Since the start of 2021, Centene has settled with nine states over allegations it overbilled state Medicaid programs for prescription drugs and services through its pharmacy benefits arm, Envolve. New Hampshire settled with the company for over $21 million in December, which will now be funneled to the state’s new routine dental care benefits.
Overall, the program is expected to cost $30 million to launch and as much as $7.5 million annually, beginning in fiscal year 2024.
The new coverage is expected to apply to 85,000 Medicaid-eligible individuals who are over 21. Benefits will be capped at $1,500 a year for non-preventive services and will include copays and deductibles.
Services will include an annual oral exam, X-rays/imaging, prophylaxis, topical fluoride, oral hygiene instruction, behavior management and smoking cessation counseling. Oral surgery and treatments necessary to relieve pain, eliminate infection or prevent imminent tooth loss will also be included.
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