Lawmakers urge CMS to expand Medicare dental coverage: 7 things to know

Members of the U.S. House of Representatives and Senate recently penned letters prompting CMS to expand dental coverage under Medicare.

Seven things to know: 

1. An earlier legislative attempt to expand dental coverage for Medicare recipients was stalled in October 2021 when a new version of Congress' reconciliation package left out the expanded benefit.

2. The letters, sent at the end of June, urged CMS Administrator Chiquita Brooks-LaSure to use her authority to expand coverage of medically necessary oral and dental healthcare for eligible Medicare beneficiaries. 

3. The letters noted that the Social Security Act excludes Medicare coverage of routine dental services but does not prohibit CMS from authorizing coverage for medically necessary dental care. It also stated that a precedent already exists for covering medically justified services; for example, medically necessary podiatry services despite routine foot care not being eligible for coverage. 

4. Medicare also covers dental services that are deemed an integral part either of a covered procedure or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw. 

5. Nearly half of all Medicare beneficiaries do not have dental coverage, amounting to about 24 million people.

6. According to the letters, the lack of coverage has led to low utilization of dental care, particularly among people of color.

7. Congress members noted the expansion of dental coverage could save the program $63.5 billion over 10 years.

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

Featured Learning Opportunities

Featured Webinars

Featured Whitepapers

Featured Podcast