Closure of controversial dental scheme a step closer—but dentists remain in the dark

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Following the announcement of a $4 billion dental package directed at children and those on low incomes, the Government has moved to close down the controversial Chronic Disease Dental Scheme (CDDS). The Health Insurance (Dental Services) Amendment Determination 2012 (No. 1), registered on 6 September 2012, amends the Health Insurance (Dental Services) Determination 2007 to bring about a staged cessation of the CDDS by 30 November 2012. The Determination is a disallowable legislative instrument which must be tabled in Parliament within six sitting days of registration. Either chamber can vote to disallow it within 15 sitting days, as this Senate brief explains.

Closure of the CDDS was flagged in the Health Minister’s announcement on the 29 August 2012, when details of the new dental package were announced. The CDDS has been controversial due to cost overruns, allegations of over-servicing and rorting, and administrative problems which prompted a Medicare audit of dentists participating in the scheme. 

At the time of the announcement of the dental package, the Health Minister indicated at her press conference that funding for the new dental program would be drawn from savings from other areas. However, the closure of the CDDS, which is estimated to cost government some $80 million a month, would not count towards funding the new dental package, as its closure had been factored into budget forecasts already. 

The CDDS is funded under Medicare, and while forward estimates of Medicare expenditure are included in budget forecasts, details of funding of specific programs under Medicare are not disaggregated. This makes it difficult to identify the level of savings the government expects from closing down the CDDS program. The Minister indicated that full costings, including where savings will be drawn from to fund the dental package, would be made available in the Mid Year Economic and Fiscal Outlook (MYEFO). 

While MYEFO should provide some clarity over the funding of the new scheme, a number of questions remain unaddressed—some of these were discussed in this previous Flagpost. Another is whether or not the government will continue to pursue reimbursement from dentists the audit revealed had failed to keep proper administrative records, or those it identified as making incorrect claims. The issue was the subject of legislation before the Senate which would have required the Minister for Human Services to drop this action. Following a Senate inquiry Minister Carr stated he would review the government’s approach to the audit and issue a new Determination that would at least in part address some of the concerns dentists had raised at the Senate inquiry. 

The Determination registered on 6 September does not refer specifically to the audit or the undertaking made by the Minister, which may disappoint some dentists who remain under audit scrutiny. It remains to be seen whether the Government will meet its commitment and issue a revised Determination that reflects the statement made by Minister Carr.