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.
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.
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.
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.
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.
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.
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.
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.