Contact: Crystal Adams, MA CDA RDH
Foundation for Health Leadership and Innovation
Email: crystal.adams@foundationhli.org
Phone: (828) 638-6719
RALEIGH, NC — A bipartisan group of North Carolina legislators will introduce a bill next week to improve access to oral health care by increasing Medicaid reimbursement rates for dental services. Oral health care remains out of reach for many North Carolinians despite Medicaid coverage. Low reimbursement rates, currently about 34 percent of billed charges, mean many providers operate at a
financial loss when treating Medicaid patients. As a result, providers often limit participation, leaving patients without access to routine care and relying on hospital emergency departments for urgent needs.
“Our Medicaid program requires an adequate network of dental providers throughout the State,” said Senator Gale Adcock (D-16), the bill’s primary sponsor. “If we want to improve access to care, we have to start by fixing the rates.”
North Carolina has not increased Medicaid dental reimbursement rates in a meaningful way since 2008 and now ranks in the bottom third nationally, behind neighboring states that have made investments in oral health access.
“The impact of many health issues is worsened by poor oral care.” said Senator Jim Burgin (R-12), a co-sponsor. “Medicaid patients deserve access to quality dental services to protect their overall health. Many providers can only afford to see a handful of Medicaid patients. We need more providers participating, and this bill is a starting point.”
The proposed legislation would invest approximately $80 million in Medicaid dental services. This increase is expected to make treating Medicaid patients financially viable for more providers and expand access to preventive and routine care statewide.
Increasing reimbursement rates would:
- Expand provider participation in Medicaid
- Improve access to preventive care
- Reduce costly emergency department visits
“Oral health is inseparable from overall health,” said Crystal Adams, Director of the North Carolina Oral Health Collaborative at the Foundation for Health Leadership and Innovation (FHLI). “This legislation is a critical step toward building a more equitable and effective oral health system for all North Carolinians.” FHLI supports this legislation as part of its mission to advance innovative, community-driven solutions that improve health outcomes across North Carolina.