The decision to remove scaling and polishing from the list of insured services under Nova Scotia’s Children’s Oral Health Program this month was based on a report from the Oral Health Advisory Group in February 2015.
The change was overruled yesterday by Premier Stephen McNeil, who told reporters it was made by a bureaucrat and was not cleared by elected officials.
“What was covered yesterday, what we paid for yesterday, we will pay for tomorrow,” McNeil said.
A Department of Health and Wellness notice dated July 12 says that minor scaling and polishing would no longer be covered under MSI, which covers children under the age of 15 for dental services. The Nova Scotia Dental Association notified its members in a memo dated July 24.
Removing those services from a specific billing code for preventive care is just one part of what was recommended by the Oral Health Advisory Group. The group’s report suggests adjusting the billing codes to provide more preventive services to high risk beneficiaries, and better track their use.
“Most patients require de-plaquing, but Dalhousie School of Dentistry teaches it is better to de-plaque using a brush rather than a rubber cup. Scaling procedures, typically only for older children, should be billed and tracked as a separate procedure,” the report says.
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The advisory group’s recommendation to government was to insure one unit of scaling for all children age 10 and over once per year, and monitor how often it is being done by creating a separate billing code. It estimates that 80 per cent of children over age 10 would need scaling. The annual estimated cost for this is listed at $237,336.
In total there are 11 recommendations in the report. When asked why part of one recommendation was implemented this month, a spokesperson for the department said in an email that the timing was “not related to anything specific.”
“Technical discussions between the Nova Scotia Dental Association and department staff to clarify the nature and scope of billing codes resulted in the change. That change had an unintended impact that was not recognized and therefore not brought forward for approval by decision makers,” said spokesperson Chrissy Matheson.
“As indicated yesterday, there will be no changes to the Children’s Oral Health Program. Services covered in the past will still be covered.”
The province says the department’s deputy minister and minister were not aware of the bulletin or its timing.
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