🚫 Medicaid Is the Baseline—Not the Bargain
As dental professionals committed to providing high-quality care, it is imperative you critically evaluate the financial agreements you enter into with insurance carriers. One increasingly concerning trend is the emergence of fee schedules that reimburse providers at rates lower than those offered by Medicaid.
The WVDA strongly advises against signing any such agreements, and here’s why:
🚫 Medicaid Is the Baseline—Not the Bargain
• Medicaid rates are already among the lowest in the industry. They are designed to cover essential care for vulnerable populations, not to reflect the true cost of delivering comprehensive dental services.
• Accepting less than Medicaid rates undermines the value of your clinical expertise, overhead costs, and patient care standards.
💸 Unsustainable Economics
• Reimbursement below Medicaid often fails to cover basic operational costs, including staff wages, materials, sterilization, and facility maintenance.
• This can lead to reduced appointment availability, rushed procedures, and burnout, ultimately compromising patient outcomes and provider well-being.
🧾 Legal and Ethical Implications
• Signing sub-Medicaid fee schedules may violate fair market value principles and raise concerns about predatory contracting practices.
• It also risks setting a dangerous precedent that devalues dentistry as a profession and weakens negotiating power.
🛡️ Protecting Your Practice and Patients
• By refusing to accept sub-Medicaid rates, you help preserve the integrity of dental care delivery and advocate for fair compensation across the profession.
• This stance also ensures that patients receive the time, attention, and quality they deserve, rather than care dictated by unsustainable reimbursement models.
Bottom Line: If a fee schedule pays less than Medicaid, it’s not a partnership—it’s a liability. Stand firm. Protect your practice. Uphold the value of your work.
