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. For dental care, one of these exceptions is:
. . . if a health care practitioner prescribes, orders, administers, furnishes, or dispenses a controlled substance to a patient as part of the patient's treatment for a surgical procedure, if the quantity of the controlled substance does not exceed a nonrefillable five-day supply of the controlled substance to be used in accordance with the directions for use . . .
The department “has adequate staff, user support, and education” to handle issues that arise with CURES use, the DOJ notice stated. Prescribers with CURES-related questions can email the DOJ or call 916.210.3187.
June 14, 2027: Replace Amalgam Separators Dental facilities with amalgam separators on June 14, 2017 must replace that separator by this date and comply with documentation requirements. Separators must be compliant with either the American National Standards Institute (ANSI) American National Standard/American Dental Association (ADA) Specification 108 for Amalgam Separators (2009) With Technical Addendum (2011) or the International Organization for Standardization (ISO) 11143 Standard (2008) or subsequent versions so long as that version requires amalgam separators to achieve at least a 95 percent removal efficiency.
July 14, 2020: Install Amalgam Separators Dental facilities without amalgam separators on June 14, 2017, with exceptions, must install an amalgam separator by this date and comply with documentation requirements. Separators must be compliant with either the American National Standards Institute (ANSI) American National Standard/American Dental Association (ADA) Specification 108 for Amalgam Separators (2009) With Technical Addendum (2011) or the International Organization for Standardization (ISO) 11143 Standard (2008) or subsequent versions so long as that version requires amalgam separators to achieve at least a 95 percent removal efficiency.
Jan. 1, 2019: Enroll or opt-out of Medicare Dentists who treat or refer Medicare enrollees or prescribe medication to Medicare patients through the Medicare Part D program must either enroll in Medicare as a provider, or opt-out of enrollment. To assure one's status with Medicare and ensure patients' Medicare benefits do not lapse, dentists should allow sufficient time for processing whichever form is submitted.
Aug. 30, 2018: Replace three Prop. 65 signs with single sign Proposition 65 regulations were amended in 2016, allowing dental practices to replace multiple notices with one notice or provide the warning as part of the written informed consent. A dentist employing 10 or more employees and using one or more of the chemicals on the Proposition 65 list must provide a warning notice. CDA strongly encourages dental offices with fewer than 10 employees to post the sign or use the warning notice, because the definition of employee is broad, and dentists should err on the side of caution. The new regulation is effective Aug. 30, 2018. However, dental practices may choose to comply with the new regulations now and they will be considered in compliance. The posting of the old Proposition 65 warning notices for restorative materials, nitrous oxide and bisphenol A is deemed compliant until the effective date of the new regulation. CDA has developed a resource guide that includes frequently asked questions and Prop. 65 notices in numerous languages.
Members may place free classified ads on the FMDS website by faxing or emailing your ad to the FMDS business office. Once your ad has been placed you will be given an opportunity to proofread and let us know of any necessary changes. Ads will remain posted for 60 days or simply call us to remove it.
A San Francisco Superior Court judge has granted final approval of the $65 million amended settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists. The comprehensive settlement is the result of a lengthy legal battle that CDA initiated in 2013 after learning of Delta Dental’s plans to reduce Premier provider rates by 8 to 12 percent. CDA brought the litigation to protect the rights of its members and to require Delta Dental to honor the terms of its contracts.
“We told our members we would go to the mat for them and that’s exactly what we did,” said CDA President Natasha Lee, DDS. “This litigation demonstrates the great lengths CDA is willing to go to protect our members especially since individual dentists feel it would have been impossible to fight a company like Delta Dental on their own.”
During litigation, CDA discovered that Delta Dental had been imposing limitations on provider annual fee filings. As part of the settlement, Premier dentists who had their fees reduced by Delta Dental’s “inflationary adjustment percentage” are eligible to receive proportionate reimbursements based on the amount their fees were limited. Those not receiving settlement reimbursements were not affected.
Specific terms of the settlement include:
Delta Dental will pay up to $65,029,299 to Premier dentists whose requests for fee increases submitted to Delta Dental were limited by the INAP.
While allocations vary significantly depending upon a dentist’s practice size and the degree to which requests for fee increases were limited by the INAP, more than 14,000 dentists have been allocated an amount ranging from $500 to many thousands of dollars, with the average allocation calculated at $4,480. A notice of allocation amounts will be sent to those involved — no claim form is required.
Delta Dental will provide Premier dentists with 120 days’ notice of material changes to participating dentist agreements. Delta Dental also will provide, for each Premier dentist affected by any future maximum fee allowance reductions, an individualized illustration of how those reductions would potentially affect the dentist’s practice. This will give dentists additional time and information to evaluate the impact of any changes and will enable them to make informed decisions about their contract with Delta Dental.
Delta Dental will provide CDA with 12 days’ notice of changes to participating dentist agreements to prepare for questions from its members.
Delta Dental will separately pay $2.35 million for attorneys’ fees and expenses.
Although this agreement does not prevent future rate reductions, CDA successfully blocked Delta Dental’s attempt to reduce Premier provider reimbursement rates during the five-year litigation, saving dentists — even those not receiving settlement payments — more than $600 million in Premier plan fee reductions.
CDA is committed to supporting members in many ways, including through advocacy, protection, practice support resources and, most recently, the creation of The Dentists Service Company Marketplace, which offers significant savings on dental supplies.
CDA will continue to keep members informed about next steps regarding the Delta Dental settlement through the Update, newsletter and cda.org. Details on the terms of the settlement agreement and all significant related documents will be available soon at DeltaDentalofCaliforniaSettlement.com.
Members with questions about the terms or meaning of the settlement may contact CDA at 800.232.7645.
CDA Presents is scheduled for September 7-9, 2018 in San Francisco
You’ve provided the education, a catered lunch and blocked out the time for you and your team. Now you’re wondering what else you should provide when it comes to continuing education events for employees — more specifically, compensation. It is a common question for employers and the answers aren’t always black and white. Generally, compensation is required for employees who spend time in lectures, courses, meetings and trainings that are directly related to their current position and held during regular working hours. Consider the following scenarios:
- Your practice schedules a bimonthly meeting on Thursday afternoons from noon to 1:30 p.m. You provide lunch and attendance is mandatory. Should you compensate? The answer is yes. If your employee’s presence is mandatory, the employee must be compensated. In addition, because your employee most likely was not provided a 30-minute unpaid, uninterrupted meal break, by law they must also be paid an additional hour of pay for the day as a penalty for not providing an uninterrupted meal break time. In order to avoid this, a suggestion is to provide your employee a 30-minute unpaid break prior to the start of the mandatory meeting.
- Your licensed staff is required to attend courses in order to legally maintain licensure. You’ve provided payment for attendance at a specific course offered in your local area. Are you required to compensate for the employee’s time in class? The answer is maybe. Presumably, it is the responsibility of licensed staff to maintain active licenses as a condition of employment. You, as the employer, are not responsible to pay for or reimburse for voluntary courses taken by your employee in order to maintain licensure, even if the time off requested is during a regularly scheduled business day. However, if you require staff to attend a specific course(s), then yes, the time in class and travel time to and from (beyond normal commute time) is compensable and reimbursement for the course is mandatory.
- What interests you about working for this practice?
- What caused you to seek new employment?
- Our practice hours are ________ and our expectations are _______________. Will you be able to work those hours? Is there anything that would keep you from attending work during a regularly scheduled workweek?
- What work experience do you have that you feel qualifies you for this position? How do you think your experience has prepared you for this job?
- Why did you choose this field?
- How would you describe your chairside manner?
- How do you handle unexpected changes to the schedule? Cancellations? Emergency patients?
- Describe your communication style.
- Describe your experience at your previous employer.
- Describe an achievement that you are most proud of. How much time and effort did you put into this achievement? When you think about getting along with others, what do you consider your strengths and weaknesses?
- Describe a situation when you dealt with a difficult patient/co-worker/employer. How did you handle it?
- Describe a time when your work was criticized and how you handled it.
- Describe how you determine your priorities on the job. How do you schedule your time?
- Describe your favorite job to date. Why?
- Least favorite job. Why?
- What are your goals and objectives as they relate to this position?
- What have you done to improve your skills?
- Only if applicable to your specific practice, what languages do you speak or write fluently?
In advance, prepare several practice scenarios that could occur and ask how the candidate would handle these.
Irrespective of an employee’s full time or part time work schedule, any time worked over 8 hours in one day or 40 hours in a workweek is considered overtime.
While this is an irregular method of payment, CDA is not aware of any regulation prohibiting a benefit plan from making payment with a credit card. We recommend calling the benefit plan and requesting a check as you have done so in the past. Another consideration is to not request assignment of benefit and have the patient pay you directly for services rendered.
The legal department of the American Dental Association conducts analyses of dental plan contracts with their providers, and makes those analyses available through the state dental associations. CDA has a collection of plan provider contracts. You can contact CDA Practice Support about the contract you wish to have an analysis of. They will likely ask for the first page of your contract, faxed or emailed, so that they can determine whether the analysis they have applies to the contract you are considering.