Center for Medicare Advocacy
PO Box 350
Willimantic, CT
United States
The Center for Medicare Advocacy’s (CMA) mission is to advance access to comprehensive Medicare coverage, health equity, and quality health care for older people and people with disabilities by providing exceptional legal analysis, education, and advocacy.
CMA has been a partner of CareQuest Institute for Oral Health since 2015, continually advocating for the expansion of Medicare to include dental coverage. Over the last four grant years, CareQuest Institute funding has supported advocacy for extensive dental benefits in Medicare Part B, and collaboration with CMS to expand the definition and coverage of medically necessary dental services in Medicare.
In 2024, grant funding supported CMA’s ongoing oral health work in advancing: (1) Medicare’s medically necessary oral health coverage policy, (2) a comprehensive oral health benefit in Part B, and (3) equitable access to covered dental services through Medicare Advantage (MA) and Dual-Special Needs Plans (D-SNPs).
CMA’s work yielded significant results, including a key role in advancing medically necessary dental coverage nominations in CMS’ annual rulemaking process leading to Medicare adding coverage for dental care needed by End-Stage Renal Disease patients undergoing dialysis. CMS also focused on implementation of the clarified dental coverage policy. For example, last summer, CMS issued a simple new form for Dentists to submit reimbursement claims to Medicare and improved its website regarding its dental policy, providing clearer information to providers/public in user-friendly form.
CMS also provided outreach and education about the recent dental coverage expansions through two co-sponsored webinars: in March with CareQuest Institute, Santa Fe Group, and Henry Schein Cares for beneficiaries, providers, advocates focusing on coverage expansions, highlighting importance of health equity/collaborative solutions; and in May with CareQuest Institute, providing more in-depth information for dental providers re scope of coverage/submitting claims to Medicare. Additionally, CMS published articles and gave presentations on quarterly calls for Medicare advocates and various OPEN and Medicare Oral Health Coalition meetings.
Funding is requested to (a) strengthen the implementation of medically necessary Medicare dental benefits and add to the list of these benefits, (b) continue to advocate for and advance the agenda for comprehensive Medicare dental benefits and (c) defend against threats to Medicare and other health benefits. CMA will continue to educate patient groups and medical and dental communities about the medically necessary coverage clarification through webinars, professional journals, and media engagement.
Throughout its work, CMA will seek the input of community partners to better ensure that its oral health policy work aligns with its values for diversity, equity, inclusion, and accessibility.
This request represents 3% of the organization’s overall budget. Budgeted line items include staff time, legal assistance, and indirect expenses.