America's Benefit Specialist November 2022

MEDICARE MATTERS

for Medicare beneficiaries,” according to the proposal. It also cites a 2021 report on oral health from the National Institutes of Health, which found that almost three in five older adults experience severe peri odontal or gum disease. Older adults also have the highest out-of-pocket dental costs. Leading dental care, patients and se niors’ advocacy organizations, along with Congressional Democrats, largely support the proposal. But, at the same time, they criticized its shortcomings. “This new rule merely expands coverage to align with the most recent medical litera ture and accepted standards of care,” Repre sentative Lloyd Doggett (D-TX), who chairs the Ways and Means Health Subcommittee and who has advocated for comprehensive coverage, said in a statement to KHN. “It is not a panacea.” In June, Doggett spearheaded a letter signed by more than 100 colleagues pressing CMS to expand dental services for certain medical conditions. In July, 22 Senate D emocrats also urged CMS to expand dental coverage.

The proposal has been criticized because it omits follow-up dental care. Extracting infected teeth has consequences, even when it’s needed to eliminate an infection that would otherwise jeopardize potentially lifesaving treatment. “If you remove the teeth, patients cannot chew and continue to nourish themselves properly,” said Dr. Dave Preble, chief strategy officer at the American Dental Association. “You’ve created another medical problem for the patient.” Full or partial dentures are not covered under Medicare. Overall, the ADA supports the proposal, although it has asked CMS for more information. Additional details to be worked out include a big one: “How do you reim burse properly for things that haven’t been covered before?” asked Preble. He ques tioned how CMS would calculate dentists’ payments and whether they would cover ancillary expenses such as supplies, utilities and equipment. The ADA’s concerns about Medicare payments and the funding of extra benefits are among the reasons it did not support legislation for more comprehensive coverage.

CMS recently released the 2023 Star Ratings for Medicare Ad vantage (Medicare Part C) and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment. Plans are rated on a one-to-five scale, with one star representing poor perfor mance and five stars represent ing excellent performance. Star Ratings are released annually and reflect the experiences of people enrolled in Medicare Advantage and Part D prescription drug plans. The Star Ratings system supports CMS’ efforts to empower people to make healthcare decisions that are best for them. People with Medicare can use the Medicare Plan Finder tool, available on Medicare.gov, to com pare plan quality through the Star Ratings, along with other informa tion, such as cost and coverage. Approximately 72% of people currently in Medicare Advantage plans that offer prescription drug coverage are enrolled in a plan that earned four or more stars in 2023. Approximately 51% of Medi care Advantage plans that offer prescription drug coverage will have an overall rating of four stars or higher in 2023. For more information, including a fact sheet, visit http://go.cms. gov/partcanddstarratings. AND PART D STAR RATINGS TO HELP PEOPLE WITH MEDICARE COMPARE PLANS CMS RELEASES 2023 MEDICARE ADVANTAGE

CONFERENCES

April 10-12 MedicareCon Las Vegas, NV https://medicarecon. com/ July 10-11 Ms. Medicare 2023 Cleveland, OH www.msmedicare.org

March 6-8 RISE National

November 14-15 National Medicare Ad vantage Conference Orlando, FL www.wcforum.com/con ferences/medicare January 29-31 Medicare Marketing &

Colorado Springs, CO www.risenational.com March 28-29 Medicare Market Innovations Forum Orlando, FL www.medicaremarketin novations.com

Sales Summit Las Vegas, NV

www.medicaremarket ingsalessummit.com

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