January 2008 Newsletter

Welcome to dentistry in 2008. It seems the only constant is the presence of change; while some dentists embrace advances and change in the field, others are reluctant. “He who rejects change is the architect of decay,” said by Harold Wilson, one of the more intellectual politicians of the twentieth century.

Change is a primary component of an American tradition of making New Year’s resolutions. A New Year’s Resolution is a commitment that an individual makes to change an aspect of their personal or professional lives; to do something differently, better. Choosing to eat healthier, quitting smoking and getting fit are common goals. Have you vowed to make this year the year to learn something new? Maybe this is the year you learn how to use the iPod and Blackberry that have been collecting dust on the shelf. Perhaps this is the year you decide to pick up a new hobby like golfing, snowboarding, or winemaking.

Professionally, you may seek a change in your practice. Has it been a while since you learned a new technique, tried a new product, or reached out other dental professionals to share opinions? The Middlesex County Dental Society (MCDS) is a great partner in helping you achieve professional goals with monthly continuing education opportunities and face-time with peers in your community. The New Year’s first opportunity for learning will be on January 15, 2008 when my good friend and colleague, Kenneth Kurtz, DDS, will join MCDS to speak about the “Biological Consequences of Clinical Intervention.” GPs and specialists alike have something to gain by attending to Dr. Kurtz’s presentation.

As for making changes, what I have learned, is that through making professional and personal changes, there is a renewed enthusiasm for work, home, and play. By choosing to do something differently or trying some new approach, you may also realize that you are the architect of an improved you. Happy New Year!

With wishes of health and happiness,
Jim

11/13/07

Attendance:Clemente, Chustckie, DeSciscio, Fahsbender, Glickman, Kahn, Krantz, Modi, Nandra, Prabhu, Savage, Schambra, Silverstein, Simos, Stein, Vitale, Weiner, Ziemba, Marlene Glickman.
Acceptance of Minutes-vote unanimous.
Treasurer’s Report-Robert Ashmen
See full report on page 3.
Editor’s Report-Bob Silverstein
Life member bios will need to be submitted immediately so that they may be printed in the next issue.
Website Editor’s Report-Bob Silverstein
I am still working on getting the Fidelity Bond. The carriers seem to have a problem with us not having an office somewhere. I think that Passaic County has this type of insurance, and I may contact them if my broker doesn’t come through in the next few days. I have the online registration for the Cranham course all ready to go, as soon as the bond is in place.
Program Chairperson’s Report-Constantine Simos
Everything is set for Dr. Hersh’s presentation next week. Dr. Cranham’s presentations will be promoted in the newsletter starting in January, online, and in the Capsule. I will also do a mailing, similarto what we did for Jameson, in January.
ADA Delegate’s Report-Peter Clemente
• The ADA is focused on access to care and is informing all members that in 2000 there were 35 million people 65 years of age and older in the U.S. representing a 12 % increase since 1990 when there were 31.2 million. By 2030 they are projecting 1 in 5 people will be 65 or older,therefore it is important that office designed to address their needs from glaucoma, arthritis, hearing loss, eye diseases, etc. Have large print on questionnaires to improve ease of reading, remove scatter rugs to reduce risk of falls, have brightly lit areas to assist reading and have chairs with arms in reception room to assist in getting out of the chair. Please check special supplement Oral LongevityTM from GSK Consumer Health, the ADA, and the ADA Foundation. The DVD is provided in hopes it will be copied and distributed to patients. Everyone received one.
• Barbara J. Smith, Phd., R.D.H., M.P.H. has accepted a new position with the ADA which addresses geriatrics and the special needs population.
• The ADA has pinpointed topics that have arisen that have an impact on older adults and dentistry and they are osteoporosis medications and their link to osteonecrosis of the jaw and the new changes in the AHA pre med. recommendation guidelines. Brochures available from ADA: “Antibiotics, Dental Treatment and Your Heart-New Recommendations” and “Osteoporosis Medication and Your Dental Health.” Also ask patients if they are on oral bisphosphonates in your medical history.
• Treating patients with coronary stents who are on antiplatelet meds requires communication with patient’s cardiologist before changing any timing of med. or dosage!!!
• Reminder that we can’t be complacent in an enviornment where awareness of dental access problems is ballooning. Healthcare in general is the number one policy issue on voter’s minds and national elections are around the corner. The ADA, state and local dental societies and individual dentists must continue to seek and create opportunities to make the case that we have better solutions to help more Americans get professional oral health care.
• Best Management Practices for Amalgam Waste: it is statutorily required to have amalgam seperators in place within 2 yrs. The ADA is developing a booklet available to be downlowded for free in Jan of 2008 to help patients understand the materials used to create dental fillings and the advantages and the disadvantages of each type of material.
• Tamper resistent prescription pads must be used by health care providers writing Medicaid prescriptions by March 31, 08.
• Voters in Juneau, Alaska last month voted by a margin of almost 2 to 1 not to reinstate flouridation of the community’s water supply.
• An article written in the Detroit News concerning “Superteeth” described the dental version of a walk in medical clinic and is the brainstorm of the founder of Supercuts. With no appointment needed and $99 for many services, the franchise “appeals to the uninsured in search of affordable dental care” as well as to insured consumers who like the convenient hours, appointment-free service and lower co-payments. Expect more iterations of retail dentistry as retail medical clinics grow.
NJDPAC Report-Mark Vitale
NJDPAC did very well in this year’s elections. Of the 40 State Senate races, NJDPAC contributed to 35 candidates of whom 33 won for a 94% winning average. (5 races NJDPAC contributed to neither candidate). Of the 80 General Assembly races, NJDPAC contributed to 58 candidates of whom 56 won for a 97% winning average. (22 candidates who won received no funding nor did their opponent). NJDPAC’s total winning average for all races to which it contributed was 96%. This is a great win.
Moreover, please note that, for the first time in NJ history and possibly the nation, 3 member dentists are serving at the same time in the State Senate, which has only 40 members. NJDPAC continued to assert itself as the top healthcare PAC in NJ.
Executive Secretary Report- Marlene Glickman
My responsibilities as Executive Secretary as numerous. Here are some of the things that I am responsible for: I answer questions from the general public and offer them assistance in finding a dentist in their area. I receive all the registrations and phone calls about the courses that MCDS presents throughout the year and create the registration information, CE forms and sign-in sheets. I contact new members and life members and create the certificates that we present to them. I facilitate the Dental Shadowing Program, which is a program that enables Rutgers students to shadow dentists in the area. I set up the registration and information for our new Dental Hygiene Club. It is quite rewarding to work with the many dedicated members of the Executive Board, who continually give their time and energy to help benefit all MCDS members.
NJDA Council Reports
Dental Benefits-Mark Vitale, Jeff Chustckie
See full report on page 5.
Membership-Tara Savage, Devang Modi
Ms. Tricia DeCotiis and the NJDA staff held their first two UMDNJ Dental School Programs. They met with the freshman class for a lunch and learn on October 17th and the sophomore class on November 7th. They will visit the dental school next on January 16th from 1-2pm for the Junior Past-Presidents Luncheon. The next MCDS study club meeting is scheduled for Thursday, December 6th at 6:30pm at the Clarion Hotel in Edison. MCDS is offering a course at no cost to MCDS and NJDA members entitled “Today’s Dental Practice: Acquisition, Management, and Lifestyle.” It will be held on January 24, 2008 at 6pm at the NJDA headquarters.
Committee Reports
Mentor-Ethan Glickman
Our next OSHA program satisfies the OSHA standard on Occupational Exposure to Blood Borne Pathogens, which is required annually for dentists and staff will be given on November 15, 2007. 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. 180 people have signed up to date. This seminar is available to our members for $15/pp as a member benefit of MCDS. 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.
The CENTRAL NEW JERSEY DENTAL HYGIENE STUDY CLUB met for the first time on October 24, 2007.
Sponsored by Middlesex County Dental Society, Twenty-eight Hygienists met at the Clarion Hotel, Rte 27 south, Edison, NJ. Two CEU credits were awarded for the meeting. Robert A. Shekitka, DMD – Immediate Past President, New Jersey Dental Association, Faculty at UMDNJ, spoke about “Ethics and Conduct in Dental Practice.” This CNJDH study club is available to our hygienists as a Dentist-member benefit of MCDS. See the insert in this Newsletter for information on registration.
Old Business
A motion was proposed by Richard Kahn and seconded by Arpan Nandra to host a reception for MCDS members and NJDA invitees at the Atlantic City Convention next year. A budget of $1000 for food and beverages was allocated for this event. Motion passed.
The Board unanimously approved the proposed changes to the By-Laws (see below).
A subcommittee comprising Ethan Glickman, Mark Vitale, Jim Courey and Dave Stein was formed to look into comparing costs of running the county meeting at Clarion vs. the Pines Manor. The findings of this committee will be presented to the Board at a subsequent meeting.
New Business
Constantine Simos will be looking into the cost of mailing CE registration packets to 3000 dentists in the State.
Respectfully Submitted, Maya Prabhu, Secretary

In Memoriam
Dr. Emil R. Blaukopf
Dr. Blaukopf practiced dentistry in South River for 50 years, and he was a past president of the Middlesex County Dental Society.

In Memoriam
Dr. John Douglas Lawson, who was honored in January 2007 as a New Life Member of the Association, passed away on October 31, 2007. Dr. Lawson practiced as a principal partner in the North Brunswick Dental Group until his retirement in 1991.

The council met on September 5, 2007 and the following items were reviewed.
• CRP Statistics was reviewed by the council with cumulative statistics from January 1, 2007 through July 31, 2007 indicating a total of 211 complaints submitted to NJDA for the year. On a monthly basis, 28 complaints were received in June, and 13 were received in July. Of that number, NJDA successfully resolved 138, 17 were for data purposes, 3 were not resolvable, and 53 are still pending. Staff provided the council with statistics on the number of CRP’s opened per component to date. Monmouth-Ocean, Tri-County and Middlesex submitted the largest number of claims.
• Letter to United Concordia concerning a code definition: The council discussed NJDA’s letter to United Concordia (UCCI) on behalf of a member whose claim for incision and drainage of a periodontal abscess was denied because “the reported procedure (D7510) does not appear to meet the CDT procedure code definition”. The council discussed this as being a problem, since some members have experienced this issue in the past. Subsequent to the meeting, NJDA received UCCI’s written response, which takes the position that since the incision was not made through the mucosa, it is a “minor procedure” that should be billed using the palliative procedure code D9110. After receiving the response, the member involved spoke to the UCCI Dental Director with the result being that the claim in question would be paid, but that technically there should be a specific procedure code for treatment of a periodontal abscess. During e-mail discussions with the council, Dr. Rempell, the ADA Council representative, stated that a new code had been considered by the ADA Coding Committee in the past, but was not approved. Since it is past the deadline for consideration in the CDT 2009, a request for the code will be made in the CDT 2011 edition.
• ADA Report on Dental Tourism and Dental Benefits: The council discussed the report to the ADA Board of Trustees, providing information on the prevalence of U.S. patients traveling out of the country for dental treatment. While dental “tourism” is nowhere near the level of medical “tourism,” one Delta source interviewed by ADA indicates that foreign dental claims are increasing (currently 2% per year). The council will continue to follow this issue, as it raises some important questions, including the lack of follow-up care subsequent to patients returning to this country.
• ADA Report on Bundling/Downcoding: The council reviewed the report on ADA’s discussion with the National Association of Dental Plans (NADP) on the issue of carrier practices related to bundling/downcoding. The council noted that in many cases, participation agreements between dentists and carriers allow plans to “bundle” procedures that otherwise would be billed separately.
• Resources on Evidence Based Dentistry: The council discussed ADA’s announcement of a grant from the National Library of Medicine and the National Institute for Dental and Craniofacial Research, which will allow the ADA to establish the Center for the Advancement of Science in Oral Health, and to develop a separate website devoted to systematic reviews on dental and oral health topics.
• Horizon Implant Codes: Staff briefed the council on what appeared to be an error in Horizon’s processing of D6057, implant abutment, and D6059, implant crown. While they appeared to be processing as duplicate services (same descriptor, same approved fee), Horizon asserts that only the descriptor is in error and the fee is correct; i.e., the approved fee for both the implant abutment and implant crown is $566. Staff verified this with several senior staff at Horizon with the same result, although Dr. McMurray did agree to have this matter reviewed by the Dental Advisory Committee.
• NJ SCHIP (Family Care) Program and Federal Eligibility Rules: The council reviewed a “Key Facts” sheet on the SCHIP program including its history and original intent, which was to reduce the number of uninsured low-income children. Since enactment, several states have received waivers to permit enrollment of adults and middle class families, including New Jersey, which covers families earning up to 350% of poverty level ($72,274 per year for a family of 4). In New Jersey, the program (FamilyCare) provides essentially the same benefits as Medicaid for most income groups, and uses the same reimbursement schedule as Medicaid. The council also discussed the federal government’s efforts to begin enforcing eligibility rules for SCHIP, including the one-year waiting period and income limits. The rules are scheduled to take effect next year, but will not apply to current beneficiaries. The state of New Jersey has sued the federal government to block implementation.
• NJDA Comment on Prompt Pay Proposal: The council reviewed NJDA’s formal comment on a proposed amendment to the prompt payment regulations that would appear to allow carriers to request reimbursement from providers on “overpaid” claims within 18 months of the initial payment. The regulation does not specify that the provision is limited to “participating providers” and NJDA contends that, currently as a matter of law, a carrier cannot recoup monies from an innocent third party creditor absent a contract with the provider. NJDA also urged the Department to include dental plans in the proposed interest rate increase to 12% on overdue payments.
• -Second Representative from each component: Mary Moskal presented to NJDA’s Board of Trustees the council’s idea of having each component appoint an “alternate” representative to the Council on Dental Benefits, since the scope and subject matter is so important. In that way, each component would be assured of coverage if the primary representative could not attend a meeting, and other members could become familiar with the issues. Some Board members thought that there may be components that are having difficulty finding even one volunteer, and stated that other ideas are also being discussed concerning the composition of councils. The Board will be exploring this idea further at its Board Retreat.
• NJ Regional Health Information Organization: The council discussed the New Jersey Department of Banking and Insurance’s (DoBI) feasibility study on the development of a Regional Health Information Organization. This effort is intended to make electronic health records available to health care givers throughout the continuum of care. The project is in its infancy and is now focused on medical information.
• DOBI Bulletin on Provider Agreements: The council reviewed a Bulletin issued to managed care organizations cautioning that provider agreements may not be used unless approved by the Department in advance. Once filed with the Department, the agreement may not be modified unless DOBI’s approval is given.

The ADA recently awarded its seal of acceptance to Wrigley sugar-free gums Orbit, Extra and Eclipse — based on studies funded at least partially by the maker of Wrigley gums, Chicago-based Wm. Wrigley Jr. Co. It's the first time the ADA has allowed its seal to appear on gum after clearing it for thousands of other products since 1930. The ADA said its independent review of the studies confirms those three gums have been shown to help prevent cavities, reduce plaque acid and strengthen teeth. It said studies submitted by Wrigley showed that chewing those gum products for 20 minutes three times a day after meals increases saliva production. Saliva, the ADA said, helps neutralize and wash away plaque acid and bathes the teeth in minerals such as calcium, phosphate and fluoride, which are known to strengthen tooth enamel and help prevent cavities.
The studies focused solely on Wrigley products. Wrigley paid $36,000 to submit its evaluation material — $12,000 per product. ADA also said Wrigley spends $35,000 to $45,000 in exhibit-booth space at its annual meeting, advertising in its publications and on other sponsorships. The seal appears on toothpaste and other dental products.

Yet another tax is being proposed in Trenton. This one, however, promises a substantial financial punch to our bank accounts. If enacted, dentists along with other professionals in New Jersey will have to pay the NJ Treasury 3.5% of their quarterly gross receipts; that’s gross, NOT net. Now more than ever we need to strengthen our NJDPAC, our strongest resource to fight such legislation. At present only 30% of NJDA members contribute to NJ’s largest and strongest health profession’s PAC. To stop the Gross Receipts Tax we need a substantial increase in participation. If you’re not a member join today. If you are a member increase your contribution. Diamond Club membership costs less than $1 a day, a bargain compared to what this tax will cost. To join or increase your membership level call Jim Schultz at NJDA 732-821-9400, or Mark Vitale, your NJDPAC representative at 732-494-7575.

Congratulations to Dr. D. Michael Hart on receiving the “Lifelong Learning and Service Recognition” Award (L.L.S.R.) from the AGD. To receive this recognition, you must be a Master in the AGD, take additional continuing education courses, and provide volunteer services to Dentistry. There are only 6 dentists in the State of New Jersey with this recognition, and three of them are in the practice of Dr. Hart, incorporated as “Gentle Dental Care, LLC”, in Edison, NJ.

This proposal was distributed in writing and read at the November General Meeting. It will be voted upon at the January General Meeting.
Background: The Program Chairperson is appointed by the President-Elect, and this person serves during the President-Elect’s term as President. The Program Chairperson position is an entry level position to the Board, but has the daunting responsibility of arranging the CE for the general meeting. The Board felt that the Society would be better served by re-arranging the CE structure as laid out below. This not only assigns the responsibility for the General Meeting CE to someone on the Board with years of experience, but also, with the decreased responsibility, this makes the entry Board position more attractive.
The By-Laws would be amended as follows: Please note that all proposed deletions are bolded and in brackets [THUS], and all proposed additions are bolded and underlined THUS.
Article IV, Section 8. Duties. Paragraph a. President:
a. President. It shall be the duty of the President:
15. To serve as the chairperson of the Educational Committee.
Article IV, Section 8. Duties. Paragraph b. President-Elect:
b. President-Elect. It shall be the duty of the President-Elect:
9. Appoints the [Program Committee’s chairperson to] Educational Coordinator who will serve during the President-Elect’s term as president.
12. To arrange for the continuing education programs for the General Meetings.
Article IX, Section 4. Standing Committees. g. Program Committee:
g. [Program] Educational Committee. [The chairperson is appointed by the President-Elect. The chairperson is to be approved by the Board of Trustees.] The Committee will consist of the President (chair), President-Elect, the Continuing Education Committee Chairperson, the Corporate Sponsorship Chairperson, the Mentor Committee Chairperson and the Educational Coordinator. The Educational Coordinator is to be approved by the Board of Trustees. The Educational Coordinator will be responsible for assisting the other members of the committee with the following: A/V equipment, meeting room preparation etc. The Education Coordinator would be responsible for taking charge in setting up Staff Night.

January 2008 Newsletter

Program:

President's Message - Dr. James Courey

MCDS Board of Trustees Report

Treasurer's Report

Announcements/Articles