Cohen Introduces Medicare Medically Necessary Dental Care Act

WASHINGTON, D.C. – Congressman Steve Cohen (D-TN-9) yesterday introduced the Medicare Medically Necessary Dental Care Act, legislation that would give Medicare patients facing certain ailments or preparing for certain surgical procedures the dental coverage they need.

“Dental health is necessary for a good quality of life,” said Congressman Cohen. “My legislation would give Medicare patients the coverage they need in order to be physically prepared to undergo serious medical procedures.”

The Cohen measure would provide coverage under Medicare part B for medically necessary dental procedures in conjunction with treatment of patients requiring prosthetic heart valve replacement and organ transplantation or the diagnoses of cancer of the head or neck, lymphoma, and leukemia.

According to the National Institute of Dental and Craniofacial Research: “More than one-third of people treated for cancer develop complications that affect the mouth. These problems may interfere with cancer treatment and diminish the patient’s quality of life.” For example, head and neck radiation and chemotherapy can cause oral complications including infections. A simple infection in the mouth can often lead to a full-blown bodily infection that can put someone’s life at risk or lead to organ rejection.

A 1999 Institute of Medicine study found that the prevention of oral infection has significant health benefits. This study concluded that it is reasonable for Congress to update the statutory language relating to coverage of dental services for Medicare beneficiaries so that it clearly covers dental care that is effective in preventing or reducing oral and systemic complications associated with serious medical conditions and the treatment of such conditions.

Since its inception, the Medicare program has strictly excluded coverage for dental services. However, the Centers for Medicare & Medicaid Services has approved coverage exceptions for limited dental services and has proposed additional exceptions based on the argument that oral health services would reduce the risk of infection and complications of medical care.