Can a non-participant with Medical Assistance (MA) provide services on a cash basis to MA recipients?
Yes. Oral health services covered under the MA program are provided to enrolled recipients through MA-participating dentists. If recipients are members of a Managed Care Health Plan, they may contact member services for their plan to be referred to a network dentist. If they are enrolled in the ACCESS/ACCESS Plus Program they may contact OMAP for a dental referral by dialing (866) 542-3015. If an MA recipient chooses to seek services from a non-participating dentist, there is no payment under the MA program for those services. DPW/OMAP does not reimburse recipients for out-of-pocket fees paid to non-participating providers, including dentists.
Answer is informational only and not intended as legal advice. Answer may contain excerpts from The ADA Practical Guide to Frequently Asked Legal Questions.