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News Bulletin : ADA News Bulletin September 2010
13 SEPTEMBER 2010 Update: MEDICARE CHRONIC DENTAL DISEASE SCHEME Members will have noted regular reports published in various ADA publications on activity associated with dentists' use of the Medicare Chronic Dental Disease Scheme (CDDS). Since late 2009, when the ADA was first advised by Medicare Australia (Medicare) of audit processes being implemented surrounding the CDDS, the ADA has been in constant communication with Medicare as to their actions. Through its publications, the ADA has kept members informed as to dentists' requirements and obligations for work done pursuant to the CDDS. It was evident from early meetings with Medicare, there were two very distinct concerns being addressed: • Abuse and exploitation of the CDDS by some dentists; and • Technical non-compliance with rules applicable to the CDDS. The ADA made it clear to Medicare that it would not condone fraud and would assist Medicare in dealing with such cases. A major concern to Medicare (and the ADA) was that in many instances where treatment had been provided under the CDDS, dentists had not been fully compliant with the administrative requirements. Two major administrative requirements not being observed were the need to: • provide a treatment plan for the dental treatment to be undertaken to the Medical General Practitioner (MGP); and • advise the patient of the anticipated cost of the treatment to be undertaken. ADA felt it was important for Medicare to be made aware of dentists' lack of familiarity with the CDDS requirements and to alert Medicare that non-compliance with these administrative requirements was in most cases innocent and done out of ignorance of the requirements. Medicare was advised that comments made by the Federal Health Minister advising of immediate closure of the CDDS had also imposed significant pressure on dentists to meet patient needs before closure. These matters lead dentists to inadvertently overlook the technical aspects of the scheme (See: ADA Member website - Item of interest: 16 July 2010 Exchanges of correspondence between ADA and Medicare Australia). Notwithstanding this Medicare advised ADA that dentists' non-compliant behaviour under the CDDS was widespread and indicated that a preliminary audit process would begin and depending on what was revealed may escalate into a wider audit process. During the first half of 2010, Medicare continued to inform ADA of the nature and extent of the audit process. Through contact with members, ADA became aware of a poor lack of appreciation by dentists as to the fundamental importance of compliance with the CDDS administrative requirements. Medicare was advised of this. Regular reports and advice were published in ADA publications. Considerable assistance has been provided by Branches in this process particularly, ADANSW and Dr David Sweeney. It should be remembered that contemporaneously with this activity was the Government's efforts to implement a Commonwealth Dental Health Program (CDHP) which would have provided funding to States and Territories to bolster public dental services. This legislation was not passed as the Government insisted that the CDDS be closed down as a prerequisite for establishment of the CDHP. The Senate did not oblige and a stalemate has resulted with the continuation of the CDDS. In mid-year, ADA suggested that Medicare should again alert dentists as to the administrative requirements of the CDDS. This culminated in all practitioners receiving a letter of advice and instruction from Medicare as to the absolute necessity for compliance with its requirements. At this time, adverse publicity was created which suggested rorting of the CDDS by dentists. Budget blowouts in respect of the CDDS were said to be solely attributable to abuse by dentists. The ADA met this head on and published rebuttals to the press reports. Media releases and discussions with journalists set the record straight that in the vast majority of cases the so
ADA News Bulletin August 2010
ADA News Bulletin October 2010