Due to reductions by the 2009 legislature, certain dental services for Medicaid recipients—such as denture repairs, deep cleanings, and house call fees—are no longer covered. Accordingly, it is true that there are mechanisms in Medical Assistance that will allow the county to deduct incurred expenses for medically necessary services that are not covered by MHCP or any other third party coverage from a person's income when determining how much of the person's income is available to pay for nursing facility (NF) care.

These expenses, when incurred, should be reported to the county by the client or the client's authorized representative. NF providers should only be receiving invoices from dental providers for residents for which they are authorized representatives. The county workers follow guidelines from the Minnesota Department of Human Services (DHS) when determining whether an expense is medically necessary, therefore enabling them to reduce the resident’s spenddown. If a nursing facility has a contract with a dental provider and agrees to pay them a fee each month, the county financial workers have been instructed by DHS to not allow the house call to be charged to the resident as an eligible deduction to the resident’s spenddown. Any questions should be directed to the specific county financial worker.

Todd Bergstrom
952.851.2486
tbergstrom@careproviders.org