Last updated February 8, 2024
Virginia Policy Watch
Catalyst's staff and leadership are currently monitoring the policy priorities for the ongoing 2024 legislative session. For a comprehensive overview of Catalyst's 2024 Legislative Priorities, click here.
Watch the Policy Webinar from 12/21/2023 that discusses:
- Adult dental benefit in Medicaid implementation updates
- Governor Youngkin's proposed 2024 state budget
- Catalyst's legislative priorities going into the legislative session
Federal Policy Watch
UPDATE: New Medicare Rule Includes Win for Oral Health
In a significant victory for oral health, Medicare has finalized a rule that will expand access to dental services for millions of Americans. This rule adds necessary dental services before or during cancer treatment via chemotherapy, Chimeric Antigen Receptor T-cell therapy, and antiresorptive therapy to the list of covered services.
This expansion is a crucial step towards addressing the long-standing gap in dental coverage for Medicare beneficiaries. It recognizes the critical link between oral health and overall health, ensuring that cancer patients can receive the comprehensive care they need to improve their chances of survival.
It is a positive development that this rule has been put in place. However, it is crucial to understand that Medicare still does not provide coverage for most routine dental care. Catalyst is committed to advocating for comprehensive dental coverage for all Medicare beneficiaries. Earlier this year, Catalyst staff met with members of the Virginia congressional delegation, including Senator Warner who serves on relevant committees, to discuss this matter further.
For step-by-step instructions on how to enroll as a Medicare provider and how to submit claims visit CMS. The ADA also has a toolkit that includes valuable resources on enrolling and billing. As more details become available, Catalyst will provide Medicare members and providers with information on how to utilize this expansion of services.
For more information and references click here.
UPDATE: Medicaid Dental Benefit
The legislature approved upgrades to the Medicaid dental program to address concerns raised by clinicians and improve care for Medicaid members. These upgrades include:
- Extending the age limitation for children receiving fluoride varnish from non-dental providers through age five, up from through age three;
- Removing the current limitation on the number of times a dentist can bill CDT Code D9920, the behavioral management code when treating adults with disabilities;
- Providing payment for crowns for patients who received root canal therapy prior to becoming a Medicaid member; and
- Providing reimbursement for pre-treatment evaluations performed by dentists treating patients requiring deep sedation or general anesthesia to match current Centers for Medicare and Medicaid Services guidelines.
We are committed to ensuring that Virginia’s Medicaid program implements these policy changes without delay. We are happy to share that these improvements will take effect on January 1, 2024.