Free Notice (Other) - District Court of Connecticut - Connecticut

Case 3:00-cv-01050-AVC Document 178 Filed 08/15/2008 Page 1 of 2
CARR v. WILSON—COKER, Civil Action No. 3:00 CV 1050 (AVC)
United States District Court ~ District Of Connecticut
NOTICE OF INTENT TO COMMENT
Purpose of this notice: This notice concerns the proposed Settlement Agreement in a
class action case, Carr v. Wilson—Coker, filed in the United States District Court, District
of Connecticut. As current orthodontic providers in the HUSKY A Medicaid program,
we wish to object to the proposed orthodontic fee schedule ofthe proposed Settlement
Agreement on the grounds that it fails to provide payments at an adequate level to attract
a sufficient number of orthodontic providers to allow Connecticut Medicaid recipients the
same access to this specialty of dental care enjoyed by the general population. If there
are insufficient orthodontic providers, the Settlement Agreement as currently proposed, is
in violation of federal Medicaid laws as provided under Title XIX of the Social Security
Act, 42 U.S.C. 1396.
Background: In the lawsuit brought in March 2001, the plaintiffs alleged that the
defendants were ". . .maintaining inadequate dental provider reimbursement rates and
claims processing requirements, and thereby failing to provide proper and efficient
operation of the program, failing to give eligible Medicaid recipients needed care with
reasonable promptness, and failing to ensure that care is provided in a manner consistent
with simplicity of administration and the best interests of the recipients". In the State of
Connecticut, the Medicaid program currently operates under a fee schedule that was
established in 1993. With the approval by the State Legislature, the Department of Social
Services has agreed to expend an additional 20 million dollars per year over the base
yearly allocation. The new fee schedule (Exhibit "A") was presented with the Settlement
Agreement. In the "Notice of Proposed Settlement Agreement and Fairness Hearing", it
is stated that "These fees represent significant increases for dental reimbursements? This
is not correct regarding orthodontic services. It was also stipulated in the Settlement
Agreement that the Department of Social Services would engage in an aggressive
program of provider recruitment to encourage dentists to participate in a program as
participating providers.
Orthodontics: Orthodontic services are currently compensated at the 1993 rate levels.
Since that time, only a small portion ofthe orthodontic community chose to participate as
providers due to inadequate remuneration. At the present time, 16.8% of 160 practicing
orthodontists in the State of Connecticut accept Husky patients. Of those who accept,
60% are over the age of 60. While the fees in Exhibit "A" ofthe Settlement Agreement
were rightfully increased for primary and preventive dental care for children, orthodontic
fees for children were reduced below the level provided in the 1993 fee schedule. While
some ofthe general dental fees were increased by as much as 350%, the orthodontic fees
were reduced 14%. There was no adjustment for inflation to orthodontic providers over a

Case 3:00-cv-01050-AVC Document 178 Filed 08/15/2008 Page 2 of 2
15 year period. If there was only a small percentage of providers at the old rate and many
of these are close to retirement, a sharp decline of providers will result in an inability of
HUSKY A eligible patients to procure the services of an orthodontist. The mandate for
the DSS to recruit additional orthodontic providers will be huitless under the proposed
fee schedule.
Marshall S. Greenberg, D.M.D. Kathryn Reluga, D.M.D.
201 Division Street 546 South Broad Street
Ansonia, CT 06401 Meriden, CT 06450
203-73 5-9600 203-23 5-5503
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