment in their Medicare reimbursement for failure to implement “meaningful use” of EHRs starting in 2015. Eligible professionals may begin participating in the Medicare EHR incentive program as early as 2011, and the program ends in 2016.
The Medicare and Medicaid program aspects of HITECH may not affect most dentists because many dentists do not provide Medicare-covered services or meet the Medicaid incentive program patient-volume threshold. However, dentists should not ignore other aspects of HITECH, especially those parts concerning Privacy, Security, and the Breach Notification Rule.
Louisiana has already started a Medicaid EHR Incentive Program in which eligible medical professionals and hospitals can receive incentive payments for adopting, implementing or upgrading certified EHR technology during their first year of participation, and can earn payments for up to five subsequent years for demonstrating meaningful use of EHR.
Health Professional Shortage Area (HPSA)
HPSAs are defined service areas that demonstrate a critical shortage of primary care physicians, dentists, or mental health providers. An HPSA can be a distinct geographic area such as a parish or grouping of census tracts, a specific population group within a defined geographic area (such as a population under 200% poverty), or a specific public or non-profit facility such a state hospital. You can learn more about HPSAs by visiting the Louisiana Department of Health and Hospitals (DHH) website.