Suit Filed on Behalf of Michigan Medicaid-Dependents Denied Access to Dental Healthcare

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In a move aimed at forcing the State of Michigan and the Legislature to protect the rights of Michigan's most vulnerable population, including the developmentally disabled and those with minimal financial resources, a lawsuit was filed in federal court against the Granholm Administration. A class of more than 400,000 at-risk Michigan residents is suing the State for failing to uphold its legal obligations with regard to funding certain dental care services under the federal Medicaid program.

The suit seeks to compel the State to bring its funding scheme for adult dental benefits under Michigan's Medicaid program back into compliance with federal law.

Although participation in the federal Medicaid program is optional, once a state 'opts in,' and thereby obtains federal funding, the State must comply with all federal requirements. The suit alleges that, by effectively eliminating adult dental benefits, Michigan is violating key federal regulatory and statutory mandates, including:

-- Failing to adopt and maintain programs and policies that operate to make dental care available for Medicaid beneficiaries throughout Michigan;

-- Failing to provide proper and efficient operation of the Medical Assistance Program, and to provide payments that facilitate provision of care in a manner consistent with the best interest of Medicaid beneficiaries;

-- Failing to provide payments that facilitate adequate participation by Michigan dental providers in the Medical Assistance Program, resulting in some Medicaid beneficiaries in Michigan being able to obtain sufficient dental care while others cannot; -- Acting in an arbitrary and capricious manner, and contrary to and in violation of the efficiency, economy, and quality of care provisions; and

-- Failing to enlist enough providers so that dental health care and services are available to Medicaid-eligible adults who reside in various geographic areas in Michigan, including, without limitation, numerous counties in the northern portion of the lower peninsula, at least to the extent that such care and services are available to the general population.

Adequate dental care is vital to overall general health. Regular dental care and treatment can prevent such catastrophic illnesses as diabetes, heart disease, arteriosclerosis, and cancer; and regular dental care is often critical in the early detection and successful treatment of these diseases. Untreated dental disease in pregnant women can cause pre-term delivery or low birth-weight babies.


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Last updated October 30 2009

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