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
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.)
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
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. DrBicuspid.com (free registration)
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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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