ADA staff will explain the minutiae of recent CMS regulations for dentists who accept public or commercial insurance in a webinar titled, “How Recent CMS Regulations Apply to Dentistry?” This will be followed by a brief presentation and moderated Q & A discussion from CMS Chief Dental Officer Dr. Natalia Chambers.
In March 2024, Centers for Medicare & Medicaid Services (CMS) released regulations that removed a prohibition on adult dental benefits as an essential health benefit. The removal of this prohibition allows states to classify adult dental care as an essential health benefit for qualified health plans sold on the individual/small group marketplace exchanges beginning in 2027. How will this affect your patients and their insurance options? Could your patients with marketplace exchange insurance have more coverage for dental services?
In April 2024, CMS released regulations that revised standards for access in Medicaid Managed Care Organizations (MCOS) and Medicaid Fee for Service (FFS) Programs. These regulations require MCOs to disclose reimbursement rates for certain healthcare services, abide by a state-set appointment wait time for providers in their network, and hire an independent entity to monitor the state-set wait-time standards and network adequacy. These regulations also set parameters for FFS programs’ Medicaid Advisory Committee, and which healthcare professionals may sit on this committee. Could these regulations help Medicaid patients access more dental services? Could these regulations possibly help a state’s advocacy efforts to increase Medicaid reimbursement for dental services?
In July 2024, CMS will be releasing its 2025 Medicare Physician Fee Schedule Proposed Rules. These rules will detail how CMS plans to further carry out the limited medically-necessary dental benefit in 2025. What new operational details of the limited medically-necessary dental benefit should healthcare providers and patients know?
The answers to these questions will be presented at this informational webinar. ADA invites you to register for the August 12 webinar to learn more.