The American Dental Association is urging CMS to strengthen dental Medicare Advantage protections, including increased oversight of supplemental dental benefits, according to a Feb. 21 news release from the ADA.
Here are five things to know:
1. In addition to greater oversight, the ADA is pushing for improved marketing of supplemental dental benefits and including all forms of supplemental dental coverage in medical loss ratio calculations.
2. The ADA expressed concerns over waivers of liability, claiming that they should not be used with supplemental dental benefits as they interfere with the dentist-patient relationship and lead to lower dentist participation.
3. The association supports a change proposed by CMS to require additional marketing materials be submitted to CMS for review.
4. The ADA suggested creating a standardized summary of specific benefits, such as dental, available under a plan that would include limitations or exclusions on services, waiting periods, alternate benefit provisions, annual maximums, coinsurance, copays, deductibles and out of network benefits.
5. The organization reemphasized that optional dental benefits fall outside of the core Medicare Advantage plan requirements and are not included in the reported medical loss ratio, but argued that optional dental benefits should be included in the calculation.