Some children and pregnant women in Kentucky have wrongly been denied access to dental care since the state abruptly cut dental and vision coverage for as many as 460,000 people, public health advocates say.
The cuts came after Gov. Matt Bevin's plan to overhaul the state's Medicaid program was blocked by a federal judge.
State officials acknowledged they have seen instances of patients being denied coverage but blamed providers for misinterpreting the eligibility rules. They said they were working to clear things up.
"We've received reports that some providers have misinterpreted earlier training and guidance, and we regret any confusion that caused Kentuckians on Medicaid to not receive the care for which they are eligible," Kristi Putnam, deputy secretary of the state Cabinet for Health and Family Services, said in a release Friday.
But it was the Republican administration's recent decision that ignited a period of "chaos and confusion," said Emily Beauregard, executive director of Kentucky Voices for Health, a patient advocacy group. The Kentucky Oral Health Coalition said it has heard from multiple dentists in recent days claiming that routine dental care was denied to children and pregnant women.
Children, pregnant women and disabled adults should have been exempt from the cutoff of Medicaid benefits announced last weekend.
State health officials insist no policy changes were made affecting eligibility for children and pregnant women, but said additional steps were being taken to ensure health providers "correctly interpret eligibility."
"According to system checks made by the cabinet, and the providers we have spoken to, vision and dental eligibility is being correctly applied for pregnant women and children," the state Cabinet for Health and Family Services said in a statement Friday.
The state agency added it has "identified examples where providers have misinterpreted computer screen eligibility information and turned away some patients despite them having coverage."
Some children and pregnant women who should still have dental coverage under Medicaid have shown up as "inactive" when dental staff look up their benefit status, Beauregard said, citing what she's been told by some providers in recent days. State health officials said Friday they have heard from some providers about how to better display information and make it easier to understand.
Medicaid is the joint state and federal health insurance program for poor and disabled people.
U.S. District Judge James E. Boasberg last week halted Kentucky's first-in-the-nation experiment with Medicaid work requirements, ruling the Trump administration glossed over potential coverage losses. He sent the state's plan back to federal authorities for another look.
Bevin's administration responded by abruptly cutting dental and vision coverage for as many as 460,000 people.
In practice, the system isn't working in correctly determining eligibility, Beauregard said in a Friday phone interview.
"We have providers who are reporting to us that there seems to be no rhyme or reason to who has benefits and who doesn't," she said.
"Some kids have benefits, some kids have lost benefits. Some pregnant women have benefits, some have lost them. Some people with disabilities have benefits, some have lost them. It doesn't make any sense."
In its statement, the Kentucky Oral Health Coalition pointed to "errors" that it said meant that some "children who show up for a dental visit have been turned away with unmet dental needs unnecessarily."
Terry Brooks, executive director of Kentucky Youth Advocates, said his organization received similar reports of denial of dental care for children. Brooks said that after conversations with senior cabinet officials Thursday, he's confident the state recognizes the problems must be dealt with in a "direct, clear and immediate manner."
State health and family services officials said Friday steps were being taken to ensure eligibility is determined correctly.
"We are working to provide more communication to supplement providers' training, and to make sure providers understand the new look of some eligibility screens on their computer system and correctly interpret eligibility," they said.
Bevin's administration has blamed the judge for the dental and vision coverage cuts, saying his ruling removed a "legal mechanism" to pay for the coverage for about 460,000 Medicaid beneficiaries and left officials with less than two days to undo a year and a half of planning.
Until the judge's ruling, Kentucky's new rules had been set to take effect in a northern Kentucky suburb of Cincinnati
Instead of blaming the judge, Beauregard said, the state should take responsibility and work with stakeholders to resolve the problems. The state spent huge amounts on the Medicaid overhaul yet "it can't even correctly determine eligibility and assign benefits," she said. "It's preposterous."