US (Washington Insider Magazine) – As part of a settlement reached in a federal class action lawsuit, some 5 million New Yorkers will now be able to obtain Medicaid coverage for previously unrecognized vital dental procedures.
Some 5 million New Yorkers will now be able to get Medicaid coverage for root canals, denture replacements, dental implants and other vital dental procedures, as part of a settlement achieved in a federal class action lawsuit.
Under the terms of the settlement announced yesterday, New York State can no longer deny crown and root canal coverage to people with more than four pairs of contacting back teeth, a restriction that required those patients to have infected or abscessed teeth.
The agreement also removes the ban on crown lengthening and dental implant coverage, as well as strict limits on replacement dentures, allowing patients to obtain coverage if the procedures are deemed medically necessary.
The Legal Aid Society, which represented the class action plaintiffs in Manhattan Federal Court, described the new rules as “landmark changes” to state Medicaid law that will benefit people who might otherwise otherwise they would not be able to pay for those dental services.
“With this agreement, millions of New Yorkers with Medicaid across the state will now have access to insurance that covers a variety of dental issues critical to maintaining overall health,” said Belkys Garcia, Attorney at the Legal Aid Society.
“Anyone can see that inadequate dental care leads to joblessness, social isolation and medical complications,” said Mary Eaton, a partner at Freshfields Bruckhaus Deringer US LLP, which along with Willkie Farr & Gallagher LLP also represented to the plaintiffs.
The Manhattan Federal Court lawsuit was initially filed against the New York State Department of Health by two men in 2018, the Daily News recalled.
Frank Ciaramella, a Staten Island (NYC) resident with end-stage renal disease who had all his teeth extracted, was denied coverage for dental implants. He was unable to obtain replacements for a set of dentures that was destroyed by a car.
Richard Palazzolo, of Suffolk County, Long Island, had to live in a homeless shelter after his father died and his lower denture was stolen along with other items in 2017. Medicaid would not replace it because the rules only they allowed replacements every eight years.
Nine other plaintiffs joined with similar stories of pain, inability to eat properly, and depression. Four of them did not live to see the deal, including Ciaramella, who died in December 2020.
In a written statement in advance of the settlement announcement, state Department of Health spokesman Cort Ruddy said Sunday: “The New York State Medicaid program provides comprehensive health coverage to more than 7.3 million New Yorkers. This agreement recognizes the importance of oral health and affirms the state’s commitment to these people.”
This article is authored by EI Diario
