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The Affordable Care Act and Oral Health in Rural Indiana

The Affordable Care Act and Oral Health in Rural Indiana. James R. Miller, DDS, MSD, PhD State Oral Health Director Indiana State Department of Health Indiana Rural Health Association Conference August 7-8, 2013 JW Marriott Indianapolis, IN. Topics. Background Dental Rural Discussion.

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The Affordable Care Act and Oral Health in Rural Indiana

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  1. The Affordable Care Actand Oral Health in Rural Indiana James R. Miller, DDS, MSD, PhD State Oral Health Director Indiana State Department of Health Indiana Rural Health Association Conference August 7-8, 2013 JW Marriott Indianapolis, IN

  2. Topics Background Dental Rural Discussion

  3. Background http://www.healthcare.gov/law/index.html Patient Protection and Affordable Care Act “PPACA” “ACA” Affordable Care Act

  4. Background Patient Protection and Affordable Care Act • Quality, Affordable Health Care for All Americans • The Role of Public Programs • Improving the Quality and Efficiency of Health Care • Prevention of Chronic Diseases and Improving Public Health • Health Care Workforce • Transparency and Program Integrity • Improving Access to Innovative Medical Therapies • Community Living Assistance Services and Supports • Revenue Provisions • http://www.healthcare.gov/law/index.html

  5. Dental http://www.cdhp.org/resource/summary_oral_health_provisions_health_care_reform Access, Coverage and Financing Prevention Infrastructure Surveillance and Monitoring Workforce and Training

  6. Dental Discepolo K and Kaplan K. (2011) The Patient Protection and Affordable Care Act Effects on Dental Care. NYSDJ • Summary of Major Provisions of PPACA Affecting Dental Care • Inclusion of pediatric oral health care as essential service • Oral health care in conjunction with qualified health plans or as a stand-alone plan • Medicaid and CHIP Payment and Access Commission (MACPAC) will review and update payments to dental professionals • Medicare Advantage

  7. Dental Discepolo K and Kaplan K. (2011) The Patient Protection and Affordable Care Act Effects on Dental Care. NYSDJ • Support oral healthcare prevention activities • Support school-based dental sealant programs • Establish oral health leadership and program guidance • Update/Expand National Oral Health Surveillance System (NOHSS)

  8. Dental Discepolo K and Kaplan K. (2011) The Patient Protection and Affordable Care Act Effects on Dental Care. NYSDJ • Grants for school-based health centers • Medically accessible equipment ( including dental offices) • Dental cluster health training programs and demonstration projects for alternative dental health care providers • New and expanded teaching health centers

  9. Rural Essential Health Benefits: … the Secretary (Dept. HHS) shall define the essential health benefits, except that such benefits shall include at least the following general categories and the items and services covered with the categories: … (J) Pediatric services, including oral and vision care … http://www.cdhp.org/resource/summary_oral_health_provisions_health_care_reform

  10. Rural “Requires that Medicaid and CHIP Payment and Access Commission (MACPAC) to review and report to Congress on payments to dental professionals.” … payments to …rural health clinics …. http://www.cdhp.org/resource/summary_oral_health_provisions_health_care_reform

  11. Rural “Establishes five-year, $4 million demonstration projects to test alternative dental health care providers.” … in order to increase access to dental health care services in rural and other underserved communities. http://www.cdhp.org/resource/summary_oral_health_provisions_health_care_reform

  12. Rural “Establishes a public health workforce track, including funding for scholarships and loan repayment programs for dental students and grants to dental schools.” … It shall be so organized to graduate not less than … 100 dental students annually; … rural communities …. http://www.cdhp.org/resource/summary_oral_health_provisions_health_care_reform

  13. However,

  14. Reservations Discepolo K and Kaplan K. (2011) The Patient Protection and Affordable Care Act Effects on Dental Care. NYSDJ Dental organizations that were opposed to this legislation: American Dental Association (ADA) and six others dental organizations American Academy of Oral and Maxillofacial Surgeons (AAOMS) Dental organizations that expressed concerns with the legislation: Academy of General Dentistry (AGD)

  15. Political Reality Discepolo K and Kaplan K. (2011) The Patient Protection and Affordable Care Act Effects on Dental Care. NYSDJ “Passage of this bill provides authorization for its provisions but does not guarantee funding. Funding is a highly political issue that will change with time”

  16. Discussion

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