Mobile and specialty anesthesia groups ask KDHE for $1,900 case rate to keep dental sedation services in communities
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Summary
Mobile anesthesia providers told the committee they receive far less than hospital case payments for special‑needs dental patients and asked KDHE to direct MCOs to adopt a $1,900 case rate and to define qualifications for office‑based anesthesia providers.
Specialty anesthesia providers represented testimony asking the committee to direct KDHE and KanCare managed care organizations to adopt a case rate near $1,900 for office‑based (mobile) anesthesia for dental patients with special needs.
Jeremy Salisbury (Special Anesthesia Services) and Jeffrey Glasgow (advanced specialty anesthesia) described a funding gap: they said KanCare pays roughly $3,000 when care is delivered in a hospital or ambulatory surgery center but mobile providers receive less than half of that in current practice, leaving mobile teams financially unsustainable for many cases. Glasgow and Salisbury said the absence of a dedicated CMS code for mobile dental anesthesia and payment complexities for D‑SNP (dual eligible special needs plans) patients worsen the problem and slow private‑office solutions.
Witnesses asked the committee to instruct KDHE to approve a fair case rate for qualified mobile anesthesia groups (proposal cited a $1,900 case rate and a proposed qualification definition including 5 years of Kansas office‑based experience and a minimum service footprint). Committee members sought aggregate fiscal impact figures and asked KDHE staff to produce fiscal notes and explore whether new CMS coding could resolve the issue in the medium term.
No formal committee action was taken; staff and witnesses discussed follow‑up to clarify provider counts, case volumes and a fiscal estimate.