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ADA offers input during HHS meeting with Sec. Tom Price

June 22, 2017

By Jennifer Garvin

Washington — The ADA was one of several health organizations with a seat at the table during a June 22 stakeholder meeting with the U.S. Department of Health and Human Services.

The meeting, led by Tom Price, M.D., HHS secretary, was designed to give the agency input on the impact government has on the doctor-patient relationship and to discuss barriers that unnecessarily interfere with providers and their patients. Seema Verma, administrator for the Centers for Medicare and Medicaid Services, also attended.

During the meeting, ADA President-elect Joseph P. Crowley shared four regulatory burdens that affect ADA members and which the Association believes adversely impact patients' access to oral health care: the Medicare Ordering and Referring rule, the Medicare Part D rule, a Medicare Part C rule and a portion of the Section 1557 Nondiscrimination rule.

Both the Medicare ordering and referring rule, and the Medicare Part D rule require dentists who do not participate in Medicare and who do not submit claims to Medicare to enroll in the program.  

"The ADA firmly believes that enrolling in Medicare is an unnecessary administrative burden and CMS already has at its disposal the necessary information that these rules are attempting to duplicate," Dr. Crowley told HHS.

Dr. Crowley recommended that HHS rescind the rule for ordering and referring, and for Medicare Part D for dentists and other providers who do not submit claims for Medicare reimbursement.

Currently, the Medicare Part C rule requires dentists who participate in Medicare Advantage dental plans to enroll in Medicare, which the ADA contends is "an unnecessary duplication" of effort by CMS and is supported by both the National Association of Dental Plans and the Delta Dental Plans, the two largest organizations that represent dental insurance plans that "this unnecessary administrative burden" may "adversely impact dentist participation" in these plans, thus reducing the ability of Medicare beneficiaries from receiving these benefits through their MA plans.

"The ADA recommends CMS rescind the regulation that would require dentists who only provide Medicare Advantage covered services to enroll in Medicare," Dr. Crowley said.

Regarding the Sec. 1557 final rule, which is based on a provision in the Affordable Care Act that prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health programs or activities that receive federal financial assistance, Dr. Crowley asked that the Office for Civil Rights enforce the regulation as written.

"The ADA is concerned that the rules regarding the translation and interpreter services for those patients where English is a second language are overly prescriptive for our small practice settings," Dr. Crowley said.   

"The ADA opposes discrimination in all forms but this rule requires the 15 most common non-English languages spoken in a state to be identified with taglines on the office notice of nondiscrimination, on websites and on 'significant communications,' " Dr. Crowley said. "Our dentists practice in communities and know their patients. They have been dealing successfully for years in providing the necessary translation and interpretation service for their patients. These rules are confusing to both the dentist and the patient."  

The HHS listening session included participants from groups that included the American Academy of Dermatology, American Academy of Family Physicians, American College of Cardiology, American Society of Clinical Oncology, American College of Radiology and American Psychiatric Association.