February 2000 Newsletter

Attendance: Bloom, Brunsden, Chustckie, Clemente, DeSciscio, Fahsbender, Fertig, Huberman, Kahn, Kline, Krantz, Livanos, Prabhu, Schambra, Silverstein, Villa, Weiner
Acceptance of Minutes –10/12/99-Accepted, vote unanimous. 11/2/99-Accepted, vote unanimous.
President’s Report-M. Schambra
• The accountant for MCDS has completed the documentation required for the IRS to designate MCDS as a “not-for-profit” organization. The completed forms, along with a copy of the MCDS by-laws and the required fee, will be mailed to the IRS this week. Dr. Villa and Dr. Schambra will keep the board apprised of the status of the application.
• Dr. Schambra spoke with other components that have executive secretaries. He found that they were long-term positions, held between 9-23 years for the four components that were contacted. The duties varied from basic secretarial like the minutes and handling phone calls to more extensive tasks like newsletter layout, keeping and printing a membership directory, and coordinating a job bank. All of the positions started part-time and expanded and became more complex over time. The Board discussed possible candidates for the position. Marlene Glickman was presented as an interested candidate. The board voted on offering her the position; 15-yes, 2-abstain. Drs. Schambra, Bloom, and Villa will meet and discuss the immediate duties of the secretary.
• The dues reduction of $13 was reflected in the bills sent to members by NJDA, so there was no net increase in dues for the MCDS members this year (this was to offset the $13 increase from ADA).
President-Elect’s Report-C. Bloom
The slate of nominees was discussed. Dr. Krantz agreed to extend his tenure as NJDA trustee. Dr. Perlmutter will remain as alternate trustee, however, he does not wish to succeed Dr. Krantz as trustee. The Board will consider other nominations to replace Dr. Perlmutter as alternate trustee.
Editor Reports
Ross Kline-Business Editor-All advertisements are paid to date. Two advertisers have renewed for another year.
Program-M. Weiner
• There will be a business meeting on “Officer’s Night”.
• A phone call was received from a member dentist asking if his office manager could attend the February lecture “Employment Law Considerations”. Until this time, the meetings and scientific lectures have been open only to member dentists and invited guests. A motion was made to allow staff members to attend scientific lectures if a member dentist in good standing accompanies them and they pay for their dinner. Discussion followed. Vote 9-yes, 5-No.
• The plaque needs to be ordered for the Sy Symanski Memorial Lecture.
• A/V equipment needs to obtained for the Symanski lecture.
Special Olympics-C. Brunsden
NJDA’s support of New Jersey Special Olympics continues. Sixty billboards are presently posted statewide.
NJDA Council Reports:
NJDA Board of Trustees Report-D. Krantz
• Art Meisel will re-examine all policies as new executive director of NJDA.
• New Jersey lost a membership seat at the ADA level because the overall membership for the state went down.
Membership-R. Kline
On November 18, 1999 the NJDA Membership Council met along with the Membership Task Force. A Forum for Minority Issues was dropped in favor of having more involvement/representation with the Minority Dental groups in the State. It was decided to have members from NJDA attend the meetings of the Minority Dental Associations, and to invite their representatives to attend our meetings, especially the Atlantic City convention, in ordered to try and foster better communications and relations. In addition, the task force will try to assess and address the needs of the members and non-members based on their years in practice. For example, Dentists will be targeted/marketed to differently based on their first 5 years in practice, their second five years and then years 10-20. Thoughts were also given to sending congratulations and welcome letters to new licenses in the State. Art Meisel reviewed the new Installment Payment plan with the hopes that this would help some the younger members afford the dues payments.
Dental Education-P. DeSciscio
A statewide Dental Radiography course will be held April 5, 2000 in North Jersey. This is a member benefit for continuing education requirements. The cost will be for meals only.
Children’s Dental Health Month-C. Brunsden
This year’s programs include the County-wide School Poster Contest, the Pediatrician’s Awareness Program, County School Nurse’s Continuing Education, NJDA at the Circus, and the Dental Health Fair and Awards Ceremony.
Peer Review-J. Fahsbender
Four cases have been reviewed and ruled in favor of the patient.
ADPAC-P. DeSciscio
This year’s fundraiser will be back at the Meadowlands for a “Night at the Races” which will be held in March or April. The date will be announced shortly.
Old Business
The bylaws need to be amended regarding the associate editor. A motion was made to pluralize to Associate Editors and add corporate sponsorship and newsletter advertising to the duties. Vote unanimous.
Respectfully submitted,
Bruce A. Huberman, DMD
Secretary

• The NJDA Board of Trustees voted to allocate funds to provide CE Record Keeping Folders to the membership for the current biennial licensing period.
• The Membership Council discussed the feasibility of inviting dental students and non-member first year licensees to the NJDA Annual Session as a vehicle for membership recruitment. It was noted that biographical information could be included on the application for the Annual Session and that the affected groups could only attend at no cost if they pre-registered. As this is only a proposal, further input will be solicited from the Council on Annual Session.
• NJDA has filed suit with Princeton Insurance Company on behalf of its members based on denial of coverage for Hurricane Floyd related damages that NJDA Counsel believes is within the parameters of covered benefits.
• The Department of Human Services had a meeting to discuss next years budget including increasing Medicaid’s dental reimbursement (currently the worst reimbursement of all 50 states!). The Medicaid Subcommittee will get together with NJDA Attorneys to discuss the issue further.
• NJDA submitted comments to the DEP on Regulated Medical Waste proposing a reduction of fees charged to small generators and/or an exemption for those generators.
• The New Jersey Health Care Consumer Information Act sets up a database with information on malpractice suits against physicians and podiatrists. The Department of Consumer Affairs is to prepare a report on expanding the data base to include, among others, dentists in the next 18 months. The bill was held at the last Senate Budget Meeting and is being closely monitored by NJDA Governmental Affairs personnel.
• In order to help “jump start” the new UMDNJ Student Component of NJDA, the Council on New Dentists proposed that the general membership be solicited to sponsor a UMDNJ Student for their $10 membership dues in addition to serving as a mentor/contact during their dental school tenure. This proposal will be brought to the NJDA Board of Trustees.

•MCDS reduced our dues portion $13 to make up for the $13 dues increase this year by the ADA, therefore giving their members no net dues increase for 2000. A combination of non-dues income (corporate sponsorship/advertising), savings from printing the newsletter in-house, and continued fiscal restraint by the MCDS Board has enabled us to provide our members with this benefit.

•Voluntary contributions from NJDA Members are strongly encouraged to support NJDA’s sponsorship of the Special Olympics. This is a worthwhile cause that is also providing member dentists with a targeted PR marketing campaign.

•MBNA has a credit card endorsed by NJDA that provides royalties (non-dues income) to NJDA based on usage.

I was reading a novel several years ago about the voyages of Marco Polo. When he was in China at the court of the Great Khan (Genghis...not Richard), he met a character who was the royal torturer and executioner. He was referred to as the royal “fondler”. So began spin and spin control; the art of using words and terminology to make everyone think you are saying something, when in reality you are saying something else. Don’t you just love the modern health care terminology? We have Preferred Provider Organizations (PPO), Dental Maintenance Organizations (DMO), Health Maintenance Organizations (HMO), Capitation, and my favorite, Managed Care. The terminology makes them seem warm and fuzzy, patient care is paramount, and damned the cost...Let’s just get the patient well. The reality of the situation is that all these terms were invented by some clever advertising and spin control experts to hide from the public the actual purpose of these entities: Cost control. PPOs, HMOs and DMOs are nothing but contract doctor organizations where the primary aim is to minimize patient reimbursement so the profitability of the insurance company is maximized. To be fair, insurance companies are legitimately interested in the health of their insured customers, but there is always an adversarial relationship lurking in the wings where the interests and needs of the insured are secondary to the interests and needs of the insurance company. This has led to many of the abuses we hear about today: Women sent home before they recover from childbirth, denial of necessary tests, and in our arena, substitution of the least costly alternative treatment.
Please understand me. There is nothing wrong with an insurance company making a profit. But while they are doing it, they should not make it seem as if the doctor is overcharging or performing unnecessary treatment, when the real reason is poor or incomplete benefits.
There are many different payment models available in the marketplace. Some are:
Indemnity Plans are dental plans where a third party payer (insurance company, union welfare plan, etc.) provides payment after the service is performed. This payment is in the form of a table of allowances, a UCR table or a schedule of allowances. The reimbursement can be subject to annual maximums, deductibles or co-charges.
Preferred Provider Organizations (PPO) are plans where there is a formal agreement between a plan purchaser and a defined group of dentists to perform particular dental services to a defined group of patients for a prenegotiated fee. This fee is usually discounted a certain percentage off of the dentist’s regular fee. In this model, the patients can only see the group of dentists and specialists in their plan. There are variations where patients can go out of network, however.
Capitation Plans are where the participating doctors are given a list of subscribed patients and are paid a specified amount up front, usually at the beginning of each month, per head (thus “capitation”). For this fee, the doctor is required to provide certain dental services at no or reduced cost to the patient. The doctor’s monthly capitation reimbursement is unrelated to whether the patient comes in or not.
Direct Reimbursement is a self-funded program, usually cutting the insurance companies out of the equation. In its purest form, the patient goes to a doctor of his choice, receives dental treatment, pays the doctor’s fee, presents the receipt to his employer and get reimbursed from his employer. There are restrictions and guidelines, however.
Fee for Service is the traditional form of dental reimbursement. The patient receives the agreed upon dental treatment and pays the agreed upon dental fee.
In future articles, I will discuss some of the advantages and pitfalls of these and other plans.
All of the opinions expressed are my own; however I try to base them on current facts and information. My primary source of information is CDT-3/2000, American Dental Association, 1999.
Daniel B. Krantz, DDS
Middlesex Representative to Council on Dental Benefits