The ADA works closely with lawmakers, regulators, and others to help mend the tattered dental safety net. This includes reforming parts of the Medicaid program, which is the largest source of funding for medical and other health-related services for people with low income in the United States. The ADA is also fighting to maintain federal requirement for states to cover dental services in their respective CHIP programs, which together cover nearly 8 million children from low-income families.
Medicaid and CHIP
- Maintaining the federal requirement for states to cover dental services under the Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program.
- Requiring states to cover dental services for Medicaid-eligible adults, and exempt all preventive dental services from cost-sharing requirements.
- Preserving the federal financing role in the Medicaid program and update the federal matching formula to address economic changes.
- Enhancing the federal Medicaid matching rate to 90/10 for dental care.
- Maintaining the federal requirement for states to cover dental services in their respective CHIP programs.
- March 21, 2023—Letter sent to Congress in support of the Medicaid Dental Benefit Act (PDF)
- March 17, 2023—Letter to Senator Ben Cardin thanking him for introducing the Medicaid Dental Benefits Act, which would make comprehensive dental care a mandatory component of Medicaid coverage for adults in every state (PDF)
- September 29, 2022—Partnership for Medicaid to Congress addressing the Medicaid fiscal cliff in Puerto Rico and the territories (PDF)
- July 7, 2022—Coalition letter to congressional leaders urging their support for H.R.4439, the Medicaid Dental Benefit Act and S. 3166, the Medicaid Dental Benefits Act of 2021. (PDF) These bills would make comprehensive dental care a required component of Medicaid coverage for adults in every state.
- June 22, 2022—ADA hosts a virtual briefing for Capitol Hill staff handling health care policy with Marko Vujicic, Ph.D., Chief Economist and Vice President and Chelsea Fosse, D.M.D., M.P.H., Senior Health Policy Analyst at the ADA’s Health Policy Institute. The HPI team presented on “Making the Case for Dental Coverage for Adults in All State Medicaid Programs” and the challenges low-income adults currently face in accessing oral health care services. (PDF)
- April 1, 2022—Coalition letter asking Congress to protect coverage for beneficiaries should lawmakers and the administration seek to unwind enhanced Medicaid protections related to the COVID-19 public health emergency. (PDF)
- February 17, 2022—Coalition Letter from the ADA, AAPD, and AAOMS to the House Ways and Means Committee asking the Committee to support the coalition’s efforts to ensure equitable access to dental surgical services in hospitals and ambulatory surgical centers for children and adults with special needs and disabilities who have debilitating oral health problems and need access to timely treatment. (PDF)
- December 17, 2021—Coalition letter calling for the Medicaid Dental Benefit Act to be included in the Senate’s Build Back Better reconciliation package (PDF). The Medicaid Dental Benefit Act would make comprehensive adult dental benefits a mandatory component of Medicaid coverage in every state.
- November 22, 2021—Letter to Senator Cardin to thank him for introducing S.3166, the Medicaid Dental Benefits Act. (PDF)
- October 13, 2020—Letter of support to U.S. Rep. Gregorio Kilili Camacho Sablan for legislation, H.R. 6495 the Insular Area Medicaid Parity Act, that would lift the Medicaid funding cap in the U.S. Territories. (PDF)
- February 22, 2023—Letter to the Centers for Medicare and Medicaid Services’ (CMS) chief dental officer regarding CMS exercising its oversight abilities as they pertain to Medicaid managed care organizations (MCOs) reporting of medical loss ratios (MLR) (PDF).
- January 31, 2023—Joint comments with AAPD to the Centers for Medicare and Medicaid Services' (CMS) response to a request for information on essential health benefits (EHBs) (PDF).
- January 30, 2023—Coalition Letter to the Centers for Medicare and Medicaid Services’ (CMS) Affordable Care Act (ACA) Notice of Benefit and Payment Parameters for 2024 (PDF).
- November 4, 2022—Comments in response to the proposed CMS rule on streamlining Medicaid and CHIP eligibility, enrollment, and renewal (PDF).
- November 3, 2022—Response to the Centers for Medicare and Medicaid Services’ (CMS) Request for Information on Promoting Efficiency and Equity Within CMS Programs, Including Medicaid (PDF).
- September 26, 2022—Letter from the ADA and the Dental Quality Alliance (DQA) to the Centers for Medicare and Medicaid Services (CMS) supporting mandatory Medicaid and Children’s Health Insurance Program (CHIP) core set reporting (PDF).
- September 13, 2022—Coalition comments urging CMS to consider including a single CDT code on the ambulatory surgical center list to be used to report covered dental procedures in ambulatory surgical center settings.(PDF)
- June 30, 2022—Coalition letter ADA, AAPD, and AAOMS sent to the Directors of the Medicare and Medicaid Centers at CMS. (PDF) The letter follows up on past meetings with other officials at CMS and asks the heads of these centers for a meeting to address the dental community’s significant concerns regarding pediatric and adult patient access to dental rehabilitation surgery in hospital outpatient and ambulatory surgical center locations.
- April 6, 2022—American Dental Association (ADA) response to the Centers for Medicare and Medicaid Services (CMS) Medicaid Request for Information (RFI) 2022 (PDF).
- April 1, 2022—Coalition letter asking the Centers for Medicare and Medicaid Services (CMS) to protect coverage for beneficiaries should lawmakers and the administration seek to unwind enhanced Medicaid protections related to the COVID-19 public health emergency.(PDF)
- November 17, 2020—Coalition Letter following up on meeting that ADA and AAPD held with Ms. Carol Blackford of CMS.(PDF)
- April 17, 2020—Letter to Secretary Azar of HHS and Administrator Verma of CMS requesting Medicaid relief funds for Dentists.(PDF)
- March 5, 2020—Letter to Health and Human Services Secretary Alex Azar thanking him for announcing the appointment of a Centers for Medicare and Medicaid Services (CMS) Chief Dental Officer, and asking for more information.(PDF)
Related stories from the dental profession's most widely read news source, ADA News.
The ADA’s Action for Dental Health (ADH) campaign is a nationwide response to the crisis in oral health care. The campaign brings dental health leaders and professionals together in support of three objectives:
- Providing care now for people suffering from untreated disease
- Strengthening and expanding the public and private safety net
- Preventing dental disease through advocacy and education
Expanding care through Medicaid and CHIP is one of seven solutions that drive the ADH campaign. Learn more on the ADH campaign page devoted to Medicaid and the safety net. Medicaid and Action for Dental Health
CMS recently established a new code that will help increase access to dental surgeries under general anesthesia in hospital operating rooms. Here is the link to the new dental code toolkit.
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Last Updated: November 30, 2021.