Rooting for a Change - 5 Million New Yorkers Win the Right to a Root Canal

Rooting for a Change - 5 Million New Yorkers Win the Right to a Root Canal

by M.C. Millman

Five million low-income New Yorkers will soon have access to routine dental care that no longer relies on whether or not they still have four pairs of matching back teeth.

The suit was filed in federal court in 2018 and charged the New York State Health Department with denying thousands of low-income New Yorkers medically necessary dental treatment.

According to New York Medicaid rules, having eight crucial teeth has long been considered adequate for functional purposes. The remaining teeth were considered redundant, no matter how many the individual was missing. This meant anything beyond those eight wasn't covered by Medicaid for root canals and crowns, resulting in teeth being pulled instead of treated and saved.

After a successful class action suit, Monday's legal settlement requires the New York Department of Health to expand Medicaid dental coverage, improving oral health for low-income patients across the state.

Given that Medicaid programs are not required to provide dental care, benefits vary from state to state with some states even providing no dental coverage. But by law, states that provide dental care options must cover all medically necessary care.  

The lawsuit argued that New York had imposed rigid restrictions on crucial services, leading to the denial of coverage for medically necessary care.

Changes in allowable dental care will now include coverage of common but costly dental procedures, including dental implants, replacement dentures, crowns, and root canals if a dentist authorizes the procedures.

The new rules are slated to take effect 90 days after the court approves the settlement agreement.

photo credit: Flickr

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