CDA-sponsored legislation that further increases dental plan transparency became law on Jan. 1. AB 954 requires dental plans to be more transparent about the leasing of dental networks. The new law will reduce patient and dentist confusion caused by the increasing number of plans leasing their networks to other payers, many times unbeknownst to the enrollee or contracted dentist(s). The law took effect for contracts entered into on or after Jan. 1, 2020.
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.
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.
The ubiquity of cellphone use puts employers in a difficult spot. See how phone use can bring up questions of productivity, professionalism and privacy in a dental office setting, and how to develop and enforce appropriate policies.
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.
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.
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.
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.
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.
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.
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.
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.
