Addressing the problem of Medicare’s lack of meaningful oral health coverage has long been a focus of the Center for Medicare Advocacy.  Over the decades, the Center has assisted beneficiaries who require access to medically necessary oral health care, challenged Medicare’s restrictive coverage policy in litigation, and worked with broad coalitions to expand Medicare oral … Read more →

For the past few years, a coalition of beneficiary advocates, disease organizations, industry groups,  oral health and medical health professionals has been advocating for medically necessary oral health care to be covered by Medicare, as authorized under current law.  The Coalition recently launched a web-based platform for members of the public to express their support … Read more →

The Center for Medicare Advocacy is pleased to share the results of new polling conducted by Morning Consult, which found that a large majority of respondents support including oral and dental health services as part of the traditional Medicare program. The Center has long advocated for a comprehensive oral health benefit in Part B of Medicare. This poll … Read more →

Medicare generally does not cover dental care (see 42 U.S.C. § 1395y(a)(12)).  Under the law, however, if dental treatment must be performed in a hospital, either because of a patient’s underlying condition or the severity of the dental procedure, Medicare Part A covers the costs of the inpatient hospitalization, even if the procedure itself is … Read more →

The Center for Medicare Advocacy is pleased that oral health in Medicare is gaining attention and focus, as evidenced by the number of Congressional bills introduced this year that would add dental benefits to the Medicare program. Among them are the Medicare Dental Benefit Act of 2019 (S.22/H.R. 2951), the Medicare and Medicaid Dental, Vision, … Read more →

As part of the Center for Medicare Advocacy’s continued commitment to improving oral health for older adults and people with disabilities, and expanding Part B to include a comprehensive oral health benefit, Center attorneys are participating in oral health partnership meetings this week. The OPEN (Oral Health Progress & Equity Network, a national network of … Read more →

The Center for Medicare Advocacy is pleased to share a new opportunity for advocates working to add a comprehensive oral health benefit to Medicare. The Oral Health Progress Equity Network (OPEN), a national network of individuals and organizations that believe oral health is essential to overall health and wellbeing, is organizing across the country to ensure that … Read more →

One of the core considerations of the Center for Medicare Advocacy’s Medicare Platform is to expand Medicare coverage to include oral health and dental care for all beneficiaries. We have also long advocated for coverage of medically necessary oral health care, which we think is currently supported by the Medicare statue but is, unfortunately, significantly limited … Read more →

The Problem Mr. Jones tripped and fell on his driveway, fracturing his cheek and jaw, tearing the musculature, and crushing several teeth.  He was stabilized in the emergency room on the day of the accident, but in the days that followed he required assessments and procedures to repair damage and restore function to his face … Read more →

Oral Health in Medicare: Kaiser Family Foundation Releases Issue Brief Kaiser Family Foundation recently released an issue brief, Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries that examines the state of oral health for Medicare beneficiaries, including use of dental services and out-of-pocket spending. Medicare currently does not cover routine dental care, and … Read more →

This week Center for Medicare Advocacy Policy Attorney Kata Kertesz presented a webinar together with Justice in Aging regarding Medicare Basics for OPEN, the Oral Health Progress and Equity Network. OPEN is a national network of individuals and organizations that believe oral health is essential to overall health and wellbeing.  OPEN is organizing across the … Read more →

Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations for Medicare, now and in the future, is the need to expand and Improve Medicare for all current and future beneficiaries, not just those in private Medicare plans. One of the key issues faced by beneficiaries … Read more →

One of the Center for Medicare Advocacy’s top priorities is to expand Medicare coverage to include oral and dental care for all beneficiaries. We have also long advocated for coverage of medically necessary oral health care, which is currently supported by the Medicare statue but is significantly limited in practice due to Medicare policy. In the … Read more →

The following is the Center for Medicare Advocacy’s legal analysis and does not represent the federal Medicare agency’s (CMS') position or interpretation of its dental coverage policy. Medicare coverage for medically necessary oral health care is supported by the Medicare statute, its legislative history, Centers for Medicare and Medicaid Services (CMS) policy, and precedent established … Read more →

We need your help getting Members of Congress to sign on to letters asking CMS to provide Medicare coverage for medically necessary dental care, as authorized by law. Right now there is an opportunity to encourage your delegation to sign on to these letters. Call (202) 224-3121 to be connected with your Senators and Representative. … Read more →

FOR IMMEDIATE RELEASE Contact: Matthew Shepard (mshepard@medicareadvocacy.org) 202-293-5760 July 19, 2018 – Washington, DC – The Center for Medicare Advocacy, along with a diverse group of partners, released a white paper, An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care. This white paper is an interprofessional, collaborative effort written … Read more →

Oral Health America (OHA) recently published the fourth volume in a series of reports titled A State of Decay, surveying the state of oral health for older Americans.  The first volume in the series focused on the cost of services and financial reimbursement rates as the primary barrier to accessing oral healthcare.  Since then, the … Read more →

Justice in Aging, one of the Center's longtime partners, recently released an issue brief, Oral Health in California: What About Older Adults? The Issue Brief includes a summary of the state of oral health for older adults in California. It cites disparities in oral health based on income level, education and race. The Brief also outlines the … Read more →

The New York Times reported on July 11, 2016 that a noninvasive alternative to dental fillings that could save money, while preventing future decay, has gained increased traction among dentists. The liquid – Silver Diamine Fluoride, or S.D.F. – can be brushed on certain types of cavities, removing the need for a drill or injection. … Read more →

As part of the Center for Medicare Advocacy’s commitment to improving oral health for older people and people with disabilities, Center attorneys recently attended a DentaQuest convening in Cambridge, Massachusetts aimed at unifying partners in this common mission. The convening focused on leadership strategies, shared network goals and collaborative work in social justice.  The Center’s … Read more →

“Dental care has been the most frustrating part of being a senior, and has the most to do with maintaining health in general.” – Michael Allen, California “This is a very important issue, the ability to eat is vital to a person[‘s] health, at age 71 I needed new dentures and I had no coverage, … Read more →

In a recent Boston Globe piece, former CMS Administrator Donald M. Berwick, MD called for expanded access to dental care, which he characterized as a critical aspect of health care that is out of reach for many. People with low incomes, people with disabilities, and older Americans all have difficulty accessing routine, preventive, and medically … Read more →

Oral Health America recently released a report, A State of Decay, a state-by-state ranking of healthcare delivery and public health factors that affect the oral health of older adults. Some of the Report’s Findings 76% or 38 states earned a Composite Score of Fair (22%) or Poor (54%); Ten states received a Composite Score of … Read more →

On May 5, 2016 Center for Medicare Advocacy executive director Judith Stein and Senior Attorney Wey-Wey Kwok, the Dental Lifeline Network, the Medicare Rights Center, and former CMS (then HCFA) administrator Bruce Vladeck, met with CMS officials to discuss coverage of medically necessary oral health care. The group’s primary goal was to advance Medicare coverage … Read more →

Medicare coverage for medically necessary oral health care is supported by the Medicare statute, its legislative history and, in some instances, even CMS policy.  For this purpose, “medically necessary oral health care” refers to treatment deemed necessary by a physician when a patient’s medical condition or treatment is or will likely be complicated by an … Read more →

Government contractors administering Medicare benefits are routinely denying coverage to cancer patients for claims involving the surgical removal of decayed and infected teeth caused by an aggressive course of radiation treatment to the head and neck.[1] The decayed and infected teeth, when left untreated, place these cancer patients at increased risk for infection, thereby decreasing … Read more →

As policymakers consider proposals to slash successful community programs including Medicare and Medicaid, older Americans and their families continue to face barriers to necessary health care, including access to dental coverage and services. A new report from Oral Health America highlights this growing dental crisis for older Americans. According to the report, lack of affordable … Read more →

Last week, the Senate Health Education Labor and Pensions Subcommittee on Primary Health and Aging held a hearing to discuss the growing dental crisis in America. As the Center recently wrote, most people who rely on Medicare go without basic dental care due to lack of coverage. The Senate hearing revealed dismaying new facts about … Read more →