Regulatory News Headlines:

LEGISLATIVE UPDATE

Infection Control Requirements

Good news.....

The Dental Board of California confirmed
on Friday, February 26, 2010 that, under the
new dental assisting law created by AB 2637
(Eng) two years ago, dentists must ensure
that only newly hired dental assistants that
are unlicensed must complete a
board-approved, eight hour infection
control course within their first year of
employment in that office. 

Initially it was thought that this section of 
the law applied to all dental assistants, 
making compliance almost impossible 
for course providers.

 

         

 RED FLAGS RULE

Compliance for the Red Flags Rule has been delayed once again and is now 
scheduled to take effect December 31, 2010. The Red Flags Rule is under the jurisdication of the Federal Trade Commission.  It extends the definition of a creditor to any entity that provides a service under a payment plan agreed upon by the provider and the customer.  The definition would apply to many orthodontic practices.  If even one patient receives services under a payment plan, an orthodontic practice would thus be a creditor. 

The final Red Flags Rule is expected to include provisions that any entity employing 20 or more employees and that extends credit to consumers must comply with new rules on identity-theft protection.

The Red Flags Rule will require the creditor to develop a written plan listing each aspect of office systems and standard procedures that could be vulnerable to efforts to obtain information about patients who are receiving credit. The plan must include safeguard procedures for all “red-flagged” items, designed to help prevent identity thieves from getting confidential information. Read more information and access sample documents to help your office comply.

The AAO Guide to Red Flags Rule includes recommendations for plan development and implementation, as well as documentation of steps taken to prevent identity theft.  Other information includes suggested scheduling of general plan updates and a listing of events that may necessitate plan updates, such as installation of new software or changeover to a new bank.

For additional details or answers to specific questions related to your practice, consult your legal counsel. For more information about the AAO Guide to Red Flags Rule, contact Kevin Dillard, AAO assistant general counsel, at 800.424.2841, ext. 525 or kdillard@aaortho.org. Click here to read more about the Red Flags Rule and to download the complete Federal Trade Commission guide.

News of Legislation and Regulations:

   

The California Dental Association and the California Association of Orthodontists – Partners in Advocacy

 

Michelle Rivas

Legislative Advocate &

Manager, External Affairs

California Dental Association

 Members of the California Dental Association and the California Association of Orthodontists have worked together over the years for the benefit of all dentists in the state.

 Legislation is introduced every year in Sacramento that has a direct impact on the dental profession and the patients you treat.   The CDA Public Policy department has staff that reads every bill introduced by the Legislature, analyzes it for any impact it may have on dentistry and provides that information to the CDA Government Affairs Council which then decides what position the organization will take and gives direction to staff.

 Additionally, we have been directed by the membership to be more proactive in dealing with third-party payer issues.   CDA has sponsored legislation the past few years to deal with specific issues as they relate to insurance issues of concern to the membership.

 Our advocacy efforts are truly a team effort – our team includes professional legislative advocates, policy experts and of course, individual members of CDA and CAO.  Participation by individual dentists is more important than ever before.  Organized dentistry understands that and has worked as closely with the members of CDA and CAO to move our legislative agenda forward.

 Here are a few examples of our successes:

Advertising Restrictions:  Legislation was introduced in 2008 as an attempt to help health care consumers verify the licensure status of their providers, by requiring providers (including dentists) to include in all “public communications” their license number, the web site and telephone number of their licensing agency, and a notice that the consumer can contact that agency for more information.  While sympathetic to the author’s and sponsor’s intentions, CDA expressed serious concern that the bill’s definitions were overly broad in scope and impractical, potentially requiring, for example, dentists to include their license number and the Dental Board’s web site and telephone number on toothbrushes that they provide at community health fairs.  Although CDA offered several amendments to modify the bill’s practical impact on providers, agreement was not reached with the author and sponsor as the bill moved through the Assembly, and CDA was forced to actively oppose the bill on the Assembly floor, where it was defeated on May 29th by a vote of 16-36. 

Mercury/Dental Amalgam Regulation:  In 2008 legislation was introduced which was intended to allow the state Department of Toxic Substances Control to begin regulating “chemicals of concern” that are potentially hazardous to health.  Mercury was included as a chemical of concern that could be regulated by the state.  Because mercury is one of the elements contained in encapsulated form in dental amalgam fillings, CDA was concerned that this bill could result in duplicative state regulation of dental amalgam that could needlessly drive up the cost of restorative materials to patients.  Because chemicals such as mercury already are regulated by the federal Food and Drug Administration, CDA opposed the legislation unless it was amended to exempt all dental restorative materials.  In response to CDA’s opposition, when the bill was taken up for a vote on the Assembly floor, the author pledged to amend the bill in the Senate to exempt dental restorative materials.  That amendment was made on June 17th, at which point CDA removed its opposition to the bill, which then passed both houses and was signed by the governor in late September. 

Dental Practice Ownership Transition:  California’s Dental Practice Act specifies that only a licensed dentist can own and operate a dental practice, including hiring other dentists.  This law is rightly intended to prevent the corporate practice of dentistry, but it had significant, arguably unintended consequences for families and patients when a dentist owner dies unexpectedly or becomes incapacitated and his or her spouse or estate wishes to keep the practice operating while they attempt to sell it permanently, were prohibited from doing so.  To remedy this unique and temporary situation in a way that encourages continuity of care for patients, CDA sponsored legislation to allow an estate, trustee, or other legal representative to employ or contract with dentists and otherwise operate the practice of a deceased or incapacitated dentist for up to 12 months, while assuring that patients are appropriately notified and assuring that the temporary operator of the practice does not interfere with a contracting dentist’s professional judgment.  As the bill moved through the legislature, amendments were adopted to clarify the legal authority for dentists to place their practices into trusteeships as a way to prepare in advance for such an eventuality.  The legislation passed by both houses with unanimous votes and was signed by the governor on October 10th. 

Denti-Cal Orthodontic Billing:   In 2007 CDA met with members of CAO to discuss the issue of Denti-Cal coverage for medically necessary orthodontic services and the requirement of submission of claims based only on monthly patient visits, which is inconsistent with the standard of care.   The requirement for monthly claim submittals forced orthodontists to schedule Denti-Cal patients for monthly visits that do not fit within the ideal sequence of treatment, which created a significant disincentive for orthodontists to participate as Denti-Cal providers.  CDA/CAO therefore sponsored legislation, to allow orthodontists to be reimbursed on a quarterly basis.  This gave participating orthodontists the ability to “bundle” a series of treatment visits into a single quarterly claim submittal, enabling them to schedule their patients’ treatment visits on a schedule fully consistent with the standard of care. 

Dental Plan Coordination of Benefits Policies:  “Coordination of benefits” is the means by which two insurance plans determine their relative responsibilities when a patient has dual coverage.  In recent years, CDA’s members and their patients had seen increasing instances in which dental plans that are the secondary payers were using “non-duplication” clauses and other similar policies to deny any additional reimbursement beyond what the primary plan has already paid.  CDA believed that these policies unfairly short-change patients and employers who have paid premiums to the secondary payer with the expectation that benefits will in fact be provided.  Therefore, CDA sponsored legislation requiring dental plans, when they are secondary payers, to provide supplemental reimbursement for the patient’s out-of-pocket costs under the primary plan for benefits covered by the secondary plan and require all dental plans to clearly disclose their coordination of benefits policies in the evidence of coverage documents they provide to their enrollees.  The legislation passed through both houses of the legislature with unanimous votes and was signed by the Governor. 

In the crowded hallways of the Capitol, lobbyists compete for legislator's time and attention and a chance to discuss their issues.   Your involvement is encouraged and very much appreciated.   To be truly successful, we all must continue to work together for the benefit of the profession of dentistry.

 

 

 Summary of CDC Guidelines for Infection Control in Dentistry

The Center for Disease Control and Prevention (CDC) released  guidelines for infection control for dentistry on December 19, 2003 - 10 years after the previous update of such guidelines.

You can view the full 68 page guideline at: http://www.ada.org/sections/publicResources/pdfs/guidelines_cdc_infection.pdf 

For further information on state regulations and dental practice in California, please click here.