By Genni Burkhart
With dental advocacy groups making recent and rather significant groundbreaking progress, 2022 was a momentous year for the dental community. This further highlights the importance of oral healthcare and the impact dental professionals have on the systemic wellness of patients.
Last year organizations such as the American Dental Association (ADA), the American Association of Oral and Maxillofacial Surgeons (AAOMS), and the American Academy of Pediatric Dentistry (AAPD) alongside the disability community lobbied for several initiatives designed to increase access to quality oral healthcare for individuals of all ages and backgrounds. These initiatives aim to positively impact people's oral health and reduce the financial burden associated with dental care – a significant achievement that deserves recognition and celebration.
Medicare & Medicaid Reimbursement for Operating Room Dental Cases
Perhaps one of the most collaborative and largest "wins" of last year, the Centers for Medicare and Medicaid Services (CMS) established new dental billing and payment arrangements to improve access to hospital-based operating rooms requiring general anesthesia for dental procedures. By revising this arrangement, dental providers can provide complex dental treatments faster while receiving timely and fair reimbursement.
The CMS also expanded dental coverage after pregnancy. Lobbied by the ADA, the CMS will now allow all those enrolled in Medicaid to have dental coverage for 60 days postpartum.
Click here to access updated, frequently asked questions about the new HCPCS code (G0330) for dental rehabilitation.
The MOBILE Health Care Act
Advocated by the ADA and signed into law on October 18, 2022, the MOBILE Health Care Act (S.958) passed with strong bipartisan support.
This legislation expands access to healthcare services for hard-to-reach urban, underserved, and rural communities by granting community health centers access to federal funds under the New Access Points (NAP) grant program to establish mobile healthcare units.
These new mobile healthcare units would provide sorely needed access to healthcare for those living in underserved areas, giving a much-needed boost to health equity.
States Prioritize Oral Healthcare
Between increased budget funding and reform aimed at expanding access and the affordability of dental care, many state legislatures prioritized oral healthcare in 2022.
In Massachusetts, the medical loss ratio (MLR) ballot measure passed, where a minimum percentage of premium dollars collected by insurance companies must be spent on actual patient care, not administrative costs such as salaries and marketing. Deemed a "watershed moment for patients and dentistry," this measure was signed into MA law in December of 2022 and requires the state's insurance carriers to invest at least 83% of patient premiums on actual patient care while not allowing "egregious" increases in premium payments.
Seventy-two percent of Massachusetts voters approved the MLR ballot measure, with dentists from around the country joining the support. The ADA contributed $5.5 million to this campaign and is now exploring similar reform at the federal level. In fact, 22 state dental societies obtained ADA funding to engage in dental insurance issues in 2022. According to the ADA, 14 new laws in eight states were enacted last year to optimize patient and provider needs concerning dental insurance.
In California, the 2022-23 state budget signed by Governor Gavin Newsom included all of the California Dental Association's (CDA) top requests. This includes investing in workforce development in healthcare, $50 million for new and expanded infrastructure to serve special needs dental patients, and $10 million to further develop clinical rotations for dental students.
Staffing shortages remain one of the top concerns facing dentistry across the U.S., causing the CDA to strongly urge for increased funding targeting this problem. California state legislature responded with $1.7 billion for staffing, recruitment, and training in the healthcare industry.
You can read more here if you want a complete list of reforms the ADA participated in last year.
As Anne Wojcicki, CEO of 23andMe stated, "One of the best aspects of health care reform is it starts to emphasize prevention."
In 2022 we saw oral healthcare reform play out nationwide and give a greater voice to those with the most need. At the federal level, the Fiscal Year (F.Y.) 2023 omnibus appropriations bill includes an increase of 3.5% for oral health across the board, with dental research and Indian dental health as significant benefactors. This is a promising sign as modern healthcare seeks to meet the growing diversity of patients where they are, sometimes with the most unique needs, and in the hardest-to-reach places.
At DOCS Education, we congratulate the tireless efforts of advocates, providers, and policymakers committed to ensuring everyone has access to high-quality, affordable dental care. With continued dedication and hard work, the dental care landscape will continue to improve in 2023.
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Author: With over 13 years as a published journalist, editor, and writer Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides on the western shores of the idyllic Puget Sound where she works as the Editor in Chief for the Incisor at DOCS Education out of Seattle, WA.