Child’s death prompts expanded dental coverage

Driver, who died after a bacterial infection that originated in his gums moved to his brain, caught national attention and highlighted serious gaps in the state’s dental care system for low-income children.

In 2006, Driver’s mother spent months looking for a dentist for her children. Treatment was hard to find, because the complicated and meager reimbursement system limited the number of dentists willing to take on patients with Medicaid, a government program that provides health insurance for people with low incomes.

After she was unable to find a dentist who would take on new patients covered by Medicaid, Alyce Driver turned to Baltimore attorney Laurie Norris for help. Norris recalled that she had to call 26 different people before she could find a dentist to help the family in November 2006, and that the first appointment could not be made until January 2007.

‘‘I certainly hope that it’s not that difficult now,” said Norris, a legal aid attorney who helps low-income residents.

Attempts to reach the Driver family were unsuccessful.

In January 2007, Deamonte Driver came home from school with a headache and was soon hospitalized and had brain surgery. He died six weeks later.

The state changes that took effect July 1 focus on increasing the reimbursement rate while simplifying and expanding the network of dentists for uninsured children, Colmers said. Until the most recent change, more than 75 percent of dentists charged more than Medicaid for dental care procedures, one of the worst payout rates in the mid-Atlantic region, according to Colmers.

This year’s budget funnels $14 million in state and federal funds to increase the payment rates, the first of three annual increases. By summer 2010, Medicaid’s dental rates for most procedures will reflect the median payouts of the private market.

‘‘The median is just what you want to shoot for,” said Harry Goodman, head of the state’s oral health division.

The first-year increase in reimbursements applies to diagnostic and preventive treatments that help catch and avoid serious dental issues for children. Officials also increased the payout for an emergency tooth extraction to $103, which might have saved Driver’s life if it had happened earlier.

Most of the increases are dramatic. Until this year, Medicaid only paid dentists $9 to seal children’s teeth, a simple procedure that cuts down on cavities. Under the new pay schedule, the same procedure pays back $33, the median cost in the state.

The boost should be enough to persuade more dentists to take on Medicaid patients, said Garner Morgan, president of the Maryland State Dental Association.

‘‘We all want to do this, but the overhead was killing us,” said Morgan, who said many younger dentists forming their own offices couldn’t afford to take on Medicaid patients.

‘‘If you’re starting out, you have student loans, and you’ve got an office that you’ve already invested $200,000, $300,000,” he said.

In addition to funding, efforts are continuing on making it easier for dentists and local health departments to provide oral care to the poor. The state health department this year added $2 million to fund local dental clinics at health departments in rural areas and relaxed rules to allow dental hygienists to do basic care without the supervision of a dentist, making it easier to hold free clinics and screenings.