February 2007 Newsletter

-1/9/07-

Attendance: Ashmen, Brunsden, Courey, Fahsbender, Galkin, Glickman, Kahn, Krantz, Patel, Prabhu, Rosen, Savage, Schambra, Silverstein, Simos, Stein, Villa, Vitale, Weiner
Acceptance of Minutes-vote unanimous.
President’s Report-Robert Silverstein
We inadvertently omitted in his bio that Carl Langbert was a past president of NJDA. I have apologized to Carl for this omission.
Treasurer’s Report-Scott Galkin
See full report on page 3.
Website Editor’s Report-Bob Silverstein
I have offered my expertise to NJDA to help them reduce their printing costs. We have 7 members registered to receive the newsletter electronically. Members are reminded that they can register by going to www.MCDSofNJ.org, clicking
on the Member link, then clicking on the Of Current Interest link.
Program Chairperson’s Report-Bob Ashmen
Dr. David Goteiner will present “Gingival Manifestations of Disease” at the February meeting. The Board approved Dr. Susan Calderbank’s lecture on Oral Complications of Cancer as this year’s Sy Symanski lecture.
Give Kids a Smile-Cavan Brunsden
On Friday February 2nd, 3000 needy children will have access to dental care at over 30 sites widely spread throughout the State. 580 volunteer dentists, hygienists, dental assistants and staff will provide humanitarian services on behalf of organized dentistry. Please join up with your colleagues as they continue to support our profession. Contact Ricky Dibofsky at NJDA and Cavan Brunsden for more information.
NJDA Council Reports:
Dental Benefits-Mark Vitale
See full report on page 8.
Governmental and Public Affairs-Mitch Weiner
See full report on page 5.
Membership-Scott Galkin
The jointly sponsored presentation by NJDA and MCDS entitled “After Dental School 101: What Do I Do Now?” was a rousing success. Drs. Cavan Brunsden, Hugh Habas, and Mitchell Weiner, all MCDS members, were the presenters and each spoke on a variety of differing subtopics within the main subject. The feedback from the diverse audience was excellent. The MCDS membership committee is contemplating having this presentation for our newer, younger members in the future. The MCDS membership committee will continue with our new member welcoming program in the New Year. Also the NJDA Membership Council is meeting on Thursday, January 25, 2007 to review state membership protocols and programs.
Membership:MCDS Study Club-Dr. Ethan Glickman, facilitator
The next meeting of the MCDS Study Club will be on Thursday, February 8, 2007. We will be meeting on the main level of the Clarion Hotel on Rte 27, Edison, NJ in the “Club Room.” This is our fourth meeting of 20 MCDS members. The format is a dinner meeting, starting at 6:30 PM, in a roundtable discussion group. We have had three very animated and enjoyable meetings.
The plan is to start a new MCDS Study Club[2] as new MCDS members join the group so that we can have viable group discussions. at each meeting in this round table format. We discuss cases that our members are actively treating and share information on everything from starting a dental practice or associating to retirement concepts. Please consider joining your fellow colleagues in this new type of Study Club at MCDS. Again this is a very valuable member benefit for all our members of MCDS. Please contact Marlene Glickman, our Executive Secretary for MCDS, at # 732-238-1255 for additional information and registration in advance.
Peer Review-John Fahsbender, Mark Vitale
Two cases were resolved through mediation.
Committee Reports:
Corporate Sponsorship-Constantine Simos
David Stein has been involved in the effort to organize sponsors for the upcoming meetings. Marlene will provide assistance with maintaining a database of vendors to facilitate future contacts.
Mentor-Ethan Glickman
Our next program that will satisfy the OSHA standard on Occupational Exposure to Blood Borne Pathogens, which is required annually for dentists and staff, will be given on May 17, 2007, Thursday Each office person trained will receive certification that they have been properly instructed for this OSHA regulation on Infection Control. Two CEU credits will be awarded to those attending this 2-hour seminar. This seminar is available to our members for $15/PP as a member benefit of MCDS.
See the OSHA insert in this Newsletter for additional information and registration. We had 37 MCDS Dentists and 59 staff attend our previous OSHA program on November 9, 2006. A big “Thank You” to Dr. Joe Fertig for arranging all our room accommodations for the MCDS-OSHA programs at St. Peter’s Medical Center in New Brunswick.
Continuing Education-Mark Schambra
Dr. John Kois is scheduled to present a course to MCDS on Fri March 9, 2007: Interdisciplinary treatment planning. This course is a must for all restorative dentists, and will be rewarding for the specialty disciplines as well. The sponsors for the course are Kuwata Pan Dent Laboratory and Benco dental supply company.
Oral Cancer Screening-Arpan Nandra and David Stein (Report by Dr. Ethan Glickman)
We are determining the needs in Middlesex County for Oral Cancer Screening & Education programs.
Many towns have Health Fairs for their residents. This would be an excellent way for MCDS to show an active participation in the community if we were to have an Oral Cancer Screening & Education booth at their Health Fair. The local shopping malls have public kiosks for consumer information and education. This would also be an opportunity for MCDS to show an active participation in the community as well. We are exploring these and other ways for the public in Middlesex County to obtain information and be educated about Oral Cancer and other Dental topics of need and interest to the public.
We will be obtaining information on purchasing a portable setup for the public to have a professional “Oral Cancer Screening.”
We are actively asking “YOU,” our members of MCDS, to volunteer for this Committee. We need your help in providing these services to the public in Middlesex County. Nationally, 30,000 people are diagnosed with Oral Cancer and 8,000 actually die each year! We can be a major force for the public and play a vital role in prevention and early diagnosis that can lead to a better survival rate for the public.
Let’s “PAY IT FORWARD” together and lend a helping hand in this very important endeavor!! Thank You
Old Business
• The Board unanimously approved a motion made by Mark Vitale to purchase an LCD projector - Sanyo PLC-XU73; XGA resolution (1024x768) 2000 Lumens, 3 year Parts and Labor, 90 days lamp, for $749. This will be used by the Program Chair for all component sponsored lectures.
• A new printer, the Xerox Phaser 7400DT was purchased for the Society.
• A motion was proposed to invite staff members of dentists to all-day lectures at the discretion of the speaker and the Board at a cost to be determined by the Board. This motion passed
New Business
• The Board discussed electronic access of the newsletter to the membership. To encourage its use, laptops will be available at the component meetings to register interested members.
• Since the current term for judicial council was coming to an end, a motion was proposed by Dr. Jim Courey, president-elect, to nominate Dr. Ira Rosen for this council. The motion was approved by the Board and will be presented to the general membership for a vote. (This nomination was approved by the General Membership on 1/16/07).
Good & Welfare
Dr. James Courey announced his retirement from the Navy Reserves. His combined time of active and reserve time was 20 1/2 years.
Respectfully Submitted,
Maya Prabhu, Secretary

NJDA Council on Public and Governmental Affairs

Legislative Initiatives
-Dental Consultant Legislation (A.2134) - This legislation, sponsored by the Assembly Insurance and Financial Institutions Chair, Neil Cohen (Union County) has four main points: (1) it requires insurers to use dentists to make initial adverse determinations when dental diagnostic judgment is used regarding the payment of claims; (2) it requires that any adverse determinations when dental diagnostic judgment is used to be reviewed by a dentist who is subject to oversight by the New Jersey State Board of Dentistry (either licensed or registered under a new certificate class); (3) it requires that the reviewing dentist’s name, address and telephone number be given to the treating dentist and that the treating dentist reserves the right to confer with the reviewing dentist and receive a written narrative if requested; and (4) it adds an additional licensed New Jersey dentist member on to the State Board who is a dental consultant and who is recommended by the New Jersey Association of Health Plans (the trade association for the insurance companies). Presently, the NJDA recommends to the Governor for the eight other dentist members on the State Board. However, the Governor is not bound to any organization to appoint their recommendations.
-This bill is a compromise worked out between the NJDA and the insurers. Negotiations occurred at the bill sponsor’s request to ensure that the legislation could advance. There was strong opposition to the compromise bill from one component. As such, the component will be offering a motion to rescind support for this legislation at the next NJDA board meeting even though the NJDA Board of Trustees already voted 16-3 to advance this compromise in November 2006.
-Cosmetic Surgery Tax Repeal Legislation (A.2282) - Although passed by both Assembly and Senate by a vote of 118-0-1 in December 2006, Governor Corzine is threatening to veto it because the state is cash strapped. The NJDA and its coalition physician partners have had meetings with the state treasurer, the Governor’s office and the legislative leadership to push for the Governor to sign the repeal into law. However, the Treasurer disagrees and said he would take any positive revenues the tax creates no matter how small.
-The NJDA has posted an action alert on its website (www.njda.org) calling on all members to contact the Governor and urge him to sign the tax repeal. They also sent out an email alert requesting the same action. Presently, the NJDA has about 55 percent of the membership’s emails.
-Limited Teaching Certificates Legislation (A.2761) - This legislation, which is being advanced by the NJ Dental School has been amended slightly so that no more than 15 persons with limited teaching certificates can come from non-Board approved schools (non-US or US territories, non-Canadian) per institution. Additionally, the limited teaching certificate will expire upon school employment termination and does not allow the individual to enter into private practice. Similar bills have been introduced in both legislative houses and it has passed out of the Assembly Committee.
-Dental Practice Ownership (A.3919) – This legislation, sponsored by Assemblyman Jeff Van Drew (Cape May), a member dentist, allows for spouses/executors to legally contract with another dentist to continue the practice of a deceased or incapacitated dentist for up to one year to ensure a reasonable time frame for the sale of the practice. Similar legislation has been passed in other states recently.
-Craniofacial Anomalies Legislation (A.3871) – Recently, this legislation was introduced to require insurers to cover treatment of congenital craniofacial anomalies. Dentistry is not yet expressly mentioned in the legislation, so the bill will need to be amended to clarify that dentists may also perform these procedures. This will be addressed by NJDA.
-Universal Healthcare Proposal (NJ) - State Senator Joseph Vitale (Middlesex), the Senate Health Committee Chair, is the primary mover behind this concept. He met with NJDA in December to get our input. At the moment, only certain limited types of dentistry would be covered under the proposal. According to the Senator, there are 1.4 million uninsured in the state and the cost to run this program would be about $1.7 billion in the first year. There are no concrete funding plans at the moment, but the thought is that it will be paid for by forced employee contributions.
-During the meeting, NJDA representatives also spoke about the need for community water fluoridation as a way to cut dental treatment costs, as well as the deplorable state of the current Medicaid program.
-UMDNJ Merger/Restructuring Hearing – The NJDA was invited to testify before a joint legislative task force on this matter. In the testimony, the NJDA stressed that the quality of UMDNJ’s dental school must be preserved regardless of the final restructuring scheme.
Regulations
-Ocean County Utilities Authority Amalgam Waste Rule Proposal – Even though the state is supposed to administer the proposed amalgam waste regulations, the Ocean County Utilities Authority is considering preparing a separate amalgam waste compliance requirement and it has the right to do so. All local wastewater facilities have the right to be more stringent in their enforcement than the state if they so desire. Today, they have the right to inspect and require sufficient remediation steps be taken by any discharger into their water treatment plant.
-PIP Rule Proposal – The Department of Banking and Insurance has proposed a regulation that would change the rules for PIP. As proposed, the regulation would have some negative impact to dentistry, particularly Oral Surgeons. NJDA prepared written comment to the Department on the proposal objecting to: (1) the proposed change to allow insurers to determine UCR; (2) the consolidation of geographic regions from three to two; (3) the Department’s proposed bilateral reduction formula; and (4) allow dentists who hold PCS permits to bill and be separately be reimbursed for that service. To date, there has been no response or formal adoption of the rule from the Department.
-Out-of-Network Fee Changes – The Department of Banking and Insurance has proposed rules to allow carriers to use the Medicare fee schedule as a basis for payment of out-of-network non-hospital provider claims (carriers would be required to pay no less than 150% of this fee schedule). However, the proposal caps what a non-participating health care provider (including dentists) can charge a covered person’s for co-payment to a maximum of 40% of the fee schedule. This will result in significantly reduced benefit payments to out-of-network non-hospital providers. The proposal requires carriers to offer at least one health plan that uses the traditional ‘UCR’ type data as a basis for payment to out-of-network non-hospital providers. At the moment, it is unclear as to whether this will pertain only to Oral Surgeons submitting medical claims or to the entire scope of dental services and dental insurance since there is no Medicare fee schedule for dental services (as they are not covered by Medicare). If this does include all dental services, then it may involve the use of NJ Medicaid fees or some modification of these fees. These regulations appear to be directed at moving non-participating dentists into networks that they have avoided, as the new regulations mandate such low re-imbursement rates that the reduced fee plans that non-participation dentists avoided previously will seem generous compared to the option of staying non-participating. This proposed regulation from the Department of Banking and Insurance was just released and the comment period is still open. The NJDA is expected to make comment on the proposal.
-OSHA Exposure Control Plan/Safety Needles - A recent Capsule article was discussed that was a response to a member dentist being fined after an OSHA inspection for failing to evaluate the availability and adequacy of safer needles (this OSHA inspection appears to be the result of a disgruntled patient and was not a ‘random’ site visit). A review of the recent Capsule article will familiarize members as to the specifics of OSHA’s requirements on this matter. Dentists are required by law to comply with all regulations, and can be fined for non-compliance regardless of how an inspection is instigated.
New Business
-The Council’s Chair, Bryon Roshong, has suggested that the NJDA investigate a legislative initiative to require that children receive a dental examination prior to entering school – similar to the state’s vaccination law. Even though a number of states already require this, NJ has no formal requirement. The reasoning is that if immunizations are required for children, why shouldn’t dental exams (by practicing dentists, and not school nurses or other auxiliary personnel)? This proposal will be discussed further at the next Council meeting.
-The Council decided that more meetings would take place each year to minimize the chances that components would feel that legislation or regulations were rushed through and not discussed more thoroughly.

Council on Dental Benefits

-CRP Statistics was reviewed from January 1, 2006 through October 31, 2006. There were 101 complaints submitted to NJDA; 54 were resolved, 17 were for data purposes, 26 are pending and 4 were not resolvable. Staff provided the council with statistics on the number of CRPs opened per component. The council noted the number of complaints due to carrier requests for refunds, and the fact that the “innocent third party creditor” concept would not apply if the dentist has an agreement with the carrier. It was reported that Horizon recently requested refunds on claims going back several years based on the patient’s eligibility status. The council then discussed whether or not there should be a limit to the time that a carrier can go back. One way individual dentists may do that is by negotiating a time limit in the contract. Another possible solution is a legislative remedy, which NJDA will investigate.
- The council discussed an article on “Evidence Based Medicine” written by a physician critical of the concept as forcing patients into a “one-size-fits-all” approach, and how this relates to the evolution of Evidence Based Dentistry (EBD). Dr. Iserson gave a PowerPoint presentation on the subject that was originally delivered by Dr. Ronald Inge at the Dental Benefits Conference. The council noted in its discussion that EBD for payment purposes and EBD for treatment purposes are not equal. The definition of EBD is the integration of scientific evidence, the dentist’s clinical expertise and judgment, and the patient’s treatment needs and preferences. EBD can be a useful tool to the dentist when presenting treatment options to the patient, but should not be the deciding factor for treatment. EBD is driven by the Federal Government to control cost. Essentially there will be report cards for health care providers and reimbursement will be based on the outcome of treatment.
-Health Standard Setting: If the DDS’s Don’t Do It, The MBA’s Will (ADA News 10/20/06): The council discussed the speech given by HHS Secretary Leavitt at the ADA House of Delegates. The thrust of his speech involved the government’s ongoing task of organizing the health care sector into an economic sector that rewards choices that produce value. He outlined the four cornerstones of such a system as: Electronic connectivity; independent assessment of patient care based on standards established by medical specialists; information on cost that is understandable and comparable; and competition. An overview of the department’s position is available on its website (www.hhs.gov) under the topic of “Value Driven Health Care.”
-Benefits for Children less than 2 years old: The council reviewed, as informational, Delta’s response to the concerns raised with regard to excluding benefits for children less than 2 years of age. The response indicated that the majority of groups do not contain that exclusion, but some employers do choose to exclude benefits for this population despite Delta’s advice.
- Delta’s Processing Policy for CDT-2007: The council reviewed, as informational, Delta Dental’s recently published processing policies for new and/or revised procedure codes. Staff reminded the council that, for participating dentists, “disallowed” means that Delta will not pay and the patient may not be charged. Dentists who participate with Delta Dental Plan would be prudent to review Delta’s October 2006 newsletter, which contains “processing policies” relative to the new ADA codes, as well as fee filing forms. Remember, too, that Delta Dental Plan of New Jersey previously announced a change in its calculation of the participating dentist “allowable charge” that is due to take effect on January 1, 2007.
- Order the CDT-2007 from the ADA Catalog on-line or call 800-947-4746. Effective on January 1, 2007, CDT-2007 contains 22 new procedure codes, 33 revisions to nomenclatures or descriptors, and three code deletions. The CDT is a useful resource for every dentist or office manager, containing answers to common coding questions, step-by-step instructions on completing the new ADA claim form, and information about the National Provider Identifier (NPI) and how to apply.
-VA Dental Program Details: The council reviewed, as informational, a description of the Veterans Administration (VA) Fee Basis Program. Given the fact that the VA is responsible to provide care for dental conditions incurred during active military duty, the needs of returning veterans exceeds the VA’s capacity, and private dentists are being asked to give priority to these individuals. The VA will approve the dentist’s treatment plan and fees in advance, and payment will be made by the VA within 30-60 days.
-Follow-up to Meeting with Horizon concerning Overpayments: Staff reported that Ms. Moskal and Mr. Meisel had a telephone conference with representatives of Horizon medical plan as a follow up to a personal meeting on the topic of Horizon medical requesting refunds (and/or withholding payments) from non-participating practitioners. Horizon’s attorney is of the opinion (which is being sent to NJDA in a formal letter) that the “innocent third party creditor” principle is trumped by a recent amendment to the law that requires plans like Horizon to inform practitioners about overpayments before automatically withholding monies from other payments. After receiving Horizon’s written confirmation of its position, NJDA expects to request an opinion on the matter from the New Jersey Department of Banking and Insurance.
-Health enterprise Zones: Staff reported that the regulation to effectuate the provisions of the HEZ statute have been published. The regulations outline the procedure for calculating the tax deduction available for qualified primary care medical and dental practices in medically underserved areas for taxable years of practices beginning on or after September 2, 2004. www.state.nj.us/treasury/taxation
-NPIs Required for Electronic Transactions by May 23, 2007: you can apply at www.npps.cms.hhs.gov. Please note that you must have separate NPI’s for each dentist in a practice along with a separate NPI for a corporation if you are set up as such.

Correction

The January newsletter section devoted to new Life Member biographies accidentally omitted that Dr. Carl Langbert was a past president of NJDA. We apologize for the omission.

Announcement

The U.S. Dental Tennis Organization (USDTA) is a recreational and educational club that boasts a membership of more than 300 dentists from the United States and Canada. Participation is available to dentists, dental auxiliaries, and their spouses. The USDTA’s most recent meeting was held in Palm Springs, CA, during which Lucian Kahan, a periodontist from East Brunswick and a member of MCDS was elected president. The meeting combined morning lectures, afternoon tennis, and evening social events. To learn more about becoming a member of this unique organization visit their website at www.dentaltennis.org

MCDS member seeking part-time associate position in and around Woodbridge,NJ area.
Please contact:
Sumathi Chandrashekhar, DMD
Phone: 607-341-1172(Cell)
email: [email protected]

On Feb 7th 2007 PCDS will be running a CE seminar entitled Modern
Pedodontics for the General Practitioner and Staff. The seminar will be
at the Grand Chalet, Route 23S, Wayne and will run from 8am until noon.
The cost is $75pp for NJDA members and $35pp for their staff -
continental breakfast and 4 CE credits included! The brochure can be
obtained by calling PCDS at 973-812-1101 or e-mailing PCDS at
[email protected].

St. Peter's Medical Library
Members of the Middlesex County Dental Society are allowed to borrow dental materials from the Medical Library at Saint Peter’s University Hospital. A valid ADA ID must be presented in order to borrow materials. Here is a list of some of the materials in the dental collection:
• Excellence in Cosmetic Dentistry-Video Series; • Gordon Christensen Video Tapes;
• Journal of Oral and Maxillofacial Surgery; • Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics.
Information about the Medical Library,
including hours of operation, can be found at www.stpeterslibrary.com

February 2007 Newsletter

Featured Speaker:

President's Message - Dr. Robert Silverstein

MCDS Board of Trustees Report

Treasurer's Report

Announcements/Articles