Kids' dental care - OUR OPINION MEDICAID HMO PILOT WITH DISPUTED RESULTS IS UNACCEPTABLE

Results of the state's dental HMO experiment for children on Medicaid are in, but they don't show if the new approach is better than the old. That's unacceptable. The project was to improve access to dental care for 200,000 Miami-Dade children on Medicaid, reducing fraud and state costs in the process. The idea was to switch them to HMO coverage in 2004 and away from standard fee-for-service Medicaid.

Now, a University of Florida study reports disturbing results for the pilot's first year, which ended in June 2005. It found the number of poor children seeing a dentist dropped 40 percent. Only 27,000 children got dental care, a drop of 35,500 from the previous year under the old program. Also, children received only $2.1 million in dental services while the state paid $15.3 million to Atlantic Dental, the HMO running the pilot.

Florida Medicaid Director Tom Arnold disputes those numbers. He says that the baseline figures of dental care are inflated by fraud and that the results are understated because Atlantic Dental and its dentists underreported services rendered. But by the state's own estimates, there is at most 10 percent fraud and abuse in Medicaid billings. And a state Senate staff report noted that fraud happens in managed-care services, too.

Mr. Arnold points to the study's survey of Medicaid families using the dental plan; 80 percent of those interviewed said they had no problem finding a dentist. But researchers noted that the families may have said what they thought pollsters wanted to hear. Mr. Arnold didn't dispute that 57 percent of the participating dentists were dissatisfied with the HMO plan.

There are too many excuses and too few reliable measures. Taxpayers should know if Medicaid is getting its money's worth. Nothing justifies 30,000 fewer poor children being served.

Mr. Arnold should scrap the experiment and go back to the old program.