Regulatory Compliance

Dentists who are purchasing or starting a practice or making a change to their business structure should be aware of a new IRS requirement. As of May 13, 2019, only individuals with a tax identification number — either a Social Security number or an individual taxpayer identification number — may request an employer identification number.

When performing procedures on exposed dental pulp, water or other methods used for irrigation must be “sterile or contain recognized disinfecting or antibacterial properties,” according to a new requirement that all licensed dentists in California must follow beginning Jan. 1, 2019.

Many bills were introduced over the past year to combat the opioid epidemic in California, as CDA previously reported. Here is an overview of CDA-supported legislation in the areas of e-prescribing, informed consent, interstate data sharing and prescription-pad requirements, that Gov. Jerry Brown signed into law in September and how these bills will affect the practice of dentistry.

Beginning Oct. 2, all licensees authorized to prescribe, order, administer, furnish or dispense controlled substances in California must, with some exceptions, check a patient’s prescription history in CURES 2.0 before prescribing a Schedule II-IV substance, as CDA first reported in April. One notable exemption to mandatory CURES consultation that applies to dental care and that CDA helped secure is summarized here.

No later than Aug. 30, 2018, dental practices that employ 10 or more employees must post at the entrance of the office the new Proposition 65 warning notice, unless the practice chooses instead to provide a warning with an informed consent form. The form must be signed by the patient prior to exposure to the chemicals regulated by Proposition 65.

On May 24, 2018, the Registered Dental Assistant Written and Registered Dental Assistant Law and Ethics examinations are expected to launch as a single combined exam. The Dental Board of California and the Dental Assisting Council in a December 2016 meeting agreed to take this action to “ensure that the combined examination is legally defensible and meets the requirements of Business and Professions Code Section 139.”

The Department of Justice on April 2 announced that California’s Controlled Substance Utilization Review and Evaluation System, also known as CURES 2.0, is ready for statewide use and that mandatory CURES consultation becomes effective Oct. 2, 2018. Beginning on this date, prescribers must check a patient’s prescription history in CURES 2.0 before prescribing a Schedule II-IV substance, with some exceptions.

In a final rule issued by the Food and Drug Administration, 24 active ingredients used in nonprescription antiseptic products are “not generally recognized as safe and effective” (GRAS/GRAE) for use by health care professionals in health care settings or situations “due to insufficient data.” The ban applies to use of these ingredients in over-the-counter antiseptics and takes effect Dec. 20, 2018.

Dentists have reported to CDA that pharmacies have rejected their prescriptions due either to forms that are out of date or are missing required elements. All prescriptions have been for controlled substances, which must be on tamper-resistant forms printed by California-approved printers and containing California-specific pre-printed elements.

The ordered closure in mid-December of a children’s dental clinic in Southern California reminds dental practices of the importance of cleaning and maintaining dental unit water lines for the safety of patients. CDA urges dentists to ensure they are following the Dental Board of California’s current requirements along with CDC recommendations.

CDA Practice Support recently received a call from a dentist about a disgruntled patient who was accusing the dentist of violating the patient’s HIPAA privacy rights because of a past-due bill.

Specifically, the patient claimed that they received a letter from a collection agency and the fact that the collection agency had their information was a violation of the Health Insurance Portability and Accountability Act (HIPAA). CDA confirmed that this is not a violation of HIPAA as long as the dentist took the proper steps to inform patients how the practice uses patient information and to provide to the collection agency only the minimum necessary information for the agency to perform its work.

What must a dental office emergency kit contain? The answer varies depending on individual state dental board requirements. There are basic necessities dentists are required to include in emergency kits, according to the American Dental Association Council on Scientific Affairs.