Final rule spells out excepted benefits under ACA | Premera reports hacking breach involving 11M customers, affiliates, workers | Patient data compromised in Advantage Dental breach

March 19, 2015
NADP SmartBrief
News affecting dental benefits

Industry News
Final rule spells out excepted benefits under ACA
Final regulations establish four categories of excepted benefits under the Affordable Care Act. The categories cover benefits that offer some medical coverage although they aren't typically considered health coverage, such as workers' compensation; limited benefits such as dental and long-term care insurance; coverage not coordinated with medical insurance, such as that for specific diseases; and supplemental medical coverage. The rules also address wraparound coverage limits and pilot programs for wraparound coverage. Employee Benefit News (3/18)
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Premera reports hacking breach involving 11M customers, affiliates, workers
A data breach affecting 11 million employees, business affiliates and members of Premera Blue Cross was reported after its IT systems were accessed by hackers beginning on May 5, 2014. The compromised information included banking information, claims data, names, addresses and Social Security numbers. Free identity theft protection and credit monitoring services are being offered to affected people for two years. (3/17), Healthcare Informatics online (3/17)
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Patient data compromised in Advantage Dental breach
The personal information of over 150,000 Advantage Dental patients was accessed by a hacker between Feb. 23 and Feb. 26, according to the Oregon company. Information including home addresses and Social Security numbers was compromised, but so far, there have been no reports of identity theft. Advantage is enhancing security, informing patients of the breach, and offering credit monitoring and other services to assist clients. The Register-Guard (Eugene, Ore.) (3/17)
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Calif. legislators grill new leader over Denti-Cal problems
California legislators voiced concerns over problems with Denti-Cal at a recent hearing on the program. A state audit found more than half of children covered by the program do not get regular oral health care, and it uncovered dental access problems in 32 of 58 counties. Jennifer Kent, the recently appointed director of the state's Department of Health Care Services, said she is addressing the issues, along with a failure to document program utilization. California Healthline (3/18)
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Texas dental clinics settle Medicaid fraud allegations for $4.5M
Smile Magic, a Texas-based chain of dental clinics, will pay $4.5 million to resolve accusations of defrauding the state Medicaid program. Four Smile Magic clinics allegedly paid kickbacks to patient recruiters who offered gift cards and monetary payments to parents in exchange for taking their children to the clinics, according to a whistleblower lawsuit. The company and its owner, Everett Chad Evans, were accused of submitting over $19 million in Medicaid claims for unnecessary or unprovided children's dental services, the lawsuit said. (free registration) (3/17)
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Other News
Selling your business? Here are 7 things you should do now.
If you're considering selling your business, you should be doing everything you can to get the best possible price. In just 7 simple steps you can improve your chances of attracting buyers and getting big bucks for your business. Read the article and learn the 7 steps.

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Oral health problems common among people with disabilities, study finds
People with disabilities tend to have difficulty with oral hygiene and poor oral health as a result, including severe inflammation and decayed teeth, according to a study presented at an International Association for Dental Research meeting. Although 75% of the disabled people involved in the study had medical insurance, their plans did not provide comprehensive care. (free registration) (3/12)
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New state reports released
NADP State Reports present a market overview including enrollment by plan type, consumers receiving benefits via small or large groups or public programs, dental workforce trends, comparison of individuals with coverage by household incomes, and employers offering benefits by company size. Brand-new NADP State Reports featuring 2013 data are available in the Knowledge Center of the NADP website, where they are free to members and $29.95 each for nonmembers.
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NADP contact center metrics report provides valuable benchmarks
What is the industry average for the speed to answer incoming calls? What is the average rate for member satisfaction? Find answers to these questions and more with the NADP/LIMRA 2013 U.S. Group Dental Contact Center Metrics report now available in the Statistical Report section of the NADP Knowledge Center. You must log in to receive member pricing.
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Anyone can become angry -- that is easy. But to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way -- that is not within everyone's power and is not easy."
-- Aristotle,
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