Will Still Take Medicaid
Cigna and Delta Dental Medicare are OK
Plot May Violate Affordable Healthcare Act,
May Violate Kentucky’s Elder Abuse Statute
Exclusive BREAKING NEWS / INVESTIGATIVE STORY / COMMENTARY, 6/25/2024, UPDATED 6/26/24
Nihil Obstat, Imprimatur
Copyright © 2024 JournalKentucky.com All rights reserved.
by Sage Editor
University of Kentucky (UK) Dental services plots to no longer accept certain dental insurance plans as of August, 2024 unless it is one of the following plans:
- Medicaid.
- Cigna Medicare.
- Delta Dental Medicare plan.
Staff at the UK Dental Student Clinic and “Kentucky Clinic Dentistry” (aka “Adult Dentistry”) are not able to explain the rationale for dumping many patients based on particular insurance plans.
Most Private Dentist Offices Refuse to Take Medicare
This means many Kentuckians, especially elderly, will either need to change dental insurance plans or be left out of UK dental services.
Medicare coverage can ordinarily be changed only during open enrollment in the autumn unless the patient qualifies for low-income subsidies. Such “qualified healthcare plans” can be changed at the start of a new fiscal quarter, meaning three times a year.
UK Dentistry’s new insurance rules will leave many unable to change plans between August and December 31, 2024.
Plot May Violate Patient Rights Under Affordable Healthcare Act
The Affordable Healthcare Act (“Obama Care”) creates a tort* for those patients whose rights are violated by any provider who is deemed to have denied access to healthcare,* apparently in anyway whatsoever.
UK Dentistry has chosen to roll out this fiat** in August, before most people are even allowed to change their Medicare plan, begging the question of how well thought-out the administrators’ plot really is.
As of the time this article was published, no prior notice has yet been given to affected patients who therefore have no opportunity to get different Medicare dental coverage before the effective date.
Apparently staff is advising patients who phone in; and, an informative letter will soon be mailed to patients.
Many aspects of this could be potential violations of the Affordable Care Act at a time when citizens are riveted by Bidenomics inflation including increased costs of basic necessities (food, utilities, gas, etc.).
Sage Editor has been unable to find one private dental practice outside of UK that will take Medicare, meaning that if UK Dental services exclude certain Medicare dental plans, many elderly patients may have no dental service, putting it on par with Great Britain and circumstances in other socialist nations.
They probably could get service at an Emergency Room, in line behind scores of illegal immigrants who use the ER as free medical care; but, it would probably need to be a true emergency like a broken tooth or infection.
Medicare primarily covers elderly (age 62 +) or disabled persons. Elderly are obligated by social security law to select a medicare plan within three months before turning age 65 or suffer a forever lifetime monthly surcharge (a “fine”) as a penalty for failing to do so. Medicare recipients can also select supplemental plans if financially able to do so. Supplemental plans add extra medical coverage that most Medicare plans do not include.
Medicaid covers a wide variety of circumstances for those in low income brackets, including children (KCHIP).
Impact on UK Dental Students
There may also be a dental-student component of UK Dental Services’ fiat to drop all but two Medicare providers.
The dental students, seeking Doctorate of Medical Dentistry (DMD) degrees, rely upon sufficient patient load to be able to complete a specific number of each procedure to qualify for their doctorate degree.
The first year of dental school is largely classroom presentations and laboratory practice “procedures” on fake teeth that migrate into hands-on patients during the second year.
Each year after that, the students do progressively more advanced procedures until graduation after four years of intense rigorous study and clinical practice on real patients.
The UK dental program has always been one of the most renowned in the nation. The students are routinely praised as extraordinarily calm and highly competent.
“You’d think they were already a licensed practicing dentist, they are that good,” one patient told Sage Editor.
Apparently, most of the patients seen by dental students come from Medicaid, some from Medicare; because people with better insurance have the choice to go to private practitioners outside UK.
Most people would probably rather go to a private practice than the student dental clinic, despite its sterling reputation.
Medicare and other insured patients can also go to Adult Dental Services at UK; but, they are also limiting Medicare plans to Cigna and Delta medicare dental insurance plans. Medicaid will still be accepted as well.
And, because all private practitioners apparently exclude Medicare patients,*** UK Dental School student clinic is their only option for dental care unless they are able to get a timely appointment at Adult dental services.
During covid emergency, UK Adult dental services closed-out new patients and only served UK staff and students, possibly existing other patients.
Contacted about the termination of most Medicare plans in August, UK Adult dental service staff advised that there is no opportunity for new patients again until possibly late July when “we get a batch of new dentists and their calendars open” at that time.
JK COMMENTARY:
Legal Issues Not Addressed
The UK Dental insurance fiat adversely impacts poor elderly Medicare patients and possibly even the dental students opportunities to interact with more patients.
UK Dental apparently failed to provide a public forum for input from all parties adversely affected by this fiat to eliminate all but two Medicare programs. Patients, students, the legislature, and the governor’s office were apparently completely ignored.
UK medical and dental exists because of gifts from the taxpayers of Kentucky every year.
Furthermore, as fiduciaries of the public trust, UK Dental owed a legal obligation to conduct such public and legislative surveys before making this type of decision.
The fiat to drop many Medicare patients in the UK Dental student clinic and Adult dentistry raises serious legal issues:
- Possible violation of Affordable Care Act prohibition on denying access to healthcare, a tort;*, ****
- Possible violation of public confidence and fiduciary obligation to the citizens due to taxpayer funded university, dental school, and clinics;
- Apparent failure to notify the state legislature and governor of this dastardly plot against public health care;
- University officials knew, or should have known, of these serious obligations before issuing the fiat to terminate many Medicare plans WITHOUT PROPER NOTICE, WITHOUT PUBLIC INPUT, WITHOUT DENTAL STUDENT INPUT, etc., unless UK did in fact poll the stakeholders listed, supra.
Scheme May Violate Elder Abuse Statute on Patient Abandonment
UK Medical complex is a tertiary and trauma medical center that receives state and federal funds, serving thousands of dental patients not only in the Bluegrass region, but from farther areas in the Commonwealth.
Therefore, if the change is construed to constitute abandoning existing elderly patients without appropriate due process, then it may actually violate Kentucky’s Elder Abuse statue which proscribes medical providers from abandoning extant patients.
The statute specifically names medical providers as subject to all provisions. Violation of any state law may serve as basis for civil tort; and, the Elder Abuse statute also contains provision for criminal charges if patients are deemed to be abandoned under the law. That type of scenario is not likely.
JK Ongoing Investigation
JK corrects all significant errors flagged for attention, and this story is being updated as better information is received.
The following politicians were contacted for comment, but no reply was received before publication of this article:
- Governor Andy Beshear (press and communications offices).
- State Sen. Reginald Thomas (Fayette).
- State Rep. George Brown, Jr. (Fayette).
Various university officials have been approached for comment via request to appropriate UK press offices.
There is no information available regarding whether the Governor’s office or legislature was notified of UK Dental services’ fiat to exclude all Medicare plans except two, supra.
However, no source indicates that the legislature or governor was notified; nor have any of the foregoing entities released any information regarding this topic, nor held any public hearings on it as far as known at this time.
UK media relations for dentistry agreed to forward Sage Editor’s request for an interview to appropriate individuals in dentistry; but, there has been no fruitful reply so far; and, no other information is available.
JournalKentucky.com will update this breaking news event as more information arrives. 4:34 p.m., E.D.S.T. Bookmark and return to this page often for updates.
___ Endnotes
* “Tort” is an act that gives rise to civil liability, meaning civil suit may be filed seeking declaration of rights and/or monetary damages (both punitive as well as actual damages). Affordable Care Act provides for all those types of grievance redresses and remedies. In Kentucky, violation of any state statute, administrative regulation, or rule can be the legal basis for a civil suit.
** “Fiat,” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/fiat. Accessed 25 Jun. 2024.
*** All private practitioners exclude Medicare patients” is true as far as Sage Editor’s research indicates only UK was accepting Medicare patients. This is believed to be due to the hassle of practitioners dealing with Government regulations, rules, and oversight which includes significant limits on what can be billed / paid for under Medicare guidelines.
You are hereby granted further permission to paraphrase as much as you need to provided you cite this article as follows:
UK Dental Kicking Out Many Medicare Patients in August, by Sage Editor, JournalKentucky.com, 6/25/24, https://journalkentucky.com/2024/06/25/uk-dental-kicking-out-many-medicare-patients-in-august/
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