In this statement, Katherine M. Iritani, Acting Director, Health Care reports that dental disease remains a significant problem for children in Medicaid. Although dental services are a mandatory benefit for the 30 million children served by Medicaid, these children often experience elevated levels of dental problems and have difficulty finding dentists to treat them. Concerns about low-income children's poor oral health, inadequate access to dental services, low payment rates for dental services, and insufficient federal and state efforts to address oral health access problems are long-standing. During subcommittee hearings in May 2007 and February 2008, concerns were raised about the effectiveness of federal oversight of state Medicaid dental services by the Centers for Medicare & Medicaid Services (CMS), the agency that oversees Medicaid at the federal level. The author's remarks are based on the report, "Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but Gaps Remain." This report was prepared at the request of the subcommittee and examined: (1) state strategies to monitor and improve access to dental care for children in Medicaid; and (2) CMS actions since 2007 to improve oversight of Medicaid dental services for children. To identify state strategies to monitor and improve children's access to Medicaid dental services, a Web-based survey of state Medicaid directors was conducted in all 50 states and the District of Columbia. The survey included questions on the methods states have used for promoting and monitoring dental utilization, statewide goals for the delivery of dental services, and the federal support provided to states for the provision of Medicaid dental services. Contracts between state Medicaid programs and nine large managed care organizations (MCO) were also reviewed to identify certain dental provisions concerning network adequacy and access standards. To examine CMS's oversight of state Medicaid dental services for children, CMS officials, dental associations, and key stakeholders were interviewed; federal laws, regulations, and CMS guidance were reviewed; and data used by CMS to monitor provision of Medicaid dental services were analyzed. The testimony concludes that states and CMS have made concerted efforts to improve access to dental services for children in Medicaid. However, information on the oral health of and receipt of dental services by Medicaid children show that more needs to be done. Four recommendations are made to CMS to strengthen the agency's monitoring of state Medicaid dental services for children and help states improve children's access to Medicaid dental services: (1) Develop a plan to review dental services for Medicaid children in all states with low utilization rates; (2) Ensure that states found to have inadequate MCO dental provider networks take action to strengthen these networks; (3) Work with stakeholders to develop needed guidance on topics of concern to states; and (4) Identify ways to improve sharing of promising practices among states. (Contains 1 figure and 11 footnotes.)