Dentists decry decrease in health plan rates
By John McPhaul
jpmcphaul@gmail.com
The Dental Surgeons Association of Puerto Rico, through its president, Dr. Arminda Rivera Mora, spoke out on Tuesday against the decisions by healthcare plans such as MMM that announced last week a reduction in the rates paid to dental professionals at the exact time when the plans are attracting Advantage patients with wider dental coverage that seems to offer more at the expense of lowering dentists’ rates.
“This unilateral and unfair decision is coupled with the inability of the Health Services Administration [ASES by its Spanish initials] to comply with a dental fee rate approved in 2018 that included a 70 percent increase in 2019,” Rivera Molina said in a written statement. “This comes after more than 25 years without an increase in dental rates.”
“Both scenarios contribute to the fact that this professional class has lost about 500 dentists in the last decade, a situation that puts the access of patients to a dentist in a precarious position, creates delays in the availability of appointments and leaves [dental] professionals economically burdened with unsustainable operational costs including increases and instability in electricity, water and materials. Also alarming is the shortage of dental assistants, who prefer to work in fast food restaurants because they receive better pay, because insurers are the ones who set the rates, according to their economic convenience and not following a scientific or standard system, and the dentist is unable to increase the salary of the auxiliary staff, already scarce.”
“Four years have passed and every executive director of ASES informs us that the increase is already approved by the Centers for Medicare and Medicaid Services pending the Financial Oversight and Management Board,” she continued. “In March, Jorge Galva, [ASES] executive director at the time, informed us that the increase was now official, which would be retroactive to October 2021. “However, the increase has never materialized. Dentists cannot continue to subsidize oral health, much less when insurers continue to increase their profits quarterly. If the government does not comply with the agreements established with the [service] suppliers, how does it intend to supervise the insurers that are totally free?”
Rivera Mora expressed disappointment with the lack of support and oversight by the government, which she said is unable to accommodate providers, who are responsible for the health the people deserve and who find themselves with their hands tied and deaf ears turned to their demands.