Dental insurance reform
Dental insurance issues are regularly rated among the most important concerns confronting dentists. On the national front and together with state dental societies, the ADA is working to achieve key legislative policy reforms.
One bill the ADA is advocating for on this is the Dental and Optometric Care Access Act, or DOC Access Act. This bipartisan legislation prohibits dental and vision plans from setting the fees network doctors may charge for services not covered by the insurers. It also protects patients and brings needed equity to insurer/provider contracting.
“We are supporting this bill because the ADA believes that patients are adversely affected by provisions in dental insurance plans that dictate what a doctor may charge for services not covered by the patient’s insurance plan,” said Mark Vitale, D.M.D., chair, ADA Council on Government Affairs.
“DOC Access will provide greater access to high-quality care by helping to curb anti-patient and anti-competitive practices of dental insurance plans,” Dr. Vitale continued. “Even though 42 states have passed laws limiting interference with the dentist-patient relationship, many dental and vision plans are federally regulated so insurers can claim they are exempt. Passage of this bill will help align the federal government with what's happening across the country, and it would also bring needed balance to contract negotiations between providers and large dental insurance companies.”
Another bill, the Ensuring Lasting Smiles Act, would make it easier for patients with congenital anomalies or birth defects to receive the dental care and other treatments they need by requiring all private group and individual health plans to cover medically necessary services for those conditions.
“This is an important issue because many craniofacial anomalies can restrict a patient’s ability to breathe, eat and speak in a normal manner,” Dr. Vitale said. “And while many private health insurance companies cover preliminary procedures, they often routinely deny or delay follow-up or corrective procedures claiming that these procedures are cosmetic in nature. This fails to recognize the medical conditions of these patients.”
“Early intervention by a team of specialists, including plastic surgeons, oral and maxillofacial surgeons, pediatric dentists, orthodontists, dermatologists and speech therapists is necessary to assess and oversee the patient’s treatment and development, sometimes over the course of several years."
Dental insurance and student debt reform. Improving Medicaid. Health equity.
Every year the ADA prioritizes the issues the Association believes have the most impact on dentists, the dental profession and public. These issues are one of the main focuses of Lobby Day, which every year brings dentists and dental students together to advocate on behalf of the profession. But they are also issues the ADA advocates for every day.
“Through advocacy efforts, the ADA fulfills our mission to help dentists succeed and support the advancement of public health,” said ADA President Cesar R. Sabates, D.D.S. “Each year, the ADA's advocacy has an impact on more than 25,000 dental students and more than 200,000 of our dentist colleagues. Perhaps most importantly, it also affects millions of patients. The message is clear: It is powerful when dentists unite."
Below are some of the top issues the ADA is advocating for in 2022.
