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

Community Statement on Medicare Coverage for Medically Necessary Oral and Dental Health Therapies
(The PCPCC joined the Community in 2019)
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.
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


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