1. Medallion, Expansion, Public Charge OH MY!
Early Dental Home Workgroup
PIOHQI Advisory Group
June 12, 2018

2. Virginia Oral Health Coalition
Striving to ensure all Virginians have access to affordable comprehensive health care that is inclusive of oral health
Advocacy | Provider Education | Public Awareness

3. This morning… Medicaid Expansion Medallion roll-out Public Charge
Dental Benefit in Medicaid

4. Medicaid Expansion This is a BIG deal!

5. Coverage in Virginia Medicare No dental benefits Medicaid and FAMIS
Comprehensive dental coverage for children & pregnant women
Extraction benefit for adults
Caretaker adults
Aged, blind and disabled
CCC+/Medallion 4.0
Traditional Dental Benefit
Prevention services are free
Yearly cap
Exchange Dental Benefit
Adult
No mandate
No subsidies

6. What does this actually mean?
400,000 newly eligible adults
Effective Jan 1 or before.
SPA
1115 waiver
Work requirements
Cost sharing

7. Dental Coverage - Medicaid

8. Medallion 4.0 Also a big deal

9. Medallion 4.0
740,000 Virginians
Managed by 6 MCO/available in all regions
Aetna
Optima
Anthem
UnitedHealthcare
Magellan
Virginia Premier
100,000 will receive a new plan
Can change within first 90 days or open enrollment
Providers can begin credentialing now
Medallion 4.0 Managed Care
Regions
Proposed Dates*
Tidewater Region
August 1, 2018
Central Region
September 1, 2018
Northern/Winchester
October 1, 2018
Charlottesville/Western
November 1, 2018
Roanoke/Alleghany
December 1, 2018
Southwest Region

10. Medallion 4.0 will also include some of these services
FAQ coming
CCC+ Value Add Services

11. Public Charge Another Big Deal!

12. Public Charge 2 in 5 US born children meet this criteria
600,000 Virginians live in a family with a non citizen who could be considered public charge under new criteria
Comparison – 5% of the current population falls under existing criteria.
“public charge” means an individual who is likely to become dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government Proposed changes would include consideration of use health and nutrition programs (Medicaid and SNAP) AND benefit use by the individual and dependents

13. But What about Dental in Medicaid??

14. Medicaid – Adult Dental
Partner Letters
Agency and Executive Branch meetings
Grassroots Advocacy
Message Development

15. How can you Help? Tell people – share info Write a letter
Meet with your legislator this summer

16. Upcoming Events!

17. Collaborate and Lead (even more!)
2-Day Workshop
Collaboration and Leadership to Improve Oral Health
Tuesday, August 21 – Wednesday, August 22 Richmond, VA
Register Now at
Cost: $15 per person Registration requested by Tuesday, August 14, 2018

18. 2018 Virginia Oral Health Summit
When: Thursday, November 8
Where: Richmond, VA
Who: All who are interested in oral health, population health, or policy change.
Policy & Programmatic Updates| Networking Idea-sharing
Dr. Camara Jones
Dr. Matt Allen