New Covered California contract addresses agent compensation | In Ky., many children are insured but underserved | Conn. governor proposes cutting Medicaid pediatric dental payment rates
April 21, 2016
NADP SmartBrief
News affecting dental benefits
Industry News
New Covered California contract addresses agent compensation
The Covered California board has approved compensation standards for agents selling qualified health plan policies from 2017 through 2019. The standards are part of a new health plan contract, under which insurers must pay equal compensation whether policies are sold during regular or special enrollment periods. Insurers also must pay the same compensation no matter which "metal level" of coverage is sold.
LifeHealthPro (4/15) 
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In Ky., many children are insured but underserved
In Louisville and Jefferson County, Ky., every child has dental coverage but only 48% of children with coverage under a public program get dental care, writes public health dental hygienist Jennifer Hasch, who sits on the executive committee of the Kentucky Oral Health Coalition. Barriers to care include poor dental health literacy among parents and too few dentists who accept Medicaid, she writes. Potential solutions include school-based dental care and sealant programs, streamlined Medicaid credentialing and payment for dental professionals, interprofessional collaboration and parent education programs.
The Courier-Journal (Louisville, Ky.) (tiered subscription model) (4/14) 
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Conn. governor proposes cutting Medicaid pediatric dental payment rates
Connecticut Gov. Dannel Malloy proposed reducing Medicaid reimbursement rates for pediatric dental care by 10%, and critics say the move would discourage dentists from treating children with Medicaid coverage. The state implemented program reforms, including an increase in reimbursement rates, in 2008 in response to a lawsuit. More dentists participate in Medicaid, a larger percentage of children have received dental sealants and more children visit a dentist at least once a year since the reforms were put in place. (Connecticut) (4/18) 
Fla. governor vetoes grant program for dentists
Florida Gov. Rick Scott vetoed a bill that would have created a grant program for dentists in underserved communities. Scott said the bill did not require dentists to serve a certain proportion of low-income patients each year or hire a specific number of employees. (4/19) 
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Oral Health
Certain oral bacteria signal pancreatic cancer risk, study finds
The presence of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans bacteria in the mouth might signal risk of developing pancreatic cancer, researchers at NYU Langone Medical Center said at the American Association for Cancer Research Annual Meeting. Study participants with P. gingivalis in the mouth were 59% more likely to develop pancreatic cancer, and those with A. actinomycetemcomitans were at 50% higher risk, the researchers reported. Both bacteria are associated with periodontitis, and the findings might lead to new approaches to preventing pancreatic cancer. (4/19) 
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Company News
DentaQuest, Advantage seek permission for partnership
DentaQuest and Advantage Dental are asking the Oregon insurance commissioner for permission to form a partnership, and public comment will be accepted through May 4. Both companies focus heavily on Medicaid beneficiaries.
The Lund Report (Portland, Ore.) (4/18) 
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Future bright for dental IT firm after $21M funding round
Brighter, a dental benefits and practice management IT company, raised $21 million in a Series D investment round. Brighter's platform helps patients find dentists and reviews, and helps dentists with scheduling and bill collections. Investors include General Catalyst Partners, DAG Ventures, Mayfield Fund, Benchmark and Tenaya Capital. Plans for the funds include building partnerships with insurers. (4/20) 
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NADP says flawed ADA report misses the mark on value of children's dental benefits
A new report out from the American Dental Association's Health Policy Institute challenging the value of private dental benefits is drawing strong criticism from leading industry groups. The ADA report claims that consumers with children covered under private dental plans are spending more out-of-pocket on premiums and copayments than their benefits are worth. But the National Association of Dental Plans and Delta Dental Plans Association say the report's conclusion, based on cherry-picked data and uninformed assumptions, is fundamentally flawed. Read more.
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CONVERGE early-bird registration ends April 29
CONVERGE 2016 early-bird registration continues through April 29 via the online registration system in the NADP Knowledge Center. Early-bird registration is $1,095 per member and $1,995 per non-member. CONVERGE is Sept. 12-15 at the Hyatt Hill Country Resort and Spa in San Antonio, Texas. Visit the CONVERGE microsite frequently as updates will be posted regarding the schedule, attendee list, golf tournament and more.
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