Health Reform Implementation

Health Connector

The MA Health Connector is an independent state agency that helps Massachusetts residents find health insurance coverage and avoid tax penalties.

Go to the Health Connector
 

Connector & the ACA

The ACA is changing the way that the MA Health Connector operates. The state has launched a new website to help individuals and small businesses understand these changes.

Visit the New Connector Site
 

 

Grassroots Network

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The goal of the MDS Grassroots Network is to ensure that every legislator has the most accurate information about dentistry and oral health in the Commonwealth.

Join Now!

MDS Legislative Agenda

Click for more information and a fact sheet on each bill.

Legislative Home
 

ADA Consumer Information Checklist

Beginning October 1st, 2014, individuals and families will have the option to purchase dental coverage in Massachusetts, many for the first time. The ADA has developed a "Consumer Information Checklist" that you can provide to patients to help them make informed decisions about purchasing dental plans through the Health Connector. 

Go to the ADA Consumer Information Checklist
 
 

Resources Available Through Health Connector

The Health Connector has published a number of resources to help Massachusetts residents and businesses understand the local impact of the ACA.  These booklets include "The Massachusetts Consumer's Comprehensive Guide to National Health Reform" and "The Massachusetts Employer's Comprehensive Guide to National Health Reform."  You can also click on the link below to download all of the available resources through the Health Connector's website.

Go to Health Connector Resources Page
 
 

Health Connector Approves Dental Plans

On September 12, 2013, the Health Connector Board awarded 2014 Final Seal of Approval to dental plans to be offered through the Connector for 2014.  A total of 24 plans were approved from the following carriers: Altus Dental, Blue Cross Blue Shield of Massachusetts, Delta Dental of Massachusetts, Guardian, and MetLife.  Click on the link below for more information (the section on Qualified Dental Plans begins on page  16).

Go to the Health Connector Seal of Approval Presentation
 
 

ACA Employer Notification Requirement 

The Patient Protection and Affordable Care Act (ACA) requires employers to issue a Marketplace Notification to current employees by October 1, 2013, and to new hires within 14 days of the employee’s start date. This is a requirement for all employers for whom the Fair Labor Standards Act (FLSA) applies. The purpose of this requirement is to help employees understand the Massachusetts Health Connector insurance marketplace. 

To learn more about this requirement, including how to determine if you need to comply with the FLSA and to download a customizable Massachusetts ACA Marketplace Notification template, visit. www.massdental.org/acanotice.

Learn More about the ACA Notification Requirements
 

  

The Affordable Care Act & Oral Health: Changing Dental Benefits Landscape

The ADA's third article in an ongoing series speculates about the effect of the ACA on dental benefits.

Go to the ADA's Projections

 

 

The Affordable Care Act and Oral Health: Dental Benefits Examined

The ADA has released the second in a series of articles focused on the impact of the ACA on oral health. The latest edition focuses on changes in dental benefit coverage.

Go to the ADA Examination of Dental Benefits

 

 

The Affordable Care Act and Oral Health: ADA Analysis of Impact

The American Dental Association (ADA) recently launched the first in a series of articles dedicated to update information on certain aspects of the Affordable Care Act (ACA) and its potential effects on dentistry and the oral health of the American public. The series begins with some preliminary questions regarding the ACA and a short retrospective.

Go to the ADA analysis

 

 

Understanding the ACA

Many are still confused about what the Affordable Care Act means for dentists as providers, employers, and health care consumers. The Kaiser Family Foundation has created a short video summarizing the major provisions of the ACA in an entertaining and accessible way.  

View "The YouToons Get Ready for Obamacare"

 

 

MA Health Connector Conditionally Approves Dental Plans

The Massachusetts Health Connector Authority (Connector) has awarded the 2014 Conditional Seal of Approval to 31 Qualified Dental Plans (QDP). While a final award of the Seal of Approval will take place in September, it is likely that these plans will be offered to consumers in the Connector beginning in October. 

 

The 31 plans represent offerings from five different issuers: Altus Dental, Blue Cross Blue Shield of Massachusetts, Delta Dental of Massachusetts, Guardian, and MetLife. All five issuers submitted small group plans, with only Delta Dental and Altus Dental offering non-group (individual plans). Twenty-one of the plans fit the standardized requirements of the Connector (see Jean Yang's presentation below), while 10 are non-standardized plans. Please click on the link below for more information about these plans (the QDP recommendations begin on page 19).

View the QDP Recommendations

 

 

Essential Health Benefits, Standalone Dental Plans & Health Connector Certification

On April 3, 2013, Jean Yang, executive director of the Massachusetts Health Connector Authority, delivered the keynote address at Beacon Hill Day.  Her presentation, entitled "Essential Health Benefits, Standalone Dental Plans, and Health Connector Certification," provided a detailed look at ACA implementation as it pertains to pediatric dental benefits. Ms. Yang answered several questions from the audience and stated that she was interested in working with the MDS on several issues. Please click on the link below to review her presentation.

View the Presentation

 

 

Medical Device Tax Update

The ADA website contains valuable information about the implementation of the medical device tax, and there are four key facts that dentists should know:

  • Dentists will not be responsible for collecting, reporting, or paying the new 2.3 percent tax.
  • The tax on "devices" specific to dentistry will, in many cases, be applied to the materials from which dental devices are manufactured rather than to the customized items supplied by a dental laboratory, whether or not a device is ultimately adjusted and adapted by the dentist for a patient.
  • The tax will result in some increased costs for dentists and dental patients.
  • Dentists should be alert in reviewing manufacturer and vendor price lists and invoices to make sure that the 2.3 percent tax is not applied as a general cost increase with respect to all items, but is only being applied in cases where the law so requires.
Go to the ADA Excise Tax Alert

 

 

MassHealth Primary Care Payment Reform

The cost containment law in Massachusetts ("Ch. 224") requires that MassHealth and other state agencies lead the way in adopting alternative payment models.  There are currently no plans to include dental benefits in these alternative methods.  It is important, however, to understand where MassHealth is heading both as providers and consumers of health care.  The link below will take you to a presentation delivered by Dr. Julian Harris, director of MassHealth, at a recent conference on alternative payment and delivery models.

View the Primary Care Payment Reform Initiative Presentation

 

 

Our Exchange: the Massachusetts Health Connector

The Massachusetts Health Connector ("Connector") has received conditional approval from the federal government to be our state's exchange when the full implementation of the Affordable Care Act ("ACA") takes effect. The Connector board and staff have been working diligently to ensure that it received this approval. While the initial work does not directly impact dentists as providers, it is valuable information for those who may be interested in knowing more about ACA implementation. Click on the links below to view presentations by the Connector staff on ACA implementation, as well as steps that are being taken in 2013 to begin to bring offered plans to where they will need to be in 2014.

 

 

Massachusetts Selects EHB Benchmark Plan

The ACA requires that plans available in the small group and individual market cover 10 Essential Health Benefits ("EHB"), including a pediatric dental benefit. States are to define the EHB by selecting a "benchmark plan," and in Massachusetts, that task fell to the Division of Insurance (DOI). The DOI selected the Blue Cross Blue Shield of Massachusetts HMO Blue plan as the benchmark, but that plan does not include a pediatric dental benefit. Therefore, the DOI recommended that the plan be supplemented with the Massachusetts Children's Health Insurance Program (CHIP) dental benefit.


Read the MA CHIP Dental Benefit Booklet

 

 

Introduction & Glossary

The Patient Protection and Affordable Care Act (ACA)—more commonly referred to as "Obamacare"—is already impacting you as a dentist and as a patient yourself. Massachusetts has already embarked on a project of sweeping "payment reform" with the passage of health care cost containment legislation. The MDS recognizes that these issues directly impact our members and we have created this website to keep you informed.  Please check back regularly, as we will add more information as it becomes available from the American Dental Association, the federal and state governments, and other sources.

Like most policy discussions, health care reform has its own confusing vocabulary and alphabet soup of acronyms. WBUR has created a useful glossary of terms that we hope you'll find useful when reviewing the materials below.

Go to the Health Reform Glossary

 

 

Effects on Dentistry

According to the ADA, "The Affordable Care Act has the potential to reshape health care in America. The expansion of medical insurance coverage, a move toward more integrated care delivery, and significant changes to how health care is financed are some of the main changes expected. Several aspects of the ACA have important implications for dentists as oral health care professionals and small business employers, as well as consumers of medical care."

Go to the ADA's "Potential Effects of the ACA on Dentistry" Report

 

 

 

The Massachusetts Perspective

Massachusetts Health Reform Home Page

In Massachusetts, the implementation of the ACA will fall largely on the Executive Office of Health and Human Services.  Follow the link above to access the EOHHS "National Health Care Reform" homepage, where you can access additional information and sign up to receive implementation updates via email.

How Does Health Reform Affect You in Massachusetts?

The impact of the ACA in Massachusetts is fairly unique because of our existing health care reform. EOHHS has also developed a useful guide on how the federal law impacts us here that you can access via the link above.


 

Payment Reform

This year, Governor Deval Patrick signed a sweeping health care cost containment and quality improvement legislation into law. (Click here to read a summary of the law). While the law does not specifically address the delivery of oral health care, there are a number of provisions that will impact dentists as providers and health care consumers. Most notably, the law makes significant reforms to medical malpractice laws and investments in community-based prevention efforts.


Go to the Implementing Health Cost Containment site