Medicare Rescinding Enrollment Requirement for Part C Advantage Plan and Part D Drug Coverage

Dentists now will be able to continue providing dental care and prescriptions for Medicare Advantage and Part D drug plan beneficiaries, without having to enroll or opt out of Medicare prior to providing services.

The ADA has successfully advocated for changes to the Centers for Medicare & Medicaid Services (CMS) requirement that dentists enroll-in or opt-out of Medicare in order for their patients’ Part D drug prescriptions to be covered.

However, the ADA News reports that CMS “has not rescinded the two-year opt-out period for providers, meaning dentists who acted in good faith and chose to opt out of the program are still prohibited from accepting payments for services covered by Medicare Part B or Medicare Advantage plans.” As a result, the claims of patients who receive care from a provider who opted out within the past two years still will be denied.

These changes do not effect enrollment requirements for dentists who perform treatment covered by Medicare Part B or who fabricate appliances for patients with sleep-related disorders. 

For more information on the requirement changes and a list of opted out providers, visit CMS.gov.