The ADA is urging federal health officials to exclude dentists from proposed regulations that would deny claims for Medicare Part D drugs unless the prescriber is enrolled in Medicare or has a valid opt-out affidavit on file.
Health officials withdrew the proposal following professional and congressional opposition, but they signaled intent to revisit and "finalize" regulations "strengthening standards for prescribers of prescription drugs," according to the ADA.
The requirement would affect most dental practices, the ADA said in a recent letter to federal health officials. The Patient Protection and Affordable Care Act (ACA) authorizes but does not require the secretary of Health and Human Services to extend the enrollment requirement to prescribers of Medicare Part D drugs.
The proposed requirement places an unnecessary administrative burden on dentists and their Medicare-eligible patients that will not serve to address the ACA's underlying rationale to stop Medicare fraud and abuse, the ADA said.
The ADA added that it is not aware of any high-billing levels associated with prescriptions written by dentists for Medicare patients.
While most physicians who prescribe covered drugs for Medicare Part D enrollees may be enrolled in an approved status in Medicare, many dentists are not currently enrolled as either a Medicare provider or as an ordering or referring provider or have not opted out with a valid affidavit on file with a Part A/Part B Medicare administrative contractor, the ADA said.
