[Congressional Record Volume 143, Number 42 (Thursday, April 10, 1997)]
[Extensions of Remarks]
[Page E634]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              MEDICARE MEDICALLY NECESSARY DENTAL CARE ACT

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                          HON. STENY H. HOYER

                              of maryland

                    in the house of representatives

                        Thursday, April 10, 1997

  Mr. HOYER. Mr. Speaker, I am pleased to introduce today, along with 
Congressmen Cardin and Stark, the Medicare Medically Necessary Dental 
Care Act. This bill will improve health care for thousands of senior 
citizens and save the Nation millions of dollars in Medicare costs.
  Under current law, Medicare cannot pay for outpatient dental work. 
However, untreated dental problems can lead to expensive complications 
when other unrelated procedures are performed. The failure to treat 
these conditions has both a high cost in suffering for seniors and a 
high price tag for Medicare.
  The Medically Necessary Dental Care Act would permit Medicare to pay 
for dental care when it is necessary to prevent complications in 
valvular heart disease, cancer of the head or neck, lymphoma, leukemia, 
and organ transplants. While expanding dental coverage in these areas 
is estimated to cost nearly $17 million, the act would save Medicare 
about $117 million by preventing further complications. The bill would 
also give the Secretary of the Department of Health and Human Services 
the authority to expand coverage of medically necessary oral health 
care in connection with other medical problems if the Health Care 
Finance Administration determines that the dental coverage will result 
in cost savings to Medicare.
  Take the case of Alma, a senior citizen in Baltimore who underwent a 
heart valve replacement surgery. Not long ago, she went to the 
University of Maryland medical system emergency room with a racing 
heart, fever, chills, and pain in her mouth. Alma was diagnosed with an 
acute abscess over her upper front teeth which had led to a systemwide 
infection. She was hospitalized, and will have to undergo 6 weeks of 
intravenous antibiotics to knock out the infection. In addition. she 
will probably have to have her heart valves replaced again.
  In many ways, Alma is lucky. Dental infection is a common cause of 
complications in heart valve replacement patients, and some die before 
their infection can be stabilized. Medicare covered the cost of Alma's 
hospitalization, and will pay the $20,000 to $40,000 bill if her heart 
valves have to be replaced again. But all of this could have been 
avoided by a simple dental checkup and treatment before her first 
surgery.
  A few years ago, James, another Maryland senior, was diagnosed with 
neck cancer and treated with radiation therapy to his head and neck. 
Over time, James started to feel pain in his lower jaw, and to have 
difficulty opening his mouth. His doctor diagnosed a jaw fracture, 
caused by radiation-related complications of previously infected teeth. 
To cure the problem, James underwent three surgeries, including removal 
of a portion of his jaw and a hip graft to replace it. Removal of 
James's infected teeth before radiation would have cost less than $300, 
but Medicare covered the actual cost of $27,950.
  This bill is supported by the American Association of Hospital 
Dentists, the American Society for Geriatric Dentistry, the Academy of 
Dentistry for Persons With Disabilities, the American Association of 
Dental Research, the American Academy of Pediatric Dentistry, the 
American Association of Dental Schools, and the American Association of 
Public Health Dentistry. More importantly, it will save taxpayers 
millions, while improving the quality of life for senior citizens. I 
urge my colleagues to join me in supporting this important legislation.

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