10, the Centers for Medicare and Medicaid Services (CMS) released an informational
bulletin providing an update on the CMS Oral Health Initiative and other
oral health related items.
may recall in April
2010, CMS through its Oral Health Initiative (OHI) established
two performance goals: (1) increase by 10 percentage points the proportion of
Medicaid and Children’s Health Insurance Program (CHIP) children ages 1 to 20
(enrolled for at least 90 days) who receive a preventative dental service; and (2)
increase by 10 percentage points the proportion of Medicaid and CHIP children
ages 6 to 9 (enrolled for at least 90 days) who receive a sealant on a
permanent molar tooth. These two performance goals are to be accomplished over
five years by federal fiscal year (FFY) 2015.
bulletin recently released announced that between FFY11 and FFY12, fifteen
states achieved at least a two percentage point improvement on their CMS Oral
Health Initiative preventative dental services goal. While fifteen states have
met or exceeded their first year incremental goal, the remaining 36 states fell
short. As a result, the CMS bulletin provides a variety of resources to states
to help them achieve their OHI goals, including a CMS supported publication
Oral Health Care Delivery in Medicaid and CHIP: A Toolkit for States.
Additionally, CMS has established the CMS
Learning Lab: Improving Oral Health Through Access, a series of
technical assistance webinars focusing on improving the delivery of oral health
services to children enrolled in Medicaid and CHIP.
CMS uses the information bulletin to clarify certain policies regarding dental
workforce innovations. Specifically, the bulletin notes the following (this
list is not exhaustive):
- Services provided by
non-dentists such as primary care medical practitioners, or by dental
professionals not under the supervision of a dentist, are considered by
Medicaid to be ‘oral health services’ provided by a licensed practitioner.
- References the
distinction between ‘dental service’ and ‘oral health service’ as an important
one in the context of reporting dental utilization data to CMS.
- Services performed by
new types of dental professionals such as dental therapists and community
dental health practitioners are considered to be ‘dental services’ if the
dental professional has some sort of supervisory relationship or agreement or
affiliation with a dentist. Services performed by new types of dental professionals
are considered to be ‘oral health services’ if no such relationship, agreement
or affiliation with a dentist exists.
- States may also allow
dental professionals who are permitted by the terms of their license to
practice without dental supervision to enroll as Medicaid providers and bill
Medicaid directly for their services.