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Lawmakers hear urgent calls to raise Medicaid dental reimbursement and streamline payments to recruit providers
Summary
Oregon Health Authority staff briefed the House committee on OHP dental rate mechanics — fee‑for‑service payments and capitation to CCOs — noting adult utilization has not fully rebounded from the pandemic, and the committee then heard hours of testimony urging an industry‑benchmarked rebasing (HB 2,597) and clearer definitions for dental subcontractors (HB 2,211).
An informational session and public hearing before the House Committee on Behavioral Health and Health Care focused on Oregon Health Plan (OHP) dental payment methods and two bills aimed at stabilizing the dental safety net: an informational presentation from Oregon Health Authority staff about fee‑for‑service and capitation components, followed by a public hearing on House Bill 2,597 (rate methodology/rebasing) and testimony on House Bill 2,211 (definition and limits for dental subcontractor scope).
Lede/nut: Ahmed Farag, oral health and dental director at the Oregon Health Authority (OHA), and Will Clarkshim, OHA chief actuary, told the committee that dental payments flow through two channels: a fee‑for‑service schedule (OHA to provider) and capitation (OHA to CCOs, which may subcontract dental services). Clarkshim explained capitation math: rate per service × utilization; utilization dropped steeply in 2020 and has only…
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