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Dr. Jan Kippax is the only oral surgeon in the Twin Cities willing to take on Medicaid patients.
This doctor, who has a history of not washing his hands between patients, occasionally using unsterilized medical instruments and ignoring patient pain, is the only local option for adults on Medicaid who need care.
Patients fortunate enough to have insurance and those wealthy enough to pay their own medical bills have choices for oral surgery, but not the poor and disabled. If they cannot travel, their only choice is Dr. Kippax, a man who -- after serving a two-week suspension imposed by the Maine Board of Dental Examiners for numerous violations of the Maine Dental Pracice Act -- will be on probation for the next five years to ensure he follows accepted guidelines for treatment and cleanliness.
The state and other dental professionals have to take some responsibility for this situation. Not for Kippax's poor office procedures, but for limiting patient choice.
Most oral surgeons decline to take Medicaid patients because the reimbursement rate is low and the paperwork the state requires for reimbursement is excessive.
Both problems can be fixed. The second more quickly than the first.
Maine knows that doctors who treat Medicaid patients are losing money and, last year, added an extra $1 million to the state budget to increase reimbursement rates to improve access.
Then came the budget crunch.
The "extra" amount dropped to $400,000, but the Department of Human Services has assured patients that as soon as more money is available the full $1 million will be allocated for dental services.
Maine is facing a $280 million shortfall in the current budget cycle, with an expected gap in the coming budget of nearly $1 billion. It's not likely that $600,000 will be reimbursed to a fund that has already been tapped to pay other bills. In fact, the $400,000 figure might disappear.
Money is only part of the solution anyway.
If specialists cite paperwork as one of the chief reasons they reject Medicaid patients, let's reduce the paperwork and remove one obstacle to patient access.
The inadequate reimbursement rate will take time and a shift in the economy, but easing the paperwork load might be enough to prompt some dentists to open their doors to Medicaid patients and give Maine's poorest patients more choice.
jmeyer@sunjournal.com
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