Kidney Community Applauds Proposed Expanded Access to Dental Services for Medicare Beneficiaries

August 25, 2022

WASHINGTON – Kidney Care Partners (KCP) – the nation’s largest non-profit, non-partisan coalition of more than 30 organizations representing patients, professional care providers, and a wide range of kidney care stakeholders –  has sent a letter of support to the Centers for Medicare and Medicaid Services (CMS) for a proposed rule that would expand access to dental services for individuals with kidney failure seeking transplant and asked that the agency consider expanding the provision to include all individuals receiving dialysis under the Medicare benefit.

“Research has long recognized that dental health can impact health outcomes for individuals living with end-stage kidney disease and we know this population has more severe oral disease than the general population,” said John P. Butler, chair of KCP. “Furthermore, oral infections can disqualify an individual from a kidney transplant. Expansion of dental health coverage is a commonsense fix that also happens to be the right policy for patients.”

The proposed rule clarifies that payment can be made under Medicare Part A and Part B for dental services that are related and integral to the clinical success of an otherwise covered medical service, like a renal organ transplant surgery, and covers services in either an inpatient or outpatient setting. The rule also notes that CMS will provide coverage for necessary dental treatments and diagnostics to eliminate oral or dental infections found during a dental or oral examination as part of a comprehensive workup prior to an organ transplant. Coverage will also be provided for services that are ancillary to these dental services, such as x-rays, administration of anesthesia, and use of the operating room.

KCP also asked that CMS consider further expanding dental services, such as regular dental exams and the ancillary services provided with them, to all individuals receiving dialysis under the Medicare benefit. The group’s clinician members report that bloodstream infections in patients living with kidney disease often begin in the mouth and recognize that regular dental visits could help reduce infections. Oral infections can also threaten transplant qualification, given that immunosuppressed transplant recipients are more susceptible to infection. In addition, individuals with poor oral health often experience periodontal diseases that can make managing anemia more difficult and increase the need for erythropoietin stimulating agents (ESAs).

“Without Medicare coverage, many beneficiaries may not have access to dental services, so we applaud CMS for expanding access to dental services for individuals with kidney failure seeking transplant and ask they consider expanding dental coverage to all Medicare beneficiaries receiving dialysis,” Butler concluded.