Calif. exchange draws 33,000 to dental coverage in initial weeks | Texas court upholds invalidation of payment holds during fraud probes | More companies add dental benefits to wellness strategies
November 19, 2015
NADP SmartBrief
News affecting dental benefits

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Calif. exchange draws 33,000 to dental coverage in initial weeks
Dentist at work.
(Peter Macdiarmid/Getty Images)
Adults in California who shop for insurance on the Covered California Affordable Care Act exchange can obtain dental coverage through optional family plans, and about 33,000 adults have done so, including about 6,000 first-time exchange users, said exchange Executive Director Peter Lee. Pediatric benefits continue to be paired with health plans, but parents can still enroll for their own coverage in family dental plans. Among state exchanges, only Washington does not offer dental plans, Delta Dental's Jeff Album said. Kaiser Health News (11/19), The Modesto Bee (Calif.) (11/11)
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Texas court upholds invalidation of payment holds during fraud probes
Texas' Supreme Court has upheld a lower court's ruling invalidating suspension of reimbursements from public programs while practitioners are being investigated for fraud. There must be "credible allegations" of fraud for holds to be placed, the court found. (free registration) (11/17)
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More companies add dental benefits to wellness strategies
Humana Chief Dental Officer Dean Fry writes that many companies are adding dental benefits to their wellness strategies. CDC data linked oral health problems to 164 million lost work hours a year, he writes, and studies have associated dental problems with other health diseases. Employee Benefit News (11/17)
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Ill. clinics fill gaps in dental care
Mostly preventable dental problems accounted for 2% of emergency department visits at two Illinois hospitals, a statistic that underscores the need for better access to dental services among lower-income people, dentists and public officials say. Cost, even for those with insurance, is a major deterrent to seeking care, and experts say low reimbursement rates under Medicaid prevent many dentists from accepting low-income patients. Clinics for those in need and vouchers for care are helping in the short term, but they aren't the solution, experts say. The Pantagraph (Bloomington, Ill.) (11/13)
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Ex-Fla. pediatric dentist faces Medicaid fraud charges
A former pediatric dentist in Jacksonville, Fla., was charged Monday with 11 counts of Medicaid fraud. Howard Schneider is accused of providing unnecessary dental procedures and submitting fraudulent claims to Medicaid. He received over $3.9 million in reimbursements from the program in the past five years, news reports said. Schneider was released on a $110,000 bond and was expected to attend a hearing Tuesday morning. WJXT-TV (Jacksonville, Fla.) (11/17)
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Other News
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Programs give children access to basic dental, medical care, study finds
Children covered under the Children's Health Insurance Program or Medicaid tend to get preventive dental and medical care more frequently than children covered by private plans, according to a study published in JAMA Pediatrics. The reasons behind the difference as well as disparities in access to specialty care aren't clear, but Dr. David Keller, who wrote an accompanying editorial, said the results send a message to Congress that the programs are keeping children safe. Medscape (free registration) (11/18)
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10 Common Website Scenarios That Make a Web CMS Essential
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Company News
Contact Center Metrics Report released
NADP recently published the 2014 NADP/LIMRA Customer Contact Center Metrics Report, and it is now available in the "Statistical Reports" section of the NADP Knowledge Center. The report provides industry benchmarks for contact center performance. For dental plan members, the report is offered as a membership benefit, and for all other members, the report is available at a preferred member discount. Log in to receive the appropriate member price.
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Save the date for CONVERGE 2016
Mark your calendars now for CONVERGE 2016, Sept. 12-15 at the Hyatt Hill Country Resort and Spa in San Antonio, Texas. CONVERGE is the best professional development opportunity the dental benefits industry has to offer. It features dynamic educational sessions, energetic networking opportunities plus informative exhibits in the Discovery Zone. At CONVERGE, you will become inspired as you share your insights and challenges with fellow colleagues and polish your skills as you learn from thought leaders and industry experts. For more information, visit
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Editor's Note
NADP SmartBrief will not publish Nov. 26
In observance of the Thanksgiving holiday, NADP SmartBrief will not publish Nov. 26. Publication will resume Dec. 3.
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Courage is resistance to fear, mastery of fear -- not absence of fear."
-- Mark Twain,
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