Important Board Action: NDA Position Statement on Comprehensive Dental Coverage for Medicare Beneficiaries

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NDA Position Statement on Adding a Dental Benefit to Medicare

Resolved, that the National Dental Association (NDA) supports a comprehensive dental benefit for all Medicare beneficiaries in legislation as part of the Build Back Better budget reconciliation package. A comprehensive dental benefit will remove the financial barrier to oral care for the elderly and people with disabilities. Out of pocket dental costs deprive approximately half of Medicare beneficiaries of dental visits. Among Medicare beneficiaries, it has been estimated that 68% of Blacks and 61% of Hispanics do not seek oral care.  Providing a dental coverage for all Medicare beneficiaries will improve oral health equity.

Resolved, that the NDA supports the dental benefit in Medicare Part B. It has the capacity to accommodate a distinct and separate process to set adequate reimbursement levels. Part B already includes different fee-setting schedules for a range of outpatient services.

Resolved, that the NDA supports provisions in the following areas to strengthen the legislation before final passage:

Benefit design:  The NDA supports a comprehensive dental benefit. A dental benefit limited to preventive services will not meet the needs of Medicare beneficiaries. Older adults often suffer from untreated tooth decay and periodontal disease. Nearly 1 in 5 adults aged 65 and older are edentulous.  To restore and maintain their oral health requires comprehensive oral care. Dentition in good repair is important because poor oral health can worsen health conditions such as diabetes and cardiovascular disease that disproportionately impact older Americans.

If a share of cost is necessary, then the NDA supports major dental services to be covered minimally at 80%. This is in line with other Part B major services. If Medicare beneficiaries are burdened with a high share of cost coverage initially that decreases over time or if covered services are phased in, low-income beneficiaries may be forced to postpone oral health services. Oral disease is a progressive disease. Postponement of oral health services will increase the cost of treatment.

Provider participation and reimbursement:  The NDA supports a reimbursement model and strategy that will attract an adequate provider network.

Timing:  The NDA supports a roll-out of benefits as soon as feasibly possible after passage of the final legislation.

Administrative Issues:  The NDA supports reasonable provider administrative requirements and eliminating barriers to provider participation to the greatest extent possible. This includes having simple claims; easy enrollment; facilitated enrollment of associate practitioners within a participating dentist’s office; feasible, realistically implementable, and pragmatic electronic record requirements; and provider incentives to participate.

The NDA believes adding a comprehensive dental benefit to Medicare Part B for all Medicare beneficiaries will provide an equitable opportunity for them to enjoy optimum oral health and achieve better overall health outcomes.

The National Dental Association is comprised of thirty-nine state and local chapters throughout the U.S. Its family member organizations include the National Dental Hygienists Association, National Dental Assistants Association, Auxiliary to the National Dental Association, and National Dental Association Foundation. The NDA is the oldest and most prestigious association of people of color in the dental profession. The NDA promotes access to oral health care by serving underserved and vulnerable populations. As both oral health providers and residents of the communities that we serve, the members of the NDA and its family organizations seek to improve the health of the underserved, eliminate disparities, and promote health equity.

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