AG wants planned dental rule nixed

Dentists pushed back on extraction change

Dale Denwalt

The Oklahoman USA TODAY NETWORK

Attorney General Gentner Drummond has told Oklahoma’s Sooner-Care agency to walk back plans to implement a new rule governing dental extractions.

In a letter to Oklahoma Health Care Authority Director Clay Bullard, Drummond complained that the agency didn’t follow state rulemaking laws when considering a new rule that requires dental patients get pre-authorized for some tooth extractions if they are on SoonerCare, Oklahoma’s Medicaid program.

Drummond’s letter accuses agency staff of changing the proposed rule twice after posting it for public comment. He warned that if the agency does not withdraw the rule voluntarily, it could face revocation by the Oklahoma Legislature or a binding opinion from the attorney general.

“The (Administrative Procedures Act) does not authorize a state agency to amend a proposed rule after publishing the rulemaking intent but before the public comment period ends,” Drummond wrote in the letter, sent Tuesday, Feb. 24. Drummond contended the rule was backed by private companies hired by the state to manage SoonerCare coverage.

Dozens of comments opposing the rule have been posted to the OHCA website, many from dentists.

One dental provider who sees SoonerCare patients wrote that requiring pre-authorization from SoonerCare to pull multiple teeth in the same day would “interfere with real-time clinical judgment, add administrative burden without clear benefit and encourage reliance on antibiotics instead of definitive treatment.”

“These changes will delay treatment for patients in pain or with active infection, allowing conditions to worsen and leading to poorer clinical outcomes,” wrote the provider, who like other commenters is only identified by her first name, Karla. “Patients will be pushed into emergency rooms, which cannot provide definitive dental care and often result in repeat visits rather than resolution, increasing healthcare costs for the state.”

In a response to The Oklahoman, an OHCA spokesperson said agency officials are discussing the issue with Drummond’s office.

“The agency is currently reviewing the letter and will continue coordinating with their office to determine the appropriate path forward,” said OHCA Public Information Officer Rebecca Sheppard.