Some areas left with no ACA plans after insurers exit | Emergency care for preventable dental problems cost Mass. up to $36M | Hospital partners with dental school on dental clinic
August 18, 2016
NADP SmartBrief
News affecting dental benefits
Industry News
Some areas left with no ACA plans after insurers exit
The Affordable Care Act's health insurance exchanges were meant to increase consumer choice and competition, but residents of some regions, including Pinal County, Ariz., might be offered no plans for 2017 on the exchange after Aetna withdraws from the market. Consumers who enroll in a plan off the exchange are ineligible for ACA subsidies.
Bloomberg (8/17) 
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Emergency care for preventable dental problems cost Mass. up to $36M
Massachusetts paid between $14.8 million and $36 million in 2014 for 36,060 hospital emergency department visits involving preventable oral health conditions, 60% of which occurred at times dental offices were open and about half of which were covered by MassHealth, a Health Policy Commission report said. MassHealth paid $11.6 million between 2008 and 2011 for emergency department care related to oral health, with young adults seeking emergency department care for oral health at higher rates than other age groups.
MetroWest Daily News (Framingham, Mass.)/State House News Service (8/16) 
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Hospital partners with dental school on dental clinic
The University of Maryland School of Dentistry and Frederick Memorial Hospital opened the Monocacy Health Partners Dental Clinic to serve low-income adults who lack dental insurance. The five-room clinic is handling only acute cases, but leaders hope to add preventive services. Patients are charged on a sliding scale, and some of the costs are expected to be offset by savings in the emergency department.
The Baltimore Sun (8/17) 
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Wichita State dental residents restore smiles for people in need
A program at Wichita State University called Gift of Smiles funds dental treatments for people with significant need who cannot afford the treatment. The program allows dental residents to perform complex procedures and extends treatment to people who otherwise would go without the care.
The Wichita Eagle (Kan.) (8/16) 
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Conn. dentist fined $717K for Medicaid fraud
A Connecticut dentist was ordered to pay $717,046 in restitution for improperly billing Medicaid for pediatric dental cleanings and fluoride treatments. Only licensed dentists or licensed dental hygienists may perform the treatments, but the dentist allegedly allowed unlicensed assistants, patients and patients' parents conduct the treatments.
Legal News Line (8/16) 
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Oral Health
Charcoal teeth whitening? Dentists say don't try it
Dentists are warning against a teeth whitening method popularized in a viral online video that involves smearing a charcoal-derived black mixture on teeth. Dentists say the product could deteriorate enamel and erode teeth. (8/15) 
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Elderly hospital patients might not be getting needed oral health care
Only about one-third of the hospital nurses caring for older people at five Canadian hospitals provided oral care in the evenings, and many seemed to believe caring for patients' oral hygiene was optional, researchers reported in Geriatric Nursing. Pathogens in dental plaque have been shown to match those in lung fluid in patients with hospital-acquired pneumonia, highlighting the need for good oral hygiene to prevent infection, the authors noted. (free registration) (8/17) 
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Research suggests mouth bacteria promotes colorectal cancer
Fusobacteria in the mouth can travel through the bloodstream and use a sugar-binding protein to attach to and accelerate growth of colorectal tumors, according to a study in Cell Host & Microbe. The study follows up earlier research showing the microbes might promote development and progression of colorectal tumors, researchers said.
Medical News Today (8/10) 
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CONVERGE presents "How DSOs Fit into Your Strategic Plan"
Numerous insurance companies are aggressively investigating alternatives to their core business. A recent trend has been to seriously consider entering the Dental Support Organization (DSO) business; in fact, a number of high-profile companies such as The Guardian Life Insurance Company and DentaQuest have already initiated these investments. CONVERGE presenter Dr. Joseph Errante, Senior Associate at The Concept Group, will present the informative breakout session, How DSOs Fit into Your Strategic Plan, on Sept. 14 from 2 to 3 p.m. at CONVERGE 2016. Visit for details. Register in the CONVERGE section of NADP Knowledge Center. Log in to receive member price.
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Sponsored webinar explores best claims practices
Take advantage of the complimentary webinar, Paper Dental Claim Processing: Best Practices in Action, sponsored by Information Capture Solutions (ICS) on Thursday, Aug. 25 at 1 p.m. Central Time. This webinar will present best practices and look at the real-world results and benefits these implementations can bring to your organization. Panelists include Brant Poore, ICS President & CEO, Ray Shears, VP, Chief of Business Operations & Co-Owner and Brian Tuttle, Senior Project Manager. Register in the NADP Knowledge Center.
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