Medicare Part B generally excludes dentistry; however, there is an exception for “medically necessary procedures.” More than 130 members of the House and Senate penned a letter to CMS urging its administrator to expand and better define this exception. They believe the agency has the authority to act without additional help from Congress. The legislators request dental care coverage associated with:
- Multiple myeloma and metastasized cancers of the lung, breast, prostate and colon, all often involving bisphosphonate drugs, for which dental health is advised to prevent osteonecrosis of the jaw.
- Implanted heart valves, arterial stents and stent grafts, which are at risk of infection due to bacteria from dental infections spreading to other parts of the body.
- Emergency department visits and hospitalizations for medical problems in which oral or bacteria from dental infections are an underlying cause.
- Diabetes management compromised by periodontal infections.
The letter did not include recommendations on the implementation of expanded benefits. AAOMS supports CMS correcting some of the inconsistencies in how Medicare covers medically necessary dental treatment and is monitoring these efforts.
