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2019

Dentists' use of Botox requires appropriate dental treatment plan documentation

At the direction of the 2018 CDA House of Delegates, CDA has been working with the Dental Board of California to better understand the scope of practice for general dentists as it relates to the use of cosmetic agents such as Botox and dermal fillers. The house directed CDA to take this action to clear up confusion that arose from the creation of the Elective Facial Cosmetic Surgery permit as it relates to the scope of cosmetic services general dentists may provide.

Deadline to cash Delta Dental settlement checks approaching

Delta Premier Providers who are class members of the Delta Dental class action lawsuit have until June 14, 2019, to cash their settlement checks. The $65 million settlement is the result of legal action CDA filed against Delta on behalf of members. Most settlement checks sent to approximately 14,000 class members have been cashed, but the class action settlement administrator reports that more than 500 settlement checks have yet to be cashed.

Employment-related claims against small businesses are rising

Claims of discrimination, retaliation and wrongful termination aren’t unique to large corporations. Federal discrimination lawsuits against Coca-Cola, Ford Motor Company and Wal-Mart tend to make the headlines with their multimillion-dollar settlements, but under the protection of state laws, California workers at smaller companies, including dental practices, can file lawsuits claiming that their legal rights as employees have been violated. And they do.

New lactation accommodation requirements take effect Jan. 1, 2020

Protections for nursing mothers in California were significantly expanded under a bill signed into law in October by Gov. Gavin Newsom. Senate Bill 142 clarifies employer obligations to provide breaks and safe, private locations that include specified accommodations. The bill increases penalties for noncompliance and requires that employers implement a written lactation accommodation policy beginning Jan. 1, 2020.

New CalAIM proposal by DHCS promises broad Medi-Cal reforms, adds SDF as statewide benefit

Health care providers can expect to see major revisions to the Medi-Cal program over the next couple of years as a result of a new initiative by the Department of Health Care Services. Released in late October, the California Advancing and Innovating Medi-Cal (CalAIM) proposal will implement “broader delivery system, program and payment reform across the Medi-Cal Program,” according to the proposal summary.

CDA Foundation’s 2019 grant recipient aims to bridge gap in oral health care

From a young age, Matthew Mecheal, DDS, has been sure about two things: his passion for helping others and his love for dentistry. Through the years, he never lost sight of his goals or the values that were instilled in him many years ago. As an advocate for the underserved and this year’s recipient of the CDA Foundation’s Student Loan Repayment Grant, Dr. Mecheal plans to focus on his personal objective to improve the oral health of underserved communities and minimize barriers to care.

FTC ruling now final against dental suppliers accused of violating antitrust laws

Two large, national dental supply companies charged in October with violating U.S. antitrust laws have declined to appeal the decision to the federal district court, according to a news release from the Federal Trade Commission. In an interim decision last month, an administrative law judge for the FTC held that Benco Dental Supply Company and Patterson Companies Inc. conspired to refuse to provide discounts to, or otherwise serve, buying groups representing dental practitioners.

Questions about coordination of benefits? CDA Practice Support has answers

CDA Practice Support receives hundreds of calls each year concerning the coordination of benefits when a patient has more than one dental plan for coverage. Standard COB allows secondary dental plans to pay up to 100% of the covered service, i.e., the primary plan pays the service at 80%, and the secondary could pick up the remaining 20%. Here, CDA’s dental benefits analyst covers the COB basics and answers common questions members have about COB.

Dentists encouraged to respond to Delta Dental recoupment demand

CDA has learned that due to a Delta Dental of California system error, crown procedure claims were erroneously processed and paid for, affecting approximately 350 self-funded employer groups between Oct. 13, 2018 and Jan. 10, 2019. Statements were sent to approximately 1,000 California dentists beginning the week of Oct. 21 seeking recoupment for procedure codes D2750-D2752 and D279-D2792.

Antibiotics not needed to manage most pulpal-related dental pain, ADA guideline advises

A new guideline from the American Dental Association advises against using antibiotics to manage pain and swelling for most pulpal and periapical conditions in immunocompetent adults. The guideline, published in the November issue of the Journal of the American Dental Association, recommends only the use of dental treatment for pulpal and periapical conditions. The new guideline comes at a time when antibiotics are under scrutiny.

Know your employee pay requirements during a utility power failure

With planned power shut-offs developing across California in attempt to avoid wildfires, employers are wondering how they are to compensate their nonexempt employees when businesses are unable to be open for work due to power failures. Employers generally are obligated to pay “reporting time pay” to hourly employees when these employees are required to report for work and aren’t provided at least half of their usual hours for the day.

Before recording, protect private patient information

Surveillance cameras in dental offices are becoming more and more common. The driving force behind them is typically security, as cameras can aid in loss control, deter theft and discourage other criminal activity. But cameras are not without their drawbacks. Prior to hitting the record button, practice owners should be aware of the laws and regulations surrounding their use. While laws vary from state to state, there are some basic guidelines.

Dentists required by new law to use updated informed consent form

Gov. Gavin Newsom signed legislation that revises language in the written informed consent form that dentists must provide to patients prior to administering general anesthesia and deep or moderate sedation. Although the new law does not impact the practice of dentistry, dentists should ensure that beginning Jan. 1, 2020, they are using a consent form that is compliant with the new law.

Auto-adjudication can expedite claims processing, but it can also confuse dentists

Today, many dental benefit plans use auto-adjudication to process a high number of their claims. While auto-adjudication can speed up claim processing, if an office is not aware that this type of technology is being used, the office can be confused and frustrated by processing errors as the result of manual claims submission. The following three examples illustrate how a plan might use auto-adjudication and how that process might affect dental reimbursement.

Not your father's Medi-Cal

Improvements to the Medi-Cal Dental program continue with new options for dentists who treat Medi-Cal members, including the ability to provide fluoride treatment and fluoride varnish as a benefit once every four months for patients under age 6. The increase in the benefit periodicity underscores the state’s commitment to regular preventive oral health visits for young children in California.

Compliance essentials: Hiring and paying temporary employees

Commonly, a dental practice will hire a temporary dental assistant, hygienist or front-office staff to fill in briefly for employee sick days, when the practice’s needs have increased or for an employee’s long-term leave of absence. CDA Practice Support finds that many employers are still puzzled about the requirements when hiring, classifying and properly paying these short-term employees.

Victory for direct-to-consumer orthodontic patient protection bill

Direct-to-consumer orthodontic patients will gain new protections when CDA-supported Assembly Bill 1519 becomes the law in January 2020. The first of its kind in the nation, the new law will protect patients from DTC orthodontic companies that are putting profits before patients by taking potentially unsafe shortcuts to the accepted standards of care.

'ABC test' is now the law, but it's not a free ticket for independent contractors

Beginning Jan. 1, 2020, it will be more difficult for most employers in California to classify workers as independent contractors, rather than employees, and in some cases will make employees out of independent contractors. And although CDA secured an exemption for dentists, employee classification still isn’t clear-cut, and dentists will need to err on the side of caution when classifying their workers.

Gift card scam targets dentists, dental professionals in California

A current email scam is using the name of CDA President Del Brunner, DDS, in an attempt to trick the recipient into purchasing a high-value gift card from a multinational retailer. As of this writing, CDA has not received any reports from members who have received the imposter email but has confirmed that the emails are circulating to individuals in the California dental field.

Dental practice pays $10K to settle disclosures of patients' PHI on social media

A private dental practice in Dallas, Texas, has agreed to pay $10,000 to the U.S. Department of Health and Human Services’ Office for Civil Rights to settle potential violations of the HIPAA privacy rule. The HHS reported that the OCR completed its investigation of a complaint by a patient who alleged that the practice disclosed on social media the patient’s last name and the details of the patient’s health condition.

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