ADA Asks Centers for Medicare & Medicaid Services to Prioritize Oral Health

Dentistry Today


The ADA has asked the Centers for Medicare & Medicaid Services (CMS) to prioritize oral healthcare. In a letter to Administrator Chiquita Brooks-LaSure, the ADA said that it looks forward to working with CMS in:

  • Ensuring that a permanent position of chief dental officer within the CMS is filled, as the position has been vacant since 2017
  • Expanding the participation of dentists through increased reimbursement and reduced administrative burden, such as the easement of credentialing, audit processes, and encouragement of clean claims paid within 15 days
  • Requiring the CMS Center for Program Integrity to issue guidance to state Medicaid agencies (SMAs) concerning best practices in dental audits and develop standardized training for dental auditors
  • Providing guidance to SMAs to streamline dentist credentialing by utilizing the ADA Council for Affordable Quality Healthcare credentialing service or equivalent
  • Establishing a benchmark floor for all Medicaid dental fees at 75th percentile of regional dental fees based on ADA survey data
  • Working to enhance consistent adult dental benefits across all Medicaid programs
  • Working with the dental community to establish an appropriate Healthcare Common Procedural Coding System billing code to help address ongoing challenges regarding access to dental rehabilitative services
  • Making pediatric oral health coverage mandatory for families with children and including maternal oral health as an essential health benefit for one year post-partum within the Affordable Care Act’s exchange plans
  • Instituting activities to increase oral health equity, including incentivizing dentists to practice in underserved communities across the United States and strengthening support for Action for Dental Health Initiatives

“We would welcome the opportunity to meet with you to discuss how we can meet these challenges together,” said the letter, which was signed by ADA president Daniel J. Klemmedson, DDS, MD, and executive director Kathleen T. O’Loughlin, DMD, MPH.

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