Lawmakers hear plan to raise MaineCare anesthesia rates to speed dental care for children
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Summary
LD 2123 would raise MaineCare anesthesia reimbursement for pediatric dental procedures at ambulatory surgery centers that meet a payer-mix threshold to reduce long wait lists; providers testified that current rates make anesthesia services a net loss and constrain capacity.
Speaker Ryan Fektow presented LD 2123 to modify MaineCare reimbursement for anesthesia used in certain pediatric dental procedures performed at ambulatory surgery centers (ASCs). He said the bill targets reimbursement increases to ASCs meeting a threshold (described in testimony as at least 50% MaineCare payer mix) so centers can remain financially viable and expand access to children who now face long waits for surgery.
Dr. Michael Dowling, a board-certified pediatric dentist and medical director of the Maine Dental Surgery Center, described day-to-day capacity constraints and long wait lists for children needing care under general anesthesia. He told the committee that treating such cases under current anesthesia reimbursement rates results in a net loss to providers: "At current rates, anesthesia services are a net loss on every case we see." Dowling said his ASC reduced prior wait times (previously ~18 months) to about six to nine months and that a modest state investment would allow treatment of roughly 200 children this fiscal year. He gave a fiscal snapshot saying an investment of less than $30,000 this year could address immediate backlog at his center.
Multiple stakeholder witnesses — including the Children's Oral Health Network, Maine Dental Association, Maine Society of Anesthesiologists and dental hygienists — testified in support, citing the mismatch between actual anesthesia costs and current MaineCare unit rates (testimony cited a present rate of about $1.51 per 15-minute anesthesia unit and a requested increase to $2.50 per 15-minute unit). Committee members asked for more detail on the current MaineCare reimbursement schedule, how many children are on wait lists, and the capital and operating costs of establishing an ASC (testimony estimated about $2.5 million to establish an ASC in leased space). The committee closed the hearing and requested additional fiscal data and numbers on wait lists and operating economics for the work session.