Community Statement on Medicare Coverage for Medically Necessary Oral and Dental Health Therapies

 

 

The undersigned organizations are proud to join in support of Medicare coverage for medically-necessary oral/dental health therapies.

 

It is well established that chronic diseases disproportionately impact Medicare beneficiaries and impose a substantial cost on the federal government. It is also well established that untreated oral microbial infections are closely linked to a wide range of costly chronic conditions, including diabetes, heart disease, dementia, and stroke. In addition, oral diseases have been documented by researchers and medical specialty societies as precluding, delaying, and even jeopardizing medical treatments such as organ and stem cell transplantation, heart valve repair or replacement, cancer chemotherapies, placement of orthopedic prostheses, and management of autoimmune diseases.

 

Despite these factors, most Medicare beneficiaries do not currently receive oral/dental care even when medically necessary for the treatment of Medicare-covered diseases. In fact, Medicare coverage extends to the treatment of all microbial infections except for those relating to the teeth and periodontium. There is simply no medical justification for this exclusion, especially in light of the broad agreement among health care providers that such care is integral to the medical management of numerous diseases and medical conditions. Moreover, the lack of medically necessary oral/dental care heightens the risk of costly medical complications, increasing the financial burden on Medicare, beneficiaries, and taxpayers.

 

A number of major insurance carriers provide medically-necessary oral and dental coverage to targeted enrollees with conditions such as diabetes, heart disease, stroke, head/neck cancers, and transplants. According to some reports, such coverage has realized important benefits, including markedly lower hospitalization and emergency department admission rates as well as substantial cost reductions. On a further note, veterans getting care through the Veterans Health Administration receive medically adjunctive oral/dental treatment in many instances when a dental diagnosis affects their medical prognosis. These are all important steps forward, and medically necessary oral/dental healthcare should be provided in traditional Medicare as well.

 

The Medicare program and all its beneficiaries should not be without the vital clinical and fiscal benefits of coverage for medically necessary oral/dental health therapies. Given the significant potential to improve health outcomes and reduce program costs, we urge Congress and the Administration to explore options for extending such evidence-based coverage for all Medicare beneficiaries.

 

 

AARP

Acuity Specialists

Adenoid Cystic Carcinoma Research Foundation

AIDS Foundation of Chicago

Allies for Independence

American Academy of Maxillofacial Prosthetics American Academy of Nursing

American Academy of Periodontology

American Association for Dental Research

American Association of Clinical Endocrinologists American Association of Colleges of Nursing

American Association of Diabetes Educators

American Association of Hip and Knee Surgeons American Association of Kidney Patients

American Association of Oral and Maxillofacial Surgeons American Association of Nurse Practitioners

American Autoimmune Related Diseases Association American College of Cardiology

American College of Emergency Physicians

American College of Gastroenterology

American College of Physicians

American College of Prosthodontists

American College of Rheumatology

American Dental Association

American Dental Education Association

American Dental Hygienists’ Association

American Diabetes Association

American Geriatrics Society

American Head and Neck Society

American Kidney Fund

American Liver Foundation

American Network of Oral Health Coalitions

American Nurses Association

American Parkinson Disease Association

American Psychiatric Association

American Public Health Association

American Society for Radiation Oncology

American Society of Clinical Oncology

American Society of Nephrology

American Society of Transplant Surgeons

American Society of Transplantation

American Thoracic Society

Arcora Foundation

Arthritis Foundation

Association of Community Cancer Centers

Association of Dental Support Organizations

Association of State and Territorial Dental Directors

Autistic Self Advocacy Network

Brain Injury Association of America

California Dental Association

California Medical Association

Catholic Health Association of the United States

Center for Health Law and Policy Innovation

Center for Medicare Advocacy

Children’s Dental Health Project

Cornerstone Dental Specialties

Crohn’s and Colitis Foundation of America

Dental Lifeline Network

Dental Trade Alliance

DentaQuest Partnership for Oral Health Advancement Disability Rights Education and Defense Fund

Eating Disorders Coalition

Epilepsy Foundation

Families USA

Georgia AIDS Coalition

Gerontological Advanced Practice Nurses Association Hartford Institute for Geriatric Nursing

Head and Neck Cancer Alliance

Henry Schein Cares Foundation

HIV Medicine Association

International Pemphigus and Pemphigoid Foundation John A. Hartford Foundation

Justice in Aging

Leukemia and Lymphoma Society

Lupus and Allied Diseases Association, Inc.

Lupus Foundation of America

Medicare Rights Center

Mending Hearts

Mental Health America

National Alliance of State & Territorial AIDS Directors National Alliance on Mental Illness

National Association of Area Agencies on Aging National Association of Community Health Centers National Association of Dental Plans

National Association of Nutrition and Aging Services Programs

National Association of Social Workers

National Association of States United for Aging and Disabilities

National Comprehensive Cancer Network

National Committee to Preserve Social Security and Medicare

National Council for Behavioral Health

National Forum for Heart Disease and Stroke Prevention

National Health Law Program

National Interprofessional Initiative on Oral Health National Kidney Foundation

National League for Nursing

National Multiple Sclerosis Society

National Network for Oral Health Access

National Osteoporosis Foundation

National Rural Health Association

National Stroke Association

Oral Cancer Foundation

Oral Health America

Oral Health Nursing Education and Practice Program Pacific Dental Services Foundation

Parkinson’s Foundation

Patient-Centered Primary Care Collaborative

PEW Dental Campaign

Preventive Cardiovascular Nurses Association ProHEALTH Dental

Renal Physicians Association

Santa Fe Group

School-Based Health Alliance

Scleroderma Foundation

Sjogren’s Syndrome Foundation

Society for Transplant Social Workers

Support for People with Oral and Head and Neck Cancer The AIDS Institute

The Arc of the United States

The Gerontological Society of America

The Michael J. Fox Foundation

The Society for Thoracic Surgeons

The TMJ Association