Dental Care Denied by Medicare Turns into Major Lawsuit
Source: Dr.Bicuspid.com Medicare's refusal to cover extensive dental treatment that is often needed to treat patients with diseases such as oral cancer and Sjögren's syndrome is unreasonable and arbitrary, according to a lawsuit pending in U.S. federal court. The litigation, originally filed in 2008 on behalf of one plaintiff, was recently amended by the Center for Medicare Advocacy (CMA) in the U.S. District Court for the District of Arizona against U.S. Health and Human Services Secretary Kathleen Sebelius on behalf of three Medicare beneficiaries who needed medically related dental care stemming from underlying medical conditions. Medicare policy, which excludes coverage of "routine" dental care, does cover dental services when they are "incident to and an integral part of" eligible medical care. Dental procedures that are covered include extractions in preparation of radiation treatment of neoplastic disease, reconstruction of ridges that are performed simultaneously with the surgical removal of oral tumors, and the wiring of teeth if done in connection with jaw fractures. "We have argued that this is a misinterpretation of the Medicare statute," said CMA attorney Sally Hart, who filed the suit. "We think that beneficiaries who require extensive dental services because of damage from Sjögren's syndrome, as well as cancer radiation treatment and other conditions that destroy the production of saliva, should not fall within the exclusion." CMS does not comment on pending litigation, CMS spokesman Tony Salters told DrBicuspid.com. Why coverage denied Each of the plaintiffs in the CMA lawsuit suffered a serious medical condition, resulting in [...]