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New FAQ addresses questions about Medicare dental benefit proposals

Washington — “The ADA has a duty to respond when Congress intends to act on adding a dental benefit to Medicare.”

This was one of the key messages in a new FAQ the ADA created in order to explain the ADA’s response to a legislative proposal currently being considered by Congress that would expand the nation’s Medicare program to include dental, hearing and vision benefits.

On Aug. 23, the U.S. House of Representatives advanced a budget resolution, previously passed by the Senate, which included a provision to expand Medicare. The resolution did not include any specifics on how such an expansion would be structured.

In the FAQ, the ADA addresses many questions dentists may have on the proposed Medicare dental benefit, including why the Association feels the need to weigh in.

“If the ADA does not lobby this issue, Congress will act without the ADA’s input, thereby creating a Medicare dental program that will not benefit patients or practitioners,” the FAQ said.

The FAQ said the ADA believes that any expansion of Medicare to include dental benefits should be through a separate and new program dedicated to providing comprehensive dental care for low-income seniors. It also explains that the current Medicare Part B structure is “wrong for dentistry” for many reasons including electronic health record requirements, coding and payment parameters “vastly different” from medicine, unknown reimbursement levels and more.

The FAQ also explains current ADA policy , which says the Association supports the oral health care of those 65 years old and older by including a range of services necessary to achieve and maintain oral health for beneficiaries with incomes up to 300% of the federal poverty level. The policy also supports “sufficiently funding and efficiently administering” expanded Medicare to ensure access to care and allowing the “freedom of choice” for patients to seek care from any dentist while continuing to receive the full program benefit.

The ADA is urging dentists who are concerned about the Congressional proposals to contact their legislators. The ADA will be sending additional grassroots communication emails out next week.

“Participating in ADA grassroots advocacy is key,” the FAQ concluded. “The dentists’ voices must be heard. The ADA cannot ignore the process happening in Washington, D.C., if we want to effect change. Let us educate Members of Congress on the right way to meet the needs of both dentists and patients by supporting what would work best instead of sitting on the sidelines.”

The ADA sent a letter to CMS Administrator Chiquita Brooks-LaSure on Aug. 31 saying the dental profession is committed to addressing the oral health needs of all Americans – including older Americans - and that an expansion of Medicare benefits should make health equity a priority. The ADA also sent a letter to Congress on Sept. 1 to help lawmakers understand the ADA’s position on this issue.

For more information on the ADA’s advocacy efforts, visit ADA.org/Advocacy .


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