From the latest on Medicare to recent court rulings affecting dentistry, FYI brings you the biggest dental policy stories.
The U.S. Centers for Medicare and Medicaid Services (CMS) has released a proposed physician fee schedule rule for 2023 that would expand access to dental care services for Medicare beneficiaries. The proposal came after lawmakers in the U.S. House of Representatives and the U.S. Senate requested that the agency broaden the definition of medically necessary dental coverage as a way to expand access for Medicare recipients.
Currently, Medicare Part B only pays for dental services when it is deemed medically necessary to treat a recipient’s primary medical condition. The proposed changes for payments could become effective as early as January 1, 2023.
The American Dental Association (ADA) has said that the cybersecurity incident it first reported in April was actually a ransomware attack, which ultimately led to the theft of member data. Although the ADA initially claimed that there was no data breach, a recent notice from the organization confirms that data theft occurred.
The notice does not share the precise data impacted, just that it was personal information tied to member names. Impacted members will receive complimentary credit monitoring and identity protection services. The ADA says it has assessed system security and reset relevant account passwords while it works to review and bolster existing policies and procedures.
A federal judge has denied an inmate’s request to order prison officials to halt their alleged unofficial policy of denying dental crowns to detainees. Beginning in November 2019, an inmate at the U.S. Penitentiary Administrative Maximum Facility in Florence, Colorado, sought treatment for broken and painful teeth. The prison dentist allegedly informed the inmate he needed a crown and teeth fillings, but the dentist could only “do one procedure per inmate per visit.”
The inmate, Peter George Noe, filed suit against the government and multiple medical personnel, claiming delayed and inadequate treatment. He asked for a preliminary injunction that would order the Bureau of Prisons to provide crowns generally, and to specifically perform his needed dental work. The district judge denied the motion, finding Noe had not shown he would suffer irreparable harm in the absence of a court order.
The U.S. Supreme Court declined to hear the case of a Minnesota dental hygienist challenging denial of workers’ compensation for medical marijuana. The hygienist, Susan K. Musta, began purchasing cannabis to treat chronic pain due to work-related injuries in 2019 under Minnesota’s legal medical cannabis program and was not reimbursed for it under her workers’ compensation coverage for workplace injuries. Minnesota courts ruled that the federal Controlled Substances Act (CSA) prevented her insurer from paying for medical cannabis.
Musta appealed the decision to the U.S. Supreme Court alongside a similar Minnesota case. The U.S. Supreme Court indicated that fewer than four justices believed the legal challenge warranted the court’s consideration. State supreme courts in New Jersey and New Hampshire have ruled the CSA doesn’t preempt their workers’ compensation laws. However, like Minnesota, Maine’s high court reached the opposite conclusion.