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Call free with all of your burning HR questions – SDDS Member benefit!

1-800-399-5331

SDDS Design Department

The SDDS Design Department is open and ready for your business. As a member benefit, our Design Department is ready to help our SDDS Members. This member benefit is something that we think will be a great opportunity for our SDDS members only. We are excited to share our talents with you – hope you call us! Click here for more information.

Job Bank

The SDDS Job Bank is a service offered only to SDDS Members. It provides a forum for job-seekers to reach other Society members who may be looking for dentists to round out their practice, and vice versa. If you are a job seeker, associate seeker, selling or buying a practice, contact SDDS at (916) 446-1227 and cash into the SDDS Job Bank!
Click here to be listed in the Job Bank

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Name Phone / Fax Email Dental School Location Specialty
Nima Aflatooni, DDS P: 916.635.9605 F: 916.635.9605 drnima[at]goldriversmiles.com Pacific Dusoni (2010) Gold River (P/T) General
Ashkan Alizadeh, DDS P: 916.487.7148 F: 916.487.1468 alizadehdds[at]gmail.com NYU (2003) Sacramento, (F/T)(P/T) General
Marjoorie Castro, DDS P: 916.538.6900 drcastro[at]sacramentodentistry.com Pontificia Universidad Javeriana (1989) Sacramento(F/T) General
George Chen, DDS P: 916.983.6051
F: 916.983.6201
drchen[at]folsomdentist.com Loma Linda 1991) Folsom (Part) General
Reuben Clark, DDS P: 916.251.6810 F: reubenjclark[at]gmail.com UT (2008) El Dorado Hills (F/T,P/T) General
Gary Clusserath, DMD P: 425.444.0500 F: 916.773.4348 gcluss[at]gmail.com OHSU/Portland (1987) Roseville, Citrus Heights P/T 3 days per week, inc Friday) General
Raul Contreras, DMD P: 530.885.6559 F: 530.885.4142 raulcontrerasdmd[at]gmail.com Temple University (2011) Auburn (P/T 2-4 days per week) General
Eloisa Espiritu, DDS P: 916.204.2819 eloisadds[at]yahoo.com UCSF(2002) Lincoln(F/T & P/T) General
Timothy Herman, DDS P: 916.408.5557
F: 916.409.5557
timhermandds[at]gmail.com UCSF (1988) Lincoln (F/T & P/T) General
Neelofar Khan, DDS/> P: 530.933.1527
F: 916.575.9413
khan_nosheen[at]hotmail.com De’Montmorency College of Dentistry (1999) Sacramento (P/T) General
KidsCare Dental Group and Orthodontics P: 916.678.3565
F: 916.469.2293
tkillian at yahoo.com; dday@kidscaredental.com Peds
KidsCare Dental Group and Orthodontics P: 916.678.3565
F: 916.469.2293
tkillian[at]yahoo.com;dday@kidscaredental.com Rancho Cordova, (F/T) Ortho
Hua Youn Kim, DDS P: 916.549.7446 kimhwayoun[at]gmail.com Seoul National University (1981) Sacramento (P/T) General
Laurie LaDow,DDS P: 916.689.6240 ladowddsinc[at]gmail.com USC (1987) Sacramento, Elk Grove (P/T, F/T) General
Make A Smile Childrens Dental P: 916.984.0304 resume[at]makeasmile.com UOP(2008), Univ Nevada 2012 Sacramento (F/T,P/T) GP, Peds
Abdon Manaloto,DDS P: 916.784.1144 abdon[at]rosevilledentist.com UCSF(1995) Roseville (F/T,P/T) GP
Thomas McKelvey, DDS P: 209.639.9851 hcmckelvey[at]gmail.com LLUSD(1986) Twain Harte (F/T) GP
Ferris Nazeri, DMD P: 916.923.3636 t
td>drnazeri[at]yahoo.com
UCLA 2002) (VA Med Ctr 2007) Sacramento (F/T, P/T) Endo
Kayla Nguyen Dringenberg, DDS P: 916.784.1144
F: 916.786.2409
knd475[at]hotmail.com UCSF (2002) Roseville/Lincoln (F/T& P/T) General
David Park, DDS P: 310.403.1117 davidparkdds[at]gmail.com UCLA 2004 (F/T) General
Upendra Patel DDS 916.483.5566 upenpateldds[at]gmail.com Sacramento (P/T, F/T) GP
Quynh-Trang Pham, DDS P: 916.419.8777 F: 916.419.8787 quynh.pham62@yahoo.com Baylor College 1993 Sacramento (P/T) GP
Ike Rahimi, DDS frontdesk.ikerahimi[at]gmail.com Placerville (P/T) GP
David Roholt, DDS P: 530.885.5696 dhroholtdds[at]gmail.com Auburn (F/T) GP
Nathalie Selvanathan, DDS P: 916.967.0358 F: 916.967.0361 nathalie.s2014[at]gmail.com Citrus Heights (P/T) Oral Surgeon
Wellspace Health Organization P: 916.469.4701 eljohnson[at]wellspacehealth.org (P/T,F/T,Fill-In) General
Jerard Wilson, DDS P: 916.663.5555 yourdentist[at]rocklindentalcenter.com UCLA (1970) Rocklin (P/T) General
Jamson Wu DDS P: 916.402.5459 jwu@lagunacreekortho[at]gmail.com UCLA(1999) Elk Grove P/T Ortho
Raj Zanzi, DDS P: 916.705.0211 smile_dentist[at]yahoo.com Tufts Univ(1999) Roseville P/T Fri & 1 Sat/ month General

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Ladi Sorunke, DDS707.714.7144oladimejisorunke@yahoo.comUCSF(1987)Part/FullGPGaetan Tchamba, DDS916.691.1650drgtchamba@gmail.comLoma Linda (2016)Temp 2 Thurs/month OnlyGP

Name Phone Email Dental School Schedule Specialty
Russell Anders, DDS 530.644.3438 ra95709[at]gmail.com UOP (1965) P/T (fill in/Locum Tenens) General
Macy Fuhs, DDS 916.205.5670 mefuhs[at]gmail.com Loma Linda Univ (2017) P/T GP
Behdad Javdan, DDS 310.403.3479 bjavdan2013[at]gmail.com UCSF (2013) P/T, F/T Perio
Steve Murphy, DMD 412.855.9914 murphy.steve[at]hotmail.com University of Connecticut (2001)
Boston University (2007)
P/T, F/T Endo
Ronald Rott, DDS 916.835.3504 ronaldrott[at]gmail.com UCSF / University of Washington (1967) P/T Perio
Steve Saffold, DDS 916.442.6566 spsaff[at]att.net Georgetown (1977) EMERGENCY Fill In Only GP

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Name Phone Email School Schedule Specialty
Janis DuFort, RDH 916.2028766 janis8766[at]gmail.com F/T RDH

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Kayla Nguyen Dringenberg DDS 916.205.7405knd475[at]gmail.comUCSF (2002)RosevilleGeneralScott Snyder, DDS916.216.3929drsnyderdds[at]sbcglobal.netUCS (2000) GeneralLadi Sorunke, DDS707.718.7144oladimejisorunke[at]yahoo.comUCSF (1987) General

Name Phone Email Dental School Location Specialty
Behdad Javdan, DDS 310.403.3479 bjavdan2013[at]gmail.com UCSF (2013) Perio
Abdon Manaloto,DDS 916.784.1144 abdon[at]rosevilledentist.com UCSF (1995) Roseville General

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Name Phone Email Dental School Location Specialty
Paul Raskin, DDS 916.971.6700 praskin[at]neubite.com University of Detroit (1964) Sacramento General
Name not disclosed elkgrovedental96@gmail.com Elk Grove General

You Should Know

Reprinted with permission from the CDA

CDA’s newest subsidiary, The Dentists Service Company, officially launched its services to CDA members this summer. TDSC was established to support dentists with the business side of dentistry, specializing in practice management advising and group purchasing services.
CDA formed TDSC in response to members’ strong interest in CDA pursuing a management services company to help members be more competitive and efficient in an ever-evolving profession, while ensuring all clinical-care decisions and practice ownership remain with dentists.
TDSC’s practice management services take a comprehensive approach to practice advising, marketing and human resources. Member-clients work with TDSC experts as an extension of their team to build a strategic action plan geared toward their own practice goals and vision.
Visit https://www.tdsc.com/ to check it out!

Reprinted with permission from CDA

Gov. Jerry Brown and the California Legislature engaged in heated negotiations before passing a final budget by a constitutionally mandated deadline of June 15. A major focus of those negotiations was the use of Proposition 56 tobacco tax revenues, for which CDA and its partners engaged in an internal and external advocacy campaign. This campaign resulted in a $30 million ongoing allocation to the state dental director’s office and an initial state allocation of $140 million for increased Denti-Cal provider rates (totaling nearly $400 million, including federal matching funds) with the potential for substantially more in future budget years. The budget also includes the full restoration of the adult Denti-Cal program beginning in 2018. This budget investment was made possible by the passage of Proposition 56 last November. In an effort to expand the reach of dental care to some of California’s most vulnerable and underserved communities, CDA along with other health care providers and advocacy groups worked to pass this measure. Voters approved the additional $2 tax on tobacco products with the intention of funds going toward boosting reimbursements for medical and dental providers and improving access to care for the 14 million Californians enrolled in the state’s Medi-Cal program. Gov. Jerry Brown’s draft budget presented earlier this year ignored the will and intent of the voters and allocated all of the Proposition 56 funds to other priorities. Through direct advocacy to the Legislature and the Brown administration, CDA and its partners ensured that the state budget more accurately reflects the will of the voters and the intent of CDA’s membership in supporting Proposition 56. CDA members are a valuable part of this direct advocacy effort. Hearing from providers allows legislators to more fully appreciate the dire consequences of not more adequately funding Denti-Cal. CDA along with coalition partners asked members to reach out to key legislators. At this writing, over 12,000 emails from CDA members and others have been directed to key decision-makers. This makes a difference in CDA’s work in the Capitol and will make a difference to those who benefit from the expanded care.

CDA will keep members informed about the developments with Denti-Cal and Proposition 56 funding on cda.org and in the CDA Update. To learn more about CDA’s advocacy work, visit cda.org/advocacy.

Reprinted with permission from CDA

A San Francisco Superior Court judge has delayed dates related to CDA’s proposed settlement agreement with Delta Dental — the June 26 deadline to opt out or object to the proposed settlement and the Aug. 31 hearing on final approval. The court’s action will provide additional time for CDA, Delta Dental and the court to review procedures that were used to estimate the impact of the inflation adjustment percentage (INAP). Delta Dental’s INAP is the basis for the alleged underpayment to class members, and it was used to determine settlement amounts for Premier Providers who had their fees limited by this procedure. It is not yet known how this may affect settlement amounts for eligible Premier Providers; however, in response to a process used by counsel for CDA and the class to audit and verify calculations, Delta Dental has indicated that some amounts were undercalculated. The court has ordered the verification to be complete by Aug. 25, and legal counsel for CDA and the class is working to ensure the process is completed accurately. Additionally, CDA has requested that Delta Dental postpone any amendments to its Participating Dentists Agreements with Premier Providers until after the settlement with class members is finalized. This would apply to amendments that are part of the settlement, as well as the additional amendments Delta notified providers of in May. This issue is still under negotiation and discussion between the parties. The proposed settlement is the result of legal action that CDA fi led against Delta Dental on behalf of members to protect their rights to fair dealings after learning of Delta’s plans to reduce Premier Provider rates by 8 to 12 percent. The legal action successfully blocked Delta’s attempt to reduce reimbursement rates for over 3 ½ years, which saved dentists nearly a half-billion dollars in fee reimbursements.

CDA will continue to keep members informed about the proposed settlement agreement through the CDA Update, newsletter and cda.org. Additionally, class members can get additional information about the settlement by visiting deltadentalofcaliforniasettlement.com

Reprinted with permission from CDA

As most know, the Affordable Care Act of 2010 allows nonphysician health care providers to enroll as providers in the Medicare program or, alternatively, to formally opt out of Medicare. An amendment to the ACA allows providers who formally opt out of Medicare to write drug prescriptions for their patients, and Medicare will pay for those medications even though Medicare does not reimburse providers who opted out for basic care they rendered.

Most dentists have chosen to opt out of Medicare, but there’s another Medicare category that dentists should consider: Registering with Medicare as an Ordering/Referring provider.

What category, if any, a dentist should choose with Medicare is complicated by the fact that Medicare does not cover routine dental procedures. It will cover certain dental procedures that have a corresponding medical code — mainly oral surgery, periodontal surgery and lab work, for example. The federal Centers for Medicare and Medicaid Services allows specialists or generalists who perform procedures for which there are medical cross-codes to opt in to Medicare as a provider. This lets them be reimbursed for those procedures. But, again, for basic oral health care such as preventive, diagnostic and basic restorative, Medicare does not provide coverage. Most dental care provided to patients who are beneficiaries within Medicare is paid on a cash basis.

In what has become a series of delays in the compliance date, CMS is now giving dentists until Jan. 1, 2019, to decide if they want to opt in or out of Medicare. Dentists who choose the opt-out are letting CMS know they are choosing not to participate in Medicare and that any services provided to a patient covered by Medicare will be provided through private arrangement between the practice and the patient. The provider who opts out will not be able to submit a claim to Medicare, even if a procedure is a covered benefit in Medicare. However, Medicare will pay for the prescription for any dentist who has opted out of Medicare and who writes a prescription for a Medicare beneficiary.
While there is no penalty to the dentist who chooses not to opt out and who essentially doesn’t register as any other provider status, the dentist’s patients will need to pay out-of-pocket for their own medications. Therefore, most dentists are choosing to opt out to benefit the patients who are obtaining prescriptions.

However, another decision by CMS has caused problems for dentists who opt out. Medicare Advantage plans provide an option for seniors to enroll with a commercial administrator for Medicare benefits that let the beneficiary’s Medicare benefits be administered in a similar way to private insurance. Most of these Medicare Advantage plans have additional riders attached to the medical benefits. One typical rider is dental coverage that enrollees may obtain through payment of an additional premium. This makes it possible for a dentist to treat a patient who has Medicare Advantage and to submit a claim to the Medicare Advantage administrator as they would to any other dental insurer.
CMS made the decision that any provider (including a dentist) who sees a Medicare Advantage enrollee must at minimum be registered as an Ordering/ Referring provider with Medicare. Being “opted out” will not permit a provider to submit claims to a Medicare Advantage plan. Most Medicare Advantage medical plans contract with dental plans to provide the networks for the dental coverage being offered to Medicare enrollees. A dentist in the network of one of these dental plans utilized for Medicare Advantage who has formally taken the opt-out route for Medicare will not be able to remain in the dental plan contract and will have their contract terminated because of CMS’s rule that opted-out providers cannot participate in Medicare Advantage plans. Any provider who sees a Medicare Advantage enrollee must be registered as an Ordering/Referring provider with Medicare. Being “opted out” will not permit a provider to submit claims to a Medicare Advantage plan. So, a dentist would need to register with Medicare as an Ordering/Referring provider if the dentist sees patients covered by a Medicare Advantage plan and submits dental claims to the patient’s plan for the dental care the practice provides. The Ordering/Referring provider form is the CMS 855o (the letter “o”). The 855o form can be readily found on the CMS site or simply through an internet search for “CMS form 855o.” In summary:

  • You may submit an opt-out affidavit along with a sample private contract you will be using when providing care to Medicare beneficiaries, and Medicare will pay for those patients’ medications.
  • If you are in a dental plan network used by a Medicare Advantage plan and have opted out of Medicare, the dental plan will likely terminate you from its network. (This is the case even though the compliance deadline for Medicare enrollment is Jan. 1, 2019. Dental plans are already removing opted-out dentists from their networks.)
  • To remain in dental networks used by Medicare Advantage plans and to be able to submit dental claims to Medicare Advantage plans, the preferred enrollment alternative is Ordering/Referring provider using the CMS Form 855o.
  • Registering with Medicare in the Ordering/ Referring category does not enroll a dentist as a Medicare provider. That category will allow a dentist to participate within networks used by Medicare Advantage plans and will allow the dentist to submit claims to those plans. Registering as an Ordering/ Referring provider will allow Medicare to pay for patient’s medications prescribed by a dentist.

As with the opt-out affidavit, the 855o form must be submitted to the Medicare administrator for the state. For California, the administrator is Noridian Healthcare Solutions.

For dentists with an address in Northern California, forms must be submitted to: Noridian JE Part B – Northern CA Enrollment P.O. Box 6774, Fargo, ND 58108-6774

If in Southern California, the address is: Noridian JE Part B – Southern CA Enrollment P.O. Box 6775, Fargo, ND 58108-6775
For additional information on submission of Medicare enrollment forms, call Noridian Provider Enrollment at 855.609.9960

Reprinted with permission from CDA

Practice owners who have questions about dismissing a patient, giving a refund or terminating an employee are not alone. The Dentists Insurance Company reports these are the top three risk management issues facing dentists today. In fact, these issues make up the majority of calls received through the Risk Management Advice Line, TDIC Risk Management analysts say. While no two cases are exactly the same, they often follow similar patterns. Following are real-life calls and recommendations offered by TDIC RM analysts.

Patient dismissals

In one case reported to the Risk Management Advice Line, a patient refused to have her permanent crown seated. The patient had been wearing a temporary crown for more than two months. She came in for the final cementation, but she was not happy about the shade. The dentist sent it back to the lab to have it redone. The office called the patient several times, but she would not return to have the crown seated. The dentist had already redone several restorations in the past, because the patient was very selective. The patient said she was disappointed that the crown was the wrong color and she was tired of the dentist always making mistakes, so she decided to have a new dentist make her final crown. The dentist was frustrated because he spent a significant amount of his chairside time in addition to money for the lab fees, only to have her not follow through with treatment. The dentist wanted to know whether he could charge the patient for the lab fees he had paid to date. He also wanted to know whether he was required to provide 30 days of emergency care. RM analysts advised the dentist to follow up with a patient termination letter that indicates the patient ended the relationship. The letter should outline the risks associated with wearing a temporary crown. Because the patient terminated the relationship, the dentist is not required to provide 30 days of emergency care. Some insurance companies do not allow dentists to charge separately for lab fees. If there was no insurance and the patient paid cash, the dentist has the right to charge for services provided if these fees were explained to the patient prior to treatment. However, the dentist was advised that charging these fees could prompt the patient to fi le a grievance with her insurance company, lodge a complaint with the dental board or post negative reviews on social media. Sometimes, the repercussions can be worse than the loss incurred when waiving a fee.

Patient refunds

TDIC reports a case in which a dentist prepped a tooth for a crown. The dentist had placed several other crowns for this patient, and the procedures always went smoothly. The patient returned several times to the office with postoperative pain. The patient was very concerned that something was wrong and asked the dentist to redo the crown. The dentist believed the patient’s pain was endodontic in origin and suggested a root canal. They went over the charges and the patient begrudgingly paid the additional fee. The root canal was uneventful and the patient’s pain resolved. Later, the patient sent an angry email demanding a refund for the root canal claiming she was not warned before the crown preparation that a root canal could become necessary. The patient threatened to take legal action if she did not receive a full refund. After the doctor evaluated the chart, he realized that the patient had not signed a consent form, nor did the dentist’s notes reflect a conversation about the risks, benefits and alternatives related to crowns. The RM analyst confirmed that there was very little documentation indicating that the patient understood the risks and suggested that it might be a good idea to agree to a refund. TDIC recommended having a consent form signed and reviewed for each tooth or appointment. In addition, the analyst advised that continuing the relationship with this patient may be less than ideal because the patient appeared to have lost confidence in his abilities. The analyst suggested that given the patient’s current dissatisfaction, the doctor should consider dismissing the patient from the practice following formal dismissal protocols.

Employee termination

In another call to the RM Advice Line, a dentist reported that a registered dental assistant employed for just under a year showed up late for work, rolled her eyes at other employees and forgot to order supplies. The employee consistently brought her personal issues into the office and was frank and open about her life and activities outside of work. This interaction would often make the doctor and staff feel uncomfortable, and they didn’t really know how to change the topic of conversation. She always apologized afterward, but the inappropriate behavior continued. Ultimately, the dentist decided that this relationship was no longer working out and the employee was not a good fit for the office. However, neither the dentist nor the office manager had ever officially sat down with the employee to discuss these issues because they assumed she was aware of her behavior and her failure to meet the employment standards expected of her. The dentist and office manager eventually set a date to move forward with termination but failed to follow through due to a busy office schedule. Two weeks later, the employee informed the office manager that she was pregnant and went home sick. The dentist was committed to moving forward with termination due to the ongoing performance issues. RM analysts acknowledged that terminating an employee is never an easy decision and the situation had taken on another level of complexity given the employee’s notification of her pregnancy. The matter was further complicated by the dentist’s failure to follow through on the earlier decision to terminate the employee as well as his failure to document the employee’s prior performance issues. When dentists are considering terminating an employee, especially an employee in a protected class such as pregnancy status, it is always best to speak to an employment attorney before taking that step. The analyst referred the doctor to an attorney specializing in employment liability for further assistance. Practice owners face a variety of employee- and patient-related situations that require a unique approach to resolution. But it is possible for dentists to avoid risk by following a few guidelines learned through common scenarios in the dental office.

For individual concerns, contact the TDIC Risk Management Advice Line at 800.733.0633, email riskmanagement@cda.org or visit tdicinsurance.com/advice-line.

Reprinted with permission from CDA

A new format for the HIPAA Notice of Privacy Practices is now available for download on the CDA Practice Support website. The new “layered” notice allows a dental practice to post only one page, instead of all pages, of the notice on the wall of the practice’s reception area while making the entire notice available elsewhere in the reception area. The first page is a summary of the complete notice. The content of the complete notice has not changed. The entire notice must be offered to each new patient and must be included on the practice website. The new format is based on the U.S. Department of Health & Human Services model notice that aims to provide the required information in a user-friendly format. Every HIPAA-covered entity is required to provide patients with its notice of privacy practices.

Download “Sample Notice of Privacy Practices – Layered” at cda.org/resources. The resource includes instructions for dental practices on completing and posting the notice

Dentists who refer a new tripartite member to CDA can receive a $100 check from CDA and a $100 American Express gift card from the ADA. The $200 reward as part of the Member Get a Member campaign, which provides incentives for every CDA member dentist who refers a new member to the tripartite membership (for a total maximum of $1,000 per referring member).

Reprinted with permission from the CDA Practice Support.

CDA members may now renew their annual membership dues online.

With membership in organized dentistry, dentists ensure their voices and the needs of the profession are represented on every level.

Members have the option of renewing their dues in full or enrolling in the electronic dues payment program. The EDP program allows for payments in equal monthly installments that will be deducted automatically from a designated checking account.

CDA provides education, practice support, protection and a stronger voice in government through its legislative advocacy work. Members also enjoy these benefits:

Waived $890 registration fee for CDA Presents, the twice-yearly convention that takes place in Anaheim in the spring and San Francisco in the fall. At the convention, members can access free continuing education units, stay current on the latest dental technology trends and receive discounted pricing on equipment and supplies. New dentists will find recommended course listings to help guide their experience.
Dedicated team of CDA professionals whose sole purpose is to advocate for the dental profession and for patients. In 2016, CDA sponsored a new law that makes the dental board’s student loan repayment program less restrictive and successfully advocated for lawmakers to remove dentists from surprise billing legislation. In recent years, CDA has also sponsored new laws that improve dentists’ and patients’ rights when working with their dental benefits and increased Denti-Cal funding through additional federal dollars and the reversal of a 10-percent reimbursement rate cut.
Access to CDA Practice Support, which offers nearly 500 valuable resources to help dentists better manage the business side of dentistry. In 2016, CDA Practice Support launched “Are you in Compliance?,” a new resource that lists laws and regulations, organized by deadline date and year, that dental practices must comply with. Other Practice Support resources include customizable sample letters, forms, checklists, FAQs and agreements. The Sample Employee Manual, Injury and Illness Prevention Plan, New Patient Forms, Guidelines for Informed Consent, Hazard Communication Plan, and Required Postings are among the most used resources.
Unlimited phone support, also through CDA Practice Support, with analysts specializing in dental benefit plans, regulatory compliance, employment practice and practice management. The analysts are available to answer everyday questions dentists have. Dentists may also use the “Ask an Expert” feature to receive a response from an expert within one business day.
Substantial multipolicy discounts with the TDIC Optimum Bundle. Professional Liability, Commercial Property and Workers’ Compensation coverage can be bundled for savings. In addition, CDA member dentists can benefit from comprehensive disability coverage at a competitive price through the MetLife association policy.
Career assistance, a Risk Management Advice Line, Peer Review and much more.
Renew CDA membership at cda.org/member.

Reprinted with permission from the CDA Practice Support.

A federal judge in Texas on Tuesday, Nov. 22, issued a nationwide injunction blocking implementation of the U.S. Department of Labor’s Fair Labor Standards Act (FLSA) rule concerning overtime pay for certain employees who are currently classified as exempt from overtime. The injunction follows lawsuits filed by multiple states and business groups.

Under the rule, which was set to take effect Dec. 1, all employers would be required to pay a minimum salary of $913 per week, or $47,476 per year in order for an employee to be classified as exempt. Employers in California would need to pay close attention to and adjust salaries over the next several years in consideration of the annual state minimum wage increases due to begin Jan. 1, 2017.

CDA reported on the new FLSA rule in the December CDA Update, noting that the rule would take effect Dec. 1. With the injunction issued, employers are not required to comply with the rule by Dec. 1. CDA will keep members updated on the status of the injunction and court case at cda.org and in the CDA Update.

Questions about the FLSA rule and the injunction may be directed to CDA Practice Support at 800.232.7645.

Reprinted with permission from the CDA Practice Support.

Legislation signed in September by Gov. Brown resolves a longstanding conflict concerning whether health care providers’ use of online marketing companies to advertise health care services constitutes fee splitting or payment for referrals, both of which are prohibited under state law.
Assembly Bill 2744 (Gordon, D-Menlo Park) permits health care providers to advertise online via vouchers for specific services through Groupon, Living Social and other similarly structured social coupon companies. Under the new law, the sale of such a voucher for health care services is not considered a payment for referral of patients as long as the third-party advertiser does not recommend, endorse or select the health care provider. Payment for referral of patients is a violation of California’s Business and Professions code, Section 650, as well as CDA’s code of ethics.
Groupon and its direct competitors operate by contracting with businesses, including health care providers, to promote discounted products and services to potential customers. In order to take advantage of the discounted service, the customer must provide advance payment directly to the online company, which typically deducts a percentage as its contracted fee and remits the balance of the payment to the business.
Questions had been raised in California and other states about the use of these online marketing companies because, unlike with traditional advertising where a flat fee is paid irrespective of how successful the advertisement is, the third party (or online marketing company) receives a share of the purchase price of each voucher sold. CDA’s previous guidance urged dentists to avoid using these online coupon programs, or to negotiate a flat-fee structure to avoid engaging in what has been construed as the noncompliant “per-referral fee.”
CDA worked with the author’s office to ensure that any gray area surrounding payment for referral of patients and fee splitting was eliminated for dentists.
Three amendments CDA requested were folded into AB 2744, allowing CDA to move from an “oppose unless amended” to a neutral position on the Groupon-sponsored bill. These amendments protect a dentist’s authority to diagnose and better inform consumers. Specifically, they require that offers of discounted health care services through social coupons include:
Disclosure of the discounted price of the advertised service in comparison with the actual cost of the service. Furthermore, the bill states, “The fee paid to the third-party advertiser must be commensurate with the services provided by the third-party advertiser.”
Disclosure that not all purchasers may be eligible for the advertised health care service and that “a consultation is required” to determine the patient’s appropriate care.
Disclosure that if the purchaser is not a candidate for the purchased health care service, or does not claim the service for any reason, the purchaser will receive a refund of the full purchase price as determined by the terms of the advertising service agreement.
To align the bill with covered benefits required under the Affordable Care Act, “basic health care services” and “essential health benefits” are excluded from services that may be offered through online advertising vouchers. Therefore, under the new law, advertising for cosmetic and adult dental services is allowable but advertising for pediatric dental services is not.
While the new law exempts marketing some health care services through social couponing from the restrictions imposed by Section 650, it maintains the ban on payment for referrals and fee splitting in all other circumstances.
The bill goes into effect Jan. 1, 2017.
For resources on compliance with this new law, please visit cda.org/practicesupport.

Reprinted with permission from the ADA.

You may know the Centers for Disease Control and Prevention (CDC) publishes a monthly “Vital Signs” report. This month’s report focused on dental sealants, and the CDC recommends sealants because:
• They are a quick, easy, and painless way to prevent most of the cavities children get in the permanent back teeth, where 9 in 10 cavities occur.
• Once applied, sealants protect against 80% of cavities for 2 years and continue to protect against 50% of cavities for up to 4 years.
• Sealants can eliminate the need for expensive and invasive treatments like dental fillings or crowns.
• Applying sealants in schools for about 7 million low-income children who don’t have them could save up to $300 million in dental treatment costs.
Read more about the CDC report in ADA News.
The ADA agrees that dental sealants are safe and effective. In fact, the ADA Council on Scientific Affairs and the American Academy of Pediatric Dentistry (AAPD) recently convened a panel that developed a clinical practice guideline on sealants that was based on a systematic review of existing literature. The guidelines were released in August, and we encourage all members to review them.
Additionally, consumer-friendly information about sealants, including a video and infographics, are available at MouthHealthy.org. Dentists may wish to share this content with their patients.

Reprinted with permission from the CDA.

Under a new law, all applicants licensed by the Dental Board of California are required to submit their email address to the board effective July 1. The board plans to contact licensed dentists annually to confirm that their email addresses on file are correct.
Licensees who have not already done so, or whose email address has since changed, should submit their email address to the board by emailing and including their name, license number and email address using the subject line “Electronic Mail Address Requirement.”
As the Department of Consumer Affairs’ new licensing and enforcement system, known as BreEZe, gains some additional features, licensees will be able to quickly update their email addresses and more online. Email addresses will be kept confidentially by the board and will not be subject to public disclosure.

Reprinted with permission from the CEA.

The USCIS announced that an updated Form I-9 has been approved. The current form had a revision date of 03/08/2013 N and expired in March this year, but is acceptable for continued use. However, on August 25, 2016, the Office of Management and Budget (OMB) approved a revised Form I-9, Employment Eligibility Verification. USCIS must publish a revised form by November 22, 2016. Employers may continue using the current version of Form I-9 until January 21, 2017. After January 21, 2017, all previous versions of Form I-9 will be invalid.
Make sure you are always using the most current, acceptable version of the Form I-9. Even if you self audit and find an employee does not have an I-9 on file, use the current version (not the version based on their date of hire) to verify the employee’s employment. For tips on self-audits and other Form I-9 issues, the “Handbook for Employers” https://www.uscis.gov/sites/default/files/files/form/m-274.pdf issued by the USCIS is extremely helpful.
The USCIS also offers free webinars on a regular basis with a live question and answer opportunity as well as other learning resources on its web site https://www.uscis.gov/i-9-central/learning-resources.
Of course, CEA has information on our web site https://www.employers.org/i-9-forms and is here to answer your questions as well.

Reprinted with permission from the ADA.

The ADA News (10/31, Burger) reports a new resolution passed by the ADA House of Delegates amended the ADA Principles of Ethics and Code of Professional Conduct to permit “dentists to announce as specialists recognized in their jurisdictions even if it’s not one of the nine dental specialties recognized by the Association.” Resolution 65H-2016 also amended the Code to specify that “a dentist holding specialty degrees should be permitted to practice to the full scope of the dental licenses that they hold so long as they maintain adequate expertise in the specialty.” Dr. Michael Halasz, Ohio-based general practitioner and chair of the Council on Ethics, Bylaws and Judicial Affairs, said, “It’s a fairly significant change.” Dr. Halasz added, “The bottom line is that it keeps dentists in line with the Code of Ethics, which puts patients first.” The amendments come as states, compelled by court decisions, are beginning to recognize specialties beyond the nine dental specialties recognized by the ADA. “We’re trying to stay ahead of the issue,” said Dr. Halasz.

Reprinted with permission from the CDA Practice Support.

Dispose of out-of-date, damaged or otherwise unusable or unwanted controlled substances, including samples, by transferring them to an entity that is authorized to receive such materials. These entities are referred to as “reverse distributors.” Contact your local DEA field office (deadiversion.usdoj.gov/offices_n_dirs/index.html) for a list of authorized reverse distributors. Mail-back programs are also available. Schedule II controlled substances should be transferred via the DEA Form 222, while Schedule III, IV and V compounds may be transferred via invoice. Maintain copies of the records documenting the transfer and disposal of controlled substances for two years. Prescribers should encourage patients to properly dispose of their unused or expired controlled substances through their local pharmacy or take-back event sponsored by local law enforcement. The DEA amended regulations in September 2014 to allow retail pharmacies, hospitals and clinics with pharmacies to collect the drugs from the ultimate users and to place collection containers at long-term care facilities.

Reprinted with permission from the CDA Practice Support.

The theft or loss of controlled substances from a prescriber’s premises must be reported to local law enforcement and to the DEA. Report the theft or loss to the DEA using form 106, available at deadiversion.usdoj.gov/21cfr_reports/theft/ index.html. Secured prescription forms that are lost or stolen must be reported to local law enforcement and the state Department of Justice CURES/PDMP no later than three days after the discovery of the loss or theft. Go to oag.ca.gov/cures-pdmp#lost to report the loss or theft. Prescribers registered to access the CURES database can use the database to electronically report the loss or theft; police report number is required.

For questions concerning how to report lost or stolen prescription pads or forms, contact the Security Prescription Printer Program at SecurityPrinter@doj.ca.gov.

By following this link. you will be able to view all of the upcoming California Dental Society Meetings and Events. Thanks to OCDS’ Executive Director, Laura Peterson, for reaching out to the societies and putting this all together!

From the March 2015 issue of The Nugget.
Reprinted with permission from CDA.

The Americans with Disabilities Act (AwDA) became law in July 1990. The AwDA and related state and federal laws prohibit discrimination on the basis of disability in employment, government, public accommodations, education, commercial facilities, telecommunications, and transportation. The law also helps guarantee access to places of public accommodation for persons with disabilities. Dental offices are viewed as places of public accommodation. Therefore, compliance with these laws in dental practices can take several forms, including:

  • Removal of barriers which may impair patient or employee access when it is “readily achievable.”
  • Proper design of office spaces to accommodate the needs of employees and patients in the case of new offices and some remodeling projects.
  • Communication being offered in forms which are readily understood by employees and patients. This may include the obligation to provide sign language interpreters at no cost to the patient.
  • Application of patient management and financial policies that are not discriminatory.
  • Responsible hiring practices which prohibit discrimination against those with physical or mental impairment coupled with reasonable accommodations for employees.

Who is considered disabled under the AwDA?
In general, the group includes those with a physical or mental impairment that substantially limits one or more of life’s major activities, those who have a record of such an impairment, and those who are regarded as being disabled. Some disabilities are obvious, others are not. In the time since the AwDA became law, the courts have deliberated on cases where the questions revolve on whether a particular “disability” is indeed a disability under the law. When dealing with someone who claims a disability, it is best to act in compliance with the law even if you are uncertain about the law’s applicability in the individual case.

Physical Accessibility Standards
California’s disability access guidelines were in place before the AwDA access regulations were adopted. Trying to comply with both sets of detailed standards has been difficult for many businesses. It is not unusual for a building to meet local building code standards while still leaving the building owner or operator vulnerable to disabled access lawsuits. California law allows private enforcement of accessibility regulations, that is, private parties may sue entities to force compliance with regulations, to recover costs of litigation and to have punitive damages assessed.

Detailed information on complying with both state and federal accessibility standards is now available for building and business owners. The Division of the State Architect has on its Web site a reference manual for compliance with physical accessibility standards, www.dgs.ca.gov/dsa/Programs/progAccess/accessmanual.aspx. Local building departments use these standards and have the authority to interpret and enforce state building codes to best fit community needs.

If you are planning construction or a remodel of your facility, take a close look at the most commonly used public areas – the parking lot, walkway, entrance, lobby, and bathrooms. Also consider including appropriate signage. If you have concerns about the accessibility of your office, experts recommend you hire a consultant who specializes in both state and federal disability access laws and regulations to inspect your office. Certified Access Specialists (CASps) are certified by the Division of the State Architect, and a list of them can be found here, www.dgs.ca.gov/dsa/Programs/programCert/casp.aspx. State law provides some protection from lawsuits for businesses that follow through on CASp recommendations to make their businesses accessible.

Also see “Best Defense Against Disability Lawsuits: Compliance,” available on cda.org/compass, www.cda.org/LinkClick.aspx?fileticket=k_rJO7ap3E0%3d&portalid=0.

Communicating with the Hearing-Impaired
You are required to communicate with a deaf or hearing-imparied patient so that the patient is able to understand what you are telling them. The options for communicating to a hearing-impaired patient include using:

  • Printed or written instructions, questions, responses via paper and pen, computer, or other device
  • Lipreading
  • Sign language

It is best to ask the patient what is his or her preferred method of communication. Not all hearing-impaired patients ask a dental practice to provide a sign language interpreter. Be prepared, however, to provide an interpreter if requested.

You may not charge the patient for the cost of providing the interpreter or for any other cost associated with ensuring you and your patient are able to communicate.

A list of organizations that provide sign language interpreters or referrals to interpreters can be found in the Directory section of cdacompass.com.

Employment
Employers are prohibited from discriminating against an employee or potential employee because of the individual’s disability. Decisions to hire, to terminate employment, or to discipline should not be influenced by disability status.

The U.S. Equal Employment Opportunity Commission answers questions about health care workers and the Americans with Disabilities Act on a Web site, www.eeoc.gov/facts/health_care_workers.html. Topics include disability accommodation, “direct threat to safety,” job requirements vs employee essential functions, and more.

Questions & Answers

How can staff determine whether a dog that a patient has brought is a legitimate service animal?
A service dog, or a service dog-in-training, should be on a leash and tagged as a guide dog, signal dog, or service dog by an identification tag issued by the county clerk, animal control department, or other authorized agency. The owner of a service dog is liable for any damage done by the dog to property or injury to individuals. Service animals are addressed in California law under Civil Code Section 54.1 through 54.7.

Is a service dog-in-training allowed the same access to a dental office as a certified service dog?
Yes, according to California Civil Code section 54.2 an individual who is licensed or otherwise authorized to train guide dogs, signal dogs, or service dogs has a right to be accompanied by a dog-in-training in public places without being required to pay an extra charge or security deposit. As with a service dog, a dog-in-training should be on a leash and tagged as a guide dog, signal dog, or service dog by an identification tag issued by the county clerk, animal control department, or other authorized agency. The individual shall be liable for any damage done to the premises or facilities by his or her dog. For more questions and answers on service dogs, see this U.S. Department of Justice Web site, www.ada.gov/qasrvc.htm.

A deaf patient insists I use a specific sign language interpreter. One of my staff knows sign language and I prefer to use my staff to interpret for this patient. Do I have to use the patient’s preferred interpreter?
The U.S Department of Justice address this situation in its Technical Assistance Manual, available here www.ada.gov/taman3.html:

Who decides what type of auxiliary aid should be provided?
Public accommodations (such as dental practices) should consult with individuals with disabilities wherever possible to determine what type of auxiliary aid is needed to ensure effective communication. In many cases, more than one type of auxiliary aid or service may make effective communication possible. While consultation is strongly encouraged, the ultimate decisions as to what measures to take to ensure effective communication rests in the hands of the public accommodation, provided that the method chosen results in effective communication.

Illustration: A patient who is deaf brings his own sign language interpreter for an office visit without prior consultation and bills the physician for the cost of the interpreter. The physician is not obligated to comply with the unilateral determination by the patient that an interpreter is necessary. The physician must be given an opportunity to consult with the patient and make an independent assessment of what type of auxiliary aid, if any, is necessary to ensure effective communication. If the patient believes that the physician’s decision will not lead to effective communication, then the patient may challenge that decision under Title III by initiating litigation or filing a complaint with the Department of Justice (see III-8.0000).

Other Resources
Complying with federal and state disability access laws can be complex. It is important to realize that local agencies also may impose additional requirements. This article and the resources listed below provide you with general information. For assistance in cases related to physical accessibility requirements, you should work with your local building department and your architect or building contractor. An attorney should be consulted in specific cases pertaining to disability discrimination.

On cda.org/compass, see “Best Defense Against Disability Lawsuits: Compliance”

www.cda.org/LinkClick.aspx?fileticket=k_rJO7ap3E0%3d&portalid=0
For full text of referenced laws and additional information, visit:
U.S. Department of Justice ADA Homepage www.usdoj.gov/crt/ada/adahom1.htm
California Disability Access Information www.disabilityaccessinfo.ca.gov
California Department of Rehabilitation www.rehab.ca.gov

From the February 2015 issue of The Nugget.
Reprinted with permission from CDA.

Following the October 2014 reclassification under federal law of hydrocodone combination products (HCPs) such as Vicodin and Norco from federal Schedule III to federal Schedule II, some dentists report pharmacies refusing to fill emergency prescriptions telephoned in for HCPs, under circumstances in which they may traditionally have been accepted. This article is intended to clarify the state of the law with regard to such HCPs and help dentists understand the requirements and limitations on oral prescriptions for a Schedule II drug.

Under both federal* and California law,** the requirements for Schedule II drugs specify that prescribers may only telephone in prescriptions for Schedule II drugs in very limited emergency situations. However, as some differences between federal and California law may be a source of confusion, to ensure a patient’s need for pain medication is met appropriately, dentists should be aware of the following information:

With regard to emergency prescriptions, federal law limits its definition of an “emergency situation” authorizing the issuance of an oral prescription for a Schedule II to those situations in which the prescriber determines:

  • Immediate administration of the controlled substance is necessary for proper treatment of the intended ultimate user.
  • No appropriate alternative treatment is available, including administration of a non-Schedule II drug.
  • It is not reasonably possible for the prescribing practitioner to provide a written prescription to be presented to the dispenser, prior to dispensing.

Further, federal law permits a pharmacist to dispense a Schedule II drug based on an oral authorization from a prescriber only when:

  • The quantity prescribed and dispensed is limited to an amount adequate to treat the patient during the emergency period.
  • The prescription is immediately reduced to writing by the pharmacist and contains all the legally required information.
  • The prescriber is either already known to the pharmacist or the pharmacist makes a reasonable effort to determine that the oral authorization came from an authorized prescriber, which may include calling back the prescriber or other efforts to verify identity.
  • Within seven days after authorizing an emergency oral prescription, the prescriber delivers (or mails) a paper or electronic prescription for the emergency quantity prescribed to the dispensing pharmacist that, in addition to conforming to the other requirements, must have written on its face “Authorization for Emergency Dispensing” and the date of the oral order.

The pharmacist must notify the Drug Enforcement Administration (DEA) if the prescriber fails to deliver the paper or electronic prescription in a timely manner, and failure by the pharmacist to do so renders the prescription invalid.

California law on emergency dispensing for Schedule II drugs is similar to the federal requirements, and dentists should also be aware of the emergency dispensing limits that apply under state law. For instance, California law defines an emergency justifying dispensing pursuant to an emergency oral prescription for a Schedule II drug only “… where failure to issue a prescription may result in loss of life or intense suffering …”

With the increasing scrutiny of opioid abuse, the pharmacy profession, which is regulated by the California Board of Pharmacy, has been charged with enforcing its responsibility to reduce the use of addictive substances, and interprets narrowly the circumstances where “intense suffering” may require a Schedule II prescription; this has historically been primarily limited to patients in hospice care and in skilled nursing and long-term care facilities. This may result in the pharmacist who receives a call from a dentist for an emergency Schedule II prescription counseling the prescriber on other options for pain relief that are not Schedule II.

When an emergency prescription is accepted by the pharmacist, it is similarly subject to several stringent requirements under California law, including that the pharmacy reduces any oral order to hard copy form prior to dispensing the controlled substance and that the prescriber provides a written prescription on a controlled substance prescription form that meets state requirements, by the seventh day following the oral order. California law also requires the pharmacy to notify the Department of Justice in writing within 144 hours of a prescriber’s failure to supply the required follow-up written prescription.

Dentists should anticipate these new barriers to prescribing emergency pain relief to patients using Schedule II drugs and should make every attempt possible to provide the patient with a written prescription. As a last result, if a dentist must telephone in a prescription for a Schedule II drug, the prescriber should provide only the number of pills required to address the emergency, be prepared to explain to the pharmacist how the failure to provide a patient with the drug is medically necessary and/or may result in intense suffering, why a written prescription is not possible, and assure the pharmacist that a written prescription that complies with all requirements will follow within seven days.

A dentist should also consider the effectiveness of prescribing a Schedule III drug instead and is encouraged to talk with pharmacist colleagues about any new contemporary pain relief medications that may fit the patient’s circumstance.

If a pharmacy refuses to fill a prescription for what you believe is an emergency that meets the standards as outlined in state law, please report the incident to CDA Practice Support at 800.232.7645. CDA continues to discuss the situation with the California Board of Pharmacy and California Pharmacists Association.

*21 CFR § 290.10, and 21 CFR § 1306.11(d)
** California Health and Safety Code section 11167

From the December 2014 issue of The NuggetReprinted with permission from the California Employers Association.

California has released a revised Whistle blower Protections Posting. The new required posting, which must be 14 pt font:

  • Expands the rights and responsibilities under the California Whistle blower Laws.
  • Refers to the laws under CA Labor Code 1102.5, and extends protections to employees who report suspected illegal behavior internally to a person with authority to investigate or correct a violation or externally to a public body conducting a hearing or investigation.

More poster changes will take place between now and the end of 2014, so instead of buying a new poster today, we suggest you download the free posting at www.dir.ca.gov/dlse/WhistleblowersNotice.pdf. Downloaded postings meet an employer’s legal obligation and will hold you over until the 2015 California/Federal All In One posters are ready.

Look for the poster in your January 2015 Nugget!

January 2015 Nugget

By Ann Milar, CDA Dental Benefits Analyst (2015 MidWinter Speaker)

Dentists need to ensure that their practices are prepared for dental procedure code changes that go into effect Jan. 1. There are 73 code changes, including 16 new procedure codes.
The ADA released the latest version of the Current Dental Terminology (CDT) Codes earlier this year.

The 16 new procedure codes include the following:

  • Re-evaluation at a postoperative office visit;
  • 3-D photographic image;
  • 3-D photographic image;
  • Sealant repair, per tooth;
  • Cleaning and inspection of removable appliances;
  • Retainers for resin bonded fixed prosthesis;
  • Missed and cancelled appointments;
  • Administrative issues; and
  • Evaluation for deep sedation or general anesthesia.

There are 52 code revisions, including these revised procedure codes:

  • Topical application of fluoride;
  • Coping;
  • Inlay/onlay restorations;
  • Clinical crown lengthening,
  • Hard tissue;
  • Osseous surgery;
  • Implant/abutment supported removable dentures;
  • Peri-implant defects;
  • Placement of temporary anchorage devices;
  • Incisional biopsies; and
  • Sedation.

Five codes have been deleted from CDT:

  • D6053 Implant-/abutment-supported removable denture for completely edentulous arch;
  • D6054 Implant-/abutment-supported removable denture for partially edentulous arch;
  • D6078 Implant-/abutment-supported fixed denture for completely edentulous arch;
  • D6079 Implant-/abutment-supported fixed denture for partially edentulous arch; and
  • D6975 Coping.

Please remember that while dental plans are required to recognize current CDT codes, they are not required to pay or provide benefits for new codes as they become effective. Dental offices are encouraged to review dental plans’ payment and processing guidelines to determine whether benefits are payable and any documentation requirements.

Copies of the CDT 2015 (both hard copy and e-book) are available for purchase through the American Dental Association’s website, ADAcatalog.org.

In 2015, CDA will offer members many dental benefit educational opportunities. Below is a chronological listing of deadlines and dates.

Dental Benefits Workshop – Sacramento (April 16-17, 2015)
This two-day CDA Dental Benefits Workshop in Sacramento will provide dentists with the skills to improve practice profitability and the confidence to work with dental plans on their terms. Registration and workshop details can be found at cda.org/dbw.

Medicare Enroll/Opt-Out Deadline (June 1, 2015)
June 1 is the deadline for dentists to enroll or opt out as Medicare providers. Regardless of which direction a dentist elects to go, this process can take several months, so dentists are encouraged to evaluate practice operations and determine which option is best for their patients and their practice well in advance of the June 1 deadline. More information regarding Medicare enrollment/opt-out can be found via the following websites: cda.org, ada.org and cms.gov.

ICD-10 Code Implementation (Oct. 1, 2015)
Effective Oct. 1, the ninth edition of the International Classification of Diseases (ICD) code sets will be replaced by ICD-10. The ICD-10 includes greater specificity than ICD-9 and more than 70,000 detailed diagnostic codes.

While dentists are not required to submit diagnostic coding for dental claims, dentists who perform oral surgery, treat temporomandibular disorders, facial pain and sleep apnea, treat patients in a hospital or outpatient surgery center and submit claims to medical plans may need to utilize the new ICD-10 diagnostic codes to ensure timely payment for treatment.

More information regarding ICD-10 can be found at cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10.

December 2014 Nugget

Reprinted with permission from the California Employers Association.

California has released a revised Whistle blower Protections Posting. The new required posting, which must be 14 pt font:

  • Expands the rights and responsibilities under the California Whistle blower Laws.
  • Refers to the laws under CA Labor Code 1102.5, and extends protections to employees who report suspected illegal behavior internally to a person with authority to investigate or correct a violation or externally to a public body conducting a hearing or investigation.

More poster changes will take place between now and the end of 2014, so instead of buying a new poster today, we suggest you download the free posting at www.dir.ca.gov/dlse/WhistleblowersNotice.pdf. Downloaded postings meet an employer’s legal obligation and will hold you over until the 2015 California/Federal All In One posters are ready.

Look for the poster in your January 2015 Nugget!

December 2014 Nugget

Reprinted with permission from CDA.

California’s data breach notification law will undergo amendments effective Jan. 1, 2015. Some reports have indicated that AB 1710 will require companies to provide credit monitoring in the event of a data breach, which is not true.

It does state, however, that when companies experience a data breach and decide to offer credit monitoring to affected individuals, they must offer the services at their own expense and for no less than one year. The breach notification must also contain all material information individuals need to take advantage of the offer.

California’s data breach notification law requires any person or business in California that owns or licenses individuals’ computerized personal information to notify any resident of California following the discovery of a breach of their unencrypted personal information.

“Personal information” is defined as a person’s first name or first initial and last name in combination with any of the following:

  • Social security number.
  • Driver’s license number or California identification card number.
  • Account number, credit/debit card number, in combination with any required security code, access code or password that would allow access to the person’s financial account.
  • Medical information, defined as “any information regarding an individual’s medical history, mental or physical condition, or medical treatment or diagnosis by a health care professional.”
  • Health insurance information, defined as “an individual’s health insurance policy number or subscriber identification number, any unique identifier used by a health insurer to identify the individual, or any information in an individual’s application and claims history, including any appeals records.”
  • A username or email address, in combination with a password or security question and answer that would permit access to an online account.

As stated above, the amendment does not require offering affected individuals credit monitoring. Companies often offer credit-monitoring services after a data breach, particularly when the breach involves an individual’s social security number. If the decision to offer credit monitoring is made, the offer must be in compliance with the amended law starting Jan. 1, 2015.

Encrypting data provides a safe harbor from breach notification. The recently released 2014 California Data Breach Report, published by the office of the California attorney general, reports that 70 percent of health care sector data breaches in 2012 and 2013 were the result of lost or stolen hardware or portable media containing unencrypted data.

The Executive Summary of the attorney general’s report states, “A recent study by the Ponemon Institute reports that criminal attacks targeting the health care system are growing and that employees’ use of unsecured portable devices is also increasing the risk of breach. The need to use encryption is a lesson that must be learned by the health care industry and we recommend that it be applied not only to laptops and portable media, but also to many computers in offices.”

Encrypting data on office computers and any removable media (such as USB sticks, tablets, smartphones, backup tapes) that contain personal information is highly recommended. In addition to providing safe harbor under California’s data breach notification law, encrypting electronic health information also provides a safe harbor under HIPAA’s data breach notification rule.

The full 2014 California Data Breach Report can be found here. It provides information on data breaches in California broken down by sector and type of breach. It also provides recommendations as to how businesses can protect their customers.

CDA Practice Support has several resources on preventing and responding to data breach incidents, including information on encryption and a sample data breach notification letter. They can be found at cda.org/practicesupport.

November 2014 Nugget

By Ben Cope, DDS 

The issue: On Aug. 22, 2014, the DEA declared that any hydrocodone containing medication is now regulated as a schedule II drug. The practical implications for a dentist are that we now have to hand write prescriptions for common narcotic pain relievers such as Norco. If a patient calls in with pain after hours or over the weekend, we would have to see them in person every time to hand write the prescription; no more calling it in to the pharmacy. This could become a huge inconvenience, and may result in more and more patients seeking emergency room treatment if their dentist is unavailable to meet them in person.

The solution: According to pharmacists, a dentist can still call in drugs like Norco (or any schedule II drug for that matter) as long as a few criteria are met:

  1. It must be an emergency situation (as defined by the dentist).
  2. It must be after-hours.
  3. The dentist can only prescribe enough to get the patient through the emergency situation (usually limited to 72 hours)
  4. The pharmacy must receive a hard copy of what the dentist phoned in. The next time the dentist is in office, he/she must physically write out the prescription
  5. This hard copy must be mailed to and received by the pharmacist within 7 days
  6. This hard copy must have the phrase “Authorization for Emergency Dispensing”, along with the date you called it in.

This information has been verified verbally with the Sacramento branch of the DEA, as well as the source information in the Code of Federal Regulation, title 21, sections 1306.11 and 290.10.

November 2014 Nugget

Reprinted with permission from CDA. 

Dentists are reminded that starting Oct. 6, hydrocodone combination products such as Vicodin and Norco are classified as Schedule II drugs and require Schedule II authority to prescribe. CDA reminds dentists to visit the DEA’s website to ensure their registration is up-to-date. Pharmacists will be checking the website for proper authority before filling Schedule II prescriptions. Dentists whose registration status is not updated should anticipate receiving pharmacists’ phone calls prior to filling prescriptions for Vicodin, Norco or similar products.

For more information, read the Sept. 23 CDA article titled “Hydrocodone reclassification set for Oct. 6.”

October 2014 Nugget

By Leslie Canham, CDA, RDA 

Regulations pertaining to healthcare and dentistry are constantly changing. There are new OSHA, HIPAA, and Dental Practice Act regulations that require dentists to take action.  Here are a few of the tasks you need to complete to be IN COMPLIANCE.

OSHA

The New Hazard Communication Standard

The OSHA Hazard Communication Standard became effective in 2013. Dentists  must train their workers in the new label and safety data sheet (formerly called MSDS) requirements by December 1, 2013.

Aerosol Transmissible Diseases
In 2009, OSHA issued a requirement for dental practices to train employees in Aerosol Transmissible Diseases (ATDs). The dental practice must have written injury and illness preventions plans addressing ATDs and adhere to the CDC Guidelines for screening patients who may be infected with an ATD.   ATDs include all types of influenza, varicella diseases, measles, smallpox, SARS, TB and other diseases and pathogens.

Bloodborne Pathogen Training
OSHA requires that employers ensure that all clinical employees participate in a training program. Training shall be provided at the time of initial assignment and at least annually thereafter. Documentation of the training must be maintained by the employer for at least 3 years.

New HIPAA Regulations require covered entities to complete required tasks

In January 2013, the new HIPAA Omnibus Final Rules were published implementing changes to HIPAA Privacy, Security, Breach Notification and Enforcement Rules.  All covered entities must revise their written policies and procedures to comply with the new rules. Training must be provided to workforce, both clinical and administrative.

Here are some of the things you need to do:

  1. Conduct and document a “Risk Assessment”
  2. Re-write and post your HIPAA Notice of Privacy Practices.
  3. Update your Business Associates Agreements and have each business associate sign the new agreement.
  4. Create new written plans to demonstrate how the dental practice will adhere to HIPAA regulations.
  5. Train your workforce on the new regulations.
  6. Understand how to prevent breaches and know when you must provide breach notification to patients.
  7. Create various Logs:

Amendment Request Log
Disclosures of Patient Information Log
Complaint Log
Breach Log
Security Incident Log
Emergency Access Log
Maintenance Repair Log
Electronic Media and Hardware Movement Log

I highly recommend that your practice purchase the American Dental Association (ADA)  “Complete HIPAA Compliance Kit ” where you can find the written forms and logs.

Dentists and Hygiensists to provide “Notices To Consumers”

Two separate “Notice to Consumers” posters are required for both dentists and dental hygienists informing patients that Dentists/Dental Hygienists are licensed and regulated by the Dental Board of California/Dental Hygiene Committee of California.  The phone number and website of  the Dental Board of California/Dental Hygiene Committee of California must also be on the poster.  All letters must be in 48 point font.

Unlicensed Dental Assistants

If hired after 1-1-2010, unlicensed dental assistants must possess the 8 Hour Infection Control certificate, take a Dental Practice Act course and hold a current CPR certificate. The supervising
is responsible for assuring dental assistants obtain these certificates within 1 year of employment.

If you would like a complimentary copy of a HIPAA Compliance Checklist, send an email to Leslie@LeslieCanham.com

In the dental fielded since 1972, Leslie helps dental teams simplify complex regulations. She provides in-office training, mock-inspections, consulting, and hands on implementation of HIPAA. Contact Leslie at 209.785.3903 or www.LeslieCanham.com.

(as of August 2014)

The X-ray machine owner is responsible for reporting the purchase, transfer, sale, or disposal of radiographic equipment to the state Department of Public Health. A form plus evidence of the purchase, transfer, sale, or disposal must be provided to the department.

(as of August 2014)

By Hilary Johnson, SDDS Member Liaison

The CDC has declared that prescription drug abuse is an epidemic in the Unites States. As a prescriber, what can one doctor do to prevent the further spread of prescription drug abuse? The California Department of Justice has an answer! The Controlled Substance Utilization Review and Evaluation System (CURES)/ Prescription Drug Monitoring Program (PDMP) system allows prescribers, pharmacists, law enforcement, and regulatory boards to access timely patient controlled substance history information.  If you think your patient may be a drug seeker, you can look him up in the CURES/PDMP database and the data may help you determine whether or not you want to prescribe to that patient.

SDDS has been getting an influx of calls wondering how to identify drug seekers and disseminate that information. Due to HIPAA regulations, neither doctors nor SDDS can release any patient information without the patient’s consent, unless the organization is working under the direction of law enforcement. Thankfully, the CURES/PDMP system allows prescribers to make informed decisions regarding their patients’ needs and avoid prescribing unnecessary medicines.  We would like to encourage all of our members to register for access to the system.

In order to access the CURES/PDMP database, you must register. There is no charge. Visit aaicures.com/register.for.access.php and follow the instructions to register! You must mail a notarized copy of your DEA Registration, CA License and state-issued ID after you complete the electronic registration. We believe our members are the best dentists in the region, and we want to provide you with the best tools for your arsenal. CURES registration will be mandatory by January 1, 2016 for all prescribers registered with the DEA.

If you discover a drug seeker, you can report it online at www.deadiversion.usdoj.gov/rxaor/ or you can call 1-877-RX-Abuse (1.877.792.2873). Identifying and denying just one drug seeker may be preventing a death!

(as of August 2014)

CDA Practice Support has received an increase in calls regarding the so-called “paperless mandate.” The calls are coming from dentists who were told by other dentists that the deadline to switch to dental electronic health records (EHR) is coming in 2015.

CDA reminds dentists that there is no requirement for dental practices to go paperless. There is an incentive program for Medicaid/Medicare providers to convert to electronic health records, however. Dentists who bill Medicare and who do not convert to EHRs will eventually see reduced payments for services.

Those Medicare payment reductions will begin in 2015. This will happen for most providers who are eligible but choose not to participate, according to the ADA. The ADA says, “The reductions will be enforced at the rate of 1 percent beginning in 2015 and will increase by 1 percent per year to a maximum of 5 percent.”

Dentists who do not participate in Medicare and are not eligible to participate in the incentive program.

EHRs are changing practices rapidly as related to benefits and clinical operations. There are many options in terms of vendors and software offerings in addition to the federal EHR incentives, new Health Insurance Portability and Accountability Act (HIPAA) rules and the push to move everything to the cloud.

For dentists who are making the transition to EHRs, CDA has the following resources available: The Dental Software Evaluation and Selection Checklist, Dental Software Contracts Checklist and Dental Software Implementation and Training Checklist. These resources prompt dentists to consider how they may address issues that arise during the software implementation phase. A veteran in the information technology profession and several electronic health experts developed the checklists.
Member dentists can find these resources by typing in the names of each resource in the Search Resources box on cda.orgpracticesupport.

(as of June 2014)

Secure electronic transmission of protected health information is one of the many requirements of the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. Dental practices should review the rule requirements to ensure compliance. More and more resources are becoming available for dentists to use to stay compliant.

The ADA has launched a new kit, for example, that helps dental practices comply with HIPAA. The ADA Complete HIPAA Compliance Kit includes a Privacy and Security Manual that outlines privacy, breach notification and security compliance in a step-by-step format. It also includes a Practical Guide to HIPAA Training that has two levels of training. Level 1 targets dental office personnel with the basics of HIPAA compliance. Level 2 targets managers to help them develop and implement a HIPAA compliance program for their offices.

ADA also is offering a three-year subscription to the HIPAA Compliance Update Service that advises subscribers whenever federal HIPAA laws change.

CDA’s HIPAA Security Rule: A summary resource can be found on cda.org/Privacy-HIPAA. Also, the Department of Health and Human Services has a Guidance on Risk Analysis resource on its website hhs.gov.

Congress passed HIPAA in 1996 to simplify, and thereby reduce the cost of, the administration of health care. HIPAA does this by, among other things, establishing standard codes and identifiers and encouraging the use of electronic transactions between health care providers and payers. Congress deemed that if the electronic transmission of patient health information was to be encouraged by the legislation, there needed to be means to protect the confidentiality of that information, and thus, the HIPAA Security Rule was created. With the exception of small health plans, which had a later compliance date, covered entities had to be compliant with the rule by April 20, 2005.

After establishing a “security officer” in the practice (similar to the designation of a privacy officer as required by the HIPAA Privacy Rule), conducting a documented risk analysis on their practices’ information systems is the first step dentists can take to be in compliance with the HIPAA Security Rule. Other things dentists can do to protect themselves include, among other things, instituting a system to regularly review records of information system activity, such as audit logs, access reports and security incident tracking reports, and having business associate agreements that require compliance with the Security Rule and notification of data breaches that occur with the respective business associate.

For pricing and to purchase the ADA Complete HIPAA Compliance Kit, visit ebusiness.ada.org

(as of May 2014)

On Monday, March 24th, trial lawyers and their allies filed signatures with county elections officials to begin the process of qualifying their anti-MICRA ballot initiative for November 2014. Californians Allied for Patient Protection (CAPP) has been preparing for this battle since the coalition was formed in 1991. The coalition of nearly 1,000 members, including SDDS, CDA, TDIC, and every dental society in California, is well positioned to make sure MICRA is protected. The committee Patients and Providers to Protect Access and Contain Health Costs has been formed to defeat this ballot measure.

For more information or to get involved visit noon46.com or contact CAPP Executive Director Lisa Maas at LMaas@micra.org.

(as of May 2014)

Inquiries have increased to CDA Practice Support recently on the subject of movie licensing. Dental practices are being contacted by mail or in person by individuals seeking to collect licensing fees. Many dentists assume it is OK to play movies they have purchased in their waiting rooms, but that is not always the case.

For more information, review the Legal Reference Guide for California Dentists HERE.

(as of May 2014)

CDA’s arbitration with Delta took a step forward on Feb. 25 with a “preliminary hearing” conference call with the panel of arbitrators assigned to the case. The purpose of the call was to schedule dates for different stages of the arbitration.

In light of the extensive briefing that has already been submitted by both parties, the panel of three arbitrators has indicated it will likely decide two significant issues by early April. The first is CDA’s “Application to Preserve the Status Quo,” which would prevent Delta’s amendments to provider contracts from being deemed effective as of Oct. 4, 2013. CDA is challenging the legality of Delta’s proposed changes to provider agreements which would eliminate a current requirement that Delta provide justification for changing its reimbursement rates and restrict dentists’ ability to use arbitration to challenge Delta’s actions. The second issue is Delta’s argument that CDA itself should not be permitted to appear in the arbitration on behalf of its members. The arbitrators concluded that these important initial issues should be decided before proceedings continue.

Delta also announced that it intends to file a “dispositive motion,” which it described only vaguely. CDA believes Delta plans to urge the arbitration panel to dismiss CDA’s claims because the Department of Managed Health Care has already approved the two amendments that are challenged in the litigation. CDA questions the strength of this motion, in light of the fact that Delta filed its application with the DMHC as a confidential filing, allowing no comment by anyone affected by it. CDA does not believe the DMHC intended its approval of Delta’s filing to have any preclusive effect on the rights of dentists. The parties have agreed to a briefing schedule so that this motion will be heard by the arbitrators on May 5.

At that same hearing, arbitrators will consider the issues of discovery, exchange of exhibits, depositions and any similar issues. We expect that the arbitrators will also set a date for the arbitration hearing itself, either at the May 5 hearing or before. We anticipate that the arbitration will be scheduled sometime in August or September.

CDA will continue to keep you informed on the progress of the arbitration in the Update, newsletter and on cda.org

(as of 4-1-14)

Now accepting applications for both the northern and southern committees. More specifically, one (1) Dental Auxiliary (Dental Assistant or Dental Hygienist) and one (1) licensed physician or psychologist are needed for Southern California and one (1) Dentist and one (1) licensed physician or psychologist are needed for Northern California. These committees assist the Board in evaluating licensees who may be impaired due to the abuse of alcohol or drugs. Each committee is composed of three dentists, one dental auxiliary, one physician or psychologist, and one public member who all have experience or knowledge in the field of chemical dependency. Diversion Committee members are appointed by the Board and serve at the Board’s pleasure.

You may find the application HERE.

(as of 3-2-14)

ADA has two new resources to assist dentists with some of the toughest transitions of their careers. The ADA Practical Guides to Valuing a Practice helps dentists understand a practice’s true value, not just its monetary worth. Both buyers and sellers get a balanced view of practice valuation. Refuting many common valuation myths, the book raises awareness of possible legal and tax issues that may arise during the process. It also provides guidance on selling or buying an entire practice, a portion of a practice, and planning a future buy-in or buy-out.

ADA’s other resource, The ADA Practical Guide to Associateships, demonstrates the risks and rewards of adding or becoming an associate – from both points of view. The book provides dentists with information to help them build a successful partnership. Strategies are offered for tackling both logistical issues (such as type of associate arrangement, compensation, contract terms, and buy-ins) and intangible issues (interpersonal considerations and compatibility, developing a practice philosophy, and conducting a goals assessment, for example).

Both books can be ordered on the ADA website: ebusiness.ada.org

(as of 3-1-14)

As questions increase about the use of Botox in dentistry, The Dentists Insurance Company advises California dentists that the use of preparations such as Botox and Dysport must be within the scope of dental practice.

“If doctors are practicing legally within the scope of their dental license, there is coverage under TDIC’s professional liability policy,” said TDIC Underwriting Director Dora Earls. However, Earls noted that if the Dental Board of California determines that use of Botox or similar drugs is not within the scope of dental practice, there is no TDIC coverage.

In California, dentistry is defined by the California Business and Professions Code section1625. The dental board lists the pertinent language of the code as, “diagnosis or treatment, by surgery or other method, of diseases and lesions and the correction of malpositions of the human teeth, alveolar process, gums, jaws or associated structures; and such diagnosis or treatment may include all necessary related procedures as well as the use of drugs, anesthetic agents and physical evaluation …” The board states that a dentist may use any legally prescribed drugs to treat patients as long as the treatment is within this specified scope of practice.

Additionally, in California dentists may not use Botox cosmetically without an Elective Facial Cosmetic Surgery permit issued by the dental board. Licensed dentists who have completed residencies in oral and maxillofacial surgery and additional criteria outlined by the dental board can apply for an Elective Facial Cosmetic Surgery permit. There are two categories for these permits. Category I relates to cosmetic facial surgery, such as contouring of the osteocartilaginous facial structure, and Category II relates to cosmetic soft tissue contouring or rejuvenation. The details of this system can be found in the California Business and Professions Code section 1638.1.

Currently, there are 26 dentists in California with these permits, according to the dental board. The dental board also states, “Some permit holders may not be authorized to perform all cosmetic surgery procedures within the scope of the Elective Facial Cosmetic Surgery permit.” Additionally, the dental board notes that all procedures authorized under the Elective Facial Cosmetic Surgery permit must be performed in an acute care hospital or a certified surgical center as defined in California Business and Professions Code section 1638.1(f).

Botox and Dysport are commercial preparations of botulinum toxin derived from the bacterium Clostridium botulinum, a nerve “blocker” that binds to the nerves and prevents the release of acetylcholine, a neurotransmitter. The result is muscle paralysis, according to the National Center for Biotechnology Information. Botulinum toxin is approved by the FDA, and its most common use is in applications to minimize fine facial wrinkles.

Concerning professional liability coverage and training or certification for dentists to use Botox or similar drugs, TDIC’s endorsement states: “Before performing the alleged injection(s), you must have obtained any license, permit, certification or training required by the state dental licensing authority where you practice.”

For more information or if you have questions regarding this topic, contact the TDIC Risk Management Advice Line at 800.733.0634. The Dentists Insurance Company offers policyholders a free advice line at 800.733.0634 for assistance with questions or concerns about potential liability. TDIC risk management analysts will work with policyholders to develop a solution.

(as of 2-2-14)

In January, dentists receiving their biennial renewal statements from the Dental Board of California (DBC) will see an increase in the total fee from $365 to $377, along with the following information:

“Pursuant to Business and Professions Code Section 208 (SB 809 – DeSaulnier, Chapter 400, Statutes of 2013), you are assessed $6 ANNUALLY which is collected at the time of renewal to cover the operation and maintenance of the Controlled Substance Utilization Review and Evaluation System (CURES). The amount of $12 per renewal cycle is hereby added to the renewal fee.”

CURES is the statewide database, administered by the Department of Justice, that collects information from dispensers of controlled substances for use in carrying out the state’s Prescription Drug Monitoring Program. It is intended to be used by law enforcement and by providers to identify fraudulent “doctor-shopping” for prescription drugs, as well as for law enforcement to identify providers who themselves are overprescribing.

The state’s deficit condition in recent years led to a crippling funding cutback for the CURES program, rendering it all but inoperable except for basic administrative tasks. SB 809 was the culmination of a several-year effort by Sen. Mark DeSaulnier (D-Concord) and Attorney General Kamala Harris to identify a dedicated funding source for maintaining and operating CURES.

The new law calls for the $6 annual licensure fee surcharge to be applied to all licensed professionals who can prescribe drugs, which include physicians, dentists, podiatrists, veterinarians, naturopathic doctors, pharmacists, registered nurses, nurse-midwives, nurse practitioners, physician assistants and optometrists. The fee will also be applied to certain drug wholesalers and clinics.

In addition, the law allows, but does not require, insurers, health care service plans and drug manufacturers to make tax-deductible contributions to the CURES fund. Finally, the new law will, by Jan. 1, 2016, require all prescribing providers to apply to the Department of Justice for access to the CURES database.

“CDA was part of a broad stakeholder group that worked with Senator DeSaulnier and the attorney general’s office as SB 809 moved through the process,” said William L. Marble, DDS, chair of CDA’s Government Affairs Council. “The CURES database is an important part of the state’s efforts to combat prescription drug abuse. Although we advocated for more broad-based funding than what ultimately ended up in the bill, we recognized that it was appropriate for prescribing providers to play a role in making the CURES program effective and sustainable.”

Has Been Amended
(as of 1-1-14)

New CA legislation (SB292) amends the definition of sexual harassment. The bill clarifies the definition of harassment in the Fair Employment and Housing Act to specify that sexually harassing conduct need not be motivated by sexual desire. Every California company with 50 or more employees must provide sexual harassment training to all supervisors and managers every two years and to each new supervisor and manager within 6 months of the assumption of their position. Additionally, employers with less than 50 employees must take all reasonable measures to promote a sexual harassment-free work environment.

(as of 12-2-13)

New changes to the Occupational Safety and Health Administration’s (OSHA) Hazard Communication Standard are bringing the United States into alignment with the Globally Harmonized System of Classification and Labeling of Chemicals (GHS). The new OSHA Standard requires employers to train all employees on the new label elements and Safety Data Sheet (SDS) format by Dec. 1, 2013.

OSHA has updated requirements for labeling of hazardous chemicals under its Hazard Communication Standard (HCS). Manufacturer labels will be required to have picto-grams, a signal word, hazard and precautionary statements, the product identifier, and supplier identification.

Click here for more information.

(as of 12-1-13)

When opening or purchasing a practice, you must register the X-ray equipment. For more information or to register your equipment, please contact:

Radiologic Health Branch
Department of Health Services
P.O. Box 997414
Sacramento, CA. 95899-7414
www.dhs.ca.gov/rhb

(as of 11-1-13)

The Health Officer of Sacramento County is requiring that each health care facility in Sacramento County implement a program requiring its health care workers to receive an annual influenza vaccination or, if they decline, to wear a mask for the duration of the influenza season while working in patient care areas.

The order also applies to dental practices in Santa Clara, Sacramento and Contra Costa Counties. The order, which resumed on Nov. 1 after it was established last year as an official memorandum by the counties, is ongoing and applies to each influenza season unless the order is rescinded. The influenza season is defined as Nov. 1 to March 31 of the following year.

The county of Sacramento is recommending it for dental practices, Members should regularly check the websites of their respective county public health departments for public health orders, information on flu outbreaks, an other information for healthcare providers.

Click here for more information.

(as of 9-10-13)

The Affordable Care Act (ACA) amended the federal Fair Labor Standards Act, indicating that employers should provide a notice to all employees of the existence of the newly formed insurance marketplace available to them along with information on how to contact the insurance marketplace to request assistance in purchasing coverage if the employee chooses to do so.

Specifically, by Oct. 1, all employers covered by the Fair Labor Standards Act, which includes all dental offices, should provide each of their employees a notice that informs the employees that there are new health insurance coverage options for purchase through Covered California. The form is designed to provide information intended to assist employees in evaluating their health and pediatric dental benefit options for 2014. Employees can access information about the options available to them through Covered California at www.coveredca.com or by calling toll-free 888.975.1142.

Click here for more information.

(as of 4-1-11)

Cal/OSHA and the Dental Board do not specifically prohibit staff from keeping long fingernails of using artificial nails. However, if a dental office is concerned that the practice may interfere with maintaining employee and patient safety procedures, the office may adopt a policy limiting fingernail length and prohibiting artificial nails. The CDC recommends this policy.

More Infection Control & CAL/OSHA FAQs can be found here.

Notice of Privacy Practices A HIPAA covered entity is required to provide patients with its notice of privacy practices. The notice must include descriptions of the types of uses and disclosures of protected health information (PHI) that the covered entity is permitted to make without the individual’s written authorization, including for each of the following purposes: treatment, payment, and health care operations. The notice also must include a statement about the other uses and disclosures the practice may use PHI; a statement on the individual’s rights with respect to the information; and description of procedures followed when a patient chooses to exercise those rights.

Click here for a Sample Notice of the HIPAA Privacy Practices.

The U.S. Census Bureau encourages dentists to inform the 2012 economic census by completing survey forms mailed to many private practice dental offices. Not all practices will receive the forms. The economic census is the government’s official five-year measure of American business and the economy.

More information regarding this matter can be found here.

For help with your form and other economic census information click here.

(as of 2-12-13)

The US Department of Labor (DOL) recently issued a final rule implementing two important expansions of the Family and Medical Leave Act (FMLA).

THE UPDATES:

  • Provide service members’ families with FMLA leave for events related to service members’ deployments.
  • Expand coverage given to current military family members to eligible families of veterans.
  • A new provision makes it easier for flight crew employees to be eligible for FMLA and use FMLA benefits.

SPECIFICS: The new FMLA rule implemented Congressional amendments to the FMLA, permitting eligible workers to take up to 26 workweeks of leave to care for a current service member with a serious injury or illness. Congress also created qualifying exigency leave, which permits eligible employees to take up to 12 workweeks of leave for qualifying exigencies arising out of active duty or call to active duty in support of a contingency operation of a family member serving in the National Guard or Reserve. The final rule also implements amendments clarifying the application of the FMLA to airline personnel and flight crews. Until the amendments, many flight crews did not meet FMLA eligibility criteria due to the unique way in which their hours are counted.

The DOL also released a new FMLA poster. The new FMLA poster must be posted by employers covered by the FMLA no later than March 8, 2013. Download the free poster here.

For more information, including the new rule, a military leave guide, fact sheets and other materials, visit the DOL website.

(effective 11-28-12)

As of November 28, 2012, dental practices are required to post a new notice to
consumers. The notice must be accessible to public view on the premises where dental services are provided. The notice must be in at least 48-point type font and include
the following statement and information:

NOTICE TO CONSUMERS
Dentists are licensed and regulated
by the Dental Board of California
(877) 729-7789
www.dbc.ca.gov

Click here to download a copy of the Notice to Consumers.

You can also find the sample notice available for download on cdacompass.com.
Pharmacists and physicians also are required to comply with a similar requirement.

(as of 12-20-12)

Find out, using this checklist!
(Created by CDA Practice Support Center. Registration and login may be required to access material)

HIPAA Training PowerPoint presentation (for staff training) can be downloaded here
(Created by CDA Practice Support Center. Registration and login may be required to access material)

ADA Practical Guide to HIPAA Compliance: Privacy and Security is available for purchase here

HIPAA FAQ’s and articles available here
(Created by CDA Practice Support Center. Registration and login may be required to access material)

(effective 7-1-12)

A new law took effect on July 1, 2012 regarding the required elements for security forms for controlled substances. Security prescription forms for controlled substances must include the preprinted address of the prescriber (Health and Safety Code section 11162.1). Prescription forms not in compliance are invalid and will no longer be accepted. Additionally, licensed health care facilities or clinics exempt under Section 1206 (those having 25 or more licensed physicians or surgeons preprinted on the form) are not required to preprint the category of licensure and license number of their facility or clinic.

View all changes in Pharmacy Law that took effect via this link: http://www.pharmacy.ca.gov/laws_regs/new_laws.pdf.

We know that mercury-containing wastes can threaten our environment. Washed down the drain, or otherwise improperly disposed of, mercury can find its way into Sacramento waterways and the environment. As health care professionals, we play a part in keeping our patients healthy. We also need to show the public that we are good environmental stewards. SDDS is working closely with the Sacramento Regional County Sanitation District to help ensure the dental community knows how they can help.

Please post this poster in your office to remind you of these best practices!

ALSO…

Sacramento Regional County Sanitation District (SRCSD) has partnered with the
Sacramento Area Sustainable Business program to develop a certification for qualified dentists that
voluntarily take actions to prevent pollution by properly disposing of mercury.

(effective 8-20-12)

The Dental Board has amended its infection control regulations, and the amendments went into effect on August 20. A copy of the amended regulations is available on cdacompass.com

The regulations require a written protocol be developed, maintained, and periodically updated for proper instrument processing, operatory cleanliness, and management of injuries. Sample written protocols can be found on cdacompass.com. A future Update article will review the changes in the regulations.