November 2010 Newsletter

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-10/12/10-

Attendance: Ashmen, Bernstein, Brunsden, Chustckie, Desai, Mir Madjlessi, Modi, Prabhu, Rizzi, Rosen, Savage, Silverstein, Simos, Stein, Villa, Vitale, Vora, Weiner, Marlene Glickman
Acceptance of Minutes-vote unanimous.
President's Report-Maya Prabhu
The next House of delegates meeting will be held on on November 10th, At Pines Manor.
Treasurer's Report-David Stein
See full report on page 3.
NJDA Trustee's Report-Mark Vitale
See full report under "NJDA Noteworthy News" on page 5.
NJDPAC Report-Mark Vitale
Give Kids a Smile-Cavan Brunsden
The first meeting for GKAS 2011 will be held in the last week of October. Dr. Brunsden and others met with School Nurses' Associations to discuss issues about efficient access to care through NJDA. The following issues were discussed: Low Medicaid participation rate, lack of state education system and absence of a dental director at the state level. Dr. Brunsden talked about dental programs at various New Jersey hospitals like RWJH, St Peters', JFK, have requested additional supplies of Pit and Fissure sealants, bonding materials and bonding agents.
NJDA Council Reports:
Annual Session-Nainesh Desai
Next annual session meeting will be held on October 20th, 2010.
Dental Benefits-Devang Modi
• CRP Statistics: Staff provided the council with cumulative statistics from January 1, 2010 through August 31, 2010 indicating a total of 82 complaints submitted to NJDA for the year. 14 were from Middlesex County (most of any county). Majority of the 82 complaints were against Metlife (20) and Horizon (16). Refund requests by MetLife and denial of claims from Horizon were the biggest problems. Staff provided the council with statistics on the number of CRPs opened per component to date and are available upon request.
• Horizon BCBS Issues: The council discussed the NJDA letter written to Dr. George McMurray regarding ongoing problems, notably bundling, and the subsequent conference call between Dr. McMurray, Dr. Vitale and Mary Moskal. Dr. McMurray had committed to changing EOB language by September, but no progress on any of the issues has been reported to date. The council discussed options for further action.
• The telephone number to reaching consultants at Horizon was made available 973-466-5711 and 973-466-4598 to help answer and resolve any claim issue. Do not abuse these telephone numbers. We emphasize and advocate calling the consultant 1st and then Dr. McMurray if necessary at 973-466-7304
• Horizon "Dental Companion" Plan: The council reviewed a new dental product offering that Horizon is marketing to its medical plan participants. In network, the plan covers 100% of its "allowed charge" for preventive and diagnostic services as well as amalgams. All other services are charged at the PPO allowance and paid directly by the patient to the participating dentist. Out of network, Horizon will pay the same PPO allowance on preventive and diagnostic services and the patient is responsible for the difference.
• Delta Dental will hold a free dental insurance course on September 29th.
Focus Group for iMedicore: Dr. Vitale reported that he, Dr. Iserson and Dr. Pettigrew were asked to sample a website (iMedicore) that is meant to serve as a HIPAA compliant web portal for patient-related communications among practitioners, and then participate in a focus group discussion. The website uses sophisticated encryption technology that is or will be required so that patient information is secure. Delta Dental is promoting this project in the hopes of using the site to submit claims in the future.
• Dental Benefit Providers Contract: The council reviewed, as informational, an amendment to the Dental Benefit Providers (DBP) contract that is being distributed to its participating dentists. The amendment deletes the provision that requires participating dentists to accept the contracted fees even if the service is not covered. The cover letter states that DBP is "updating its Agreement to reflect changes in the regulatory environment pertaining to billing of members for non-covered services."
• Federal Employee Dental Plan: The council reviewed a MetLife communication to participating dentists concerning the federal employee dental plan (which is exempt from government regulation). According to MetLife, legislative actions concerning billing for non-covered services do not apply to the Federal plan; that is, dentists may charge only the contracted fee. Another issue deals with the MetLife federal plan as secondary to another federal plan, in which case the dentist may charge a maximum of the PPO fee.
• Oral CDx: Staff reported on a telephone call she received from a representative of Oral CDx subsequent to the article that was published in the NJDA Advocate on brush biopsies. The representative insisted that the article was "patently false" and misleading, especially the advice that dentists use the appropriate brush biopsy code and not the CPT code for incisional biopsy. Staff explained the information in the ADA Coding Companion and requested documentation from a reliable authority to the contrary. NJDA stands by the article as written.
• Please use ADA code D7288 for brush biopsy. You cannot bill incisional biopsy to medical insurance if you're doing a brush biopsy.
• Dental Benefits Course Evaluations: The council briefly discussed the two courses presented at Annual Session. Dr. Vitale requested input on whether the same format should be used next year, a change should be made to provide one longer course, or whether the council should just "sit out" the next year. This discussion will be continued after speaking to the Council on Annual Session.
•NEW BUSINESS: Update on Legal and Regulatory Matters (Oral Report): Mr. Meisel updated the council on pending litigation, including the recently filed suit against "Beach Bum Tanning Salon" and well as the suits against Horizon and MetLife/Aetna. Mr. Schulz reported on the NJDA meeting with the Commissioner of Banking and Insurance, a former lobbyist for MetLife, and the discussion involving proposed legislation on copayment waivers.
• H.R. 5000 – Non-Covered Services Legislation: Mr. Schulz reported to the council on the introduction of HR 5000, the Dental Coverage Value and Transparency Act, which is federal legislation to amend ERISA to bar dental plans from dictating fees for non-covered services among other reforms. ERISA is the federal law that governs self-insured and union plans that are exempt from state regulation. Mr. Schulz was not optimistic about the future of this bill.
• The next meeting is scheduled for January 5, 2011.
Dental Education-Bob Ashmen
For the Weekend Study Club, NJDA did not produce and mail a tri-fold ad for the first time, and the registration numbers were about the same. We will be annually forwarding the course evaluation sheets of the WESC to the Council on Annual Sessions for review/consideration as potential speakers for Annual Sessions in the future. CE courses have been developed and offered by the NJDA Partners Program participants and Endorsed Programs. Seven courses are scheduled to occur through Jan 2011, and these are free to the NJDA membership. Feedback on the first 2 courses was exceptional.
The Council meeting with the Dental Assisting Program directors and high school guidance counselors in April 2010 seemed to reveal a common concern. This concern was that non-CODA accredited programs were misleading applicants and students regarding eligibility to sit for the CDA examination. The Council will request a report from the accredited programs identifying the offending non-accredited programs with documentation supporting the claim. When received and reviewed by the Council and any ethical breach is shown, the Council will recommend a letter be sent to the offending non-accredited programs from our executive director and general counsel. Dr. Brunsden emphasized that misleading information is being given out by a few other non-CODA accredited programs.
The Council will be continuing our scholarship program for Dental assisting program students, with 2 scholarships of $1000 instead of 4 scholarships of $500.
Governmental and Public Affairs-Mitch Weiner
• NJDA has been asked for input from the hygienists association in relation to proposed legislation that would permit general supervision of hygienists in private practice (this already exists in NJ institutions- hospitals, etc.).
• There are many competing organizations in at least 41 states that are moving towards implementing or experimenting with mid-level providers. Even at the ADA level, different factions are forming (Austin Group vs. Boston Group) that are either staunchly against mid-level providers or are willing to hear all sides and work out a compromise on this controversial issue for the profession going forward.
• There are over 800 State Boards and Commissions in NJ. The governor has eliminated 60 State Boards and Commissions to consolidate and save money. The State Board of Dentistry has been preserved as a stand alone Board. However, the State Medical Examiner and State Crime Labs are slated to consolidate, which may have an impact on the NJDA Dental Victim Identification Team (DVIT), which had an excellent working relationship with the stand alone ME's office.
• There have been 'customer service' issues with the Division of Consumer Affairs for a while, mostly due to internal clashes. We have an attentive Board, but infighting between the division and the attorney general's office is creating inefficiencies. At the same time, the governor wants to re-define the role of the lieutenant governor by giving the economic development corp. oversight over to the Lieut. Governor and is considering taking some of the State Boards (including Dentistry) away from the Div. of Consumer Affairs and giving them to the Lieut. Governor's jurisdiction.
• A Federal Qualified Health Center opened up in Perth Amboy with state of the art dental equipment that local private practitioners feel is aggressively marketing in the attempt to erode their patient pools. The clinic mostly treats Medicaid and Charity Care/Indigent patients so the potential impact on these local practices is still being debated, with NJDA attempting to mediate the matter while protecting the interests of our member dentists.
• NJ still has no dentist as Dental Director and therefore no one to manage and aggressively pursue the application process for millions of dollars in federal funding towards oral healthcare that NJ can benefit from and loses out from each year. NJDA is working with the NJ Dental School to propose that the Dental School Dean be given the title of NJ Dental Director and hopefully, with the dental schools advocacy, this would open the door to federal grant money for oral health programs in the state.
Legislative Matters:
• Suits against Metlife and Aetna: Metlife wanted the suit to be decided in Federal court and NJDA wanted it decided in State Court. The federal judges decided that the suit should be in state court (in NJDA's favor). A summary judgment on the matter is expected in the coming weeks.
• Assignment of Benefits Lawsuit against Horizon: Horizon is interested in settling and NJDA is in the process of working with Horizons' attorneys on the wording of the settlement. Once finalized, it should go into effect on 1/1/2011, similar to the legislation for medical insurance assignment which was passed previously.
Membership-Tara Savage
We have 4645 members as of Oct 7th up 39 from last yr. We are still short by 129 from last year's end.
Peer Review-Sandy Goldstein
We had one case successfully mediated in September
Committee Reports:
Budget and Finance-Ira Rosen
Budget was presented and approved by the board.
Mentor-Amit Vora/Nima MirMadjlessi
Our next bi-annual OSHA program that satisfies the OSHA standard on Occupational Exposure to Blood Borne Pathogens, which is required annually for dentists and staff, will be given on November 4, 2010 at St. Peter's Medical Center, New Brunswick. Two CEU credits are awarded to the Dentists & staff members attending these 2-hour seminars. These seminars are available to our members & staff for $25/pp as a member benefit of MCDS. A very big "Thank You" to Dr. Joe Fertig, Director of Dental Services - St. Peter's Medical Center, for arranging all our room accommodations for the MCDS OSHA-Mentor programs at St. Peter's Medical Center in New Brunswick.
Dr. Larry Brent will present the next mentor program on December 9, 2010. He will speak about: "Everything I did not Learn in Dental School" at the NJDA Headquarters, North Brunswick.
Please see the insert in this newsletter for additional information and registration for the Mentor/OSHA program.
Continuing Education-Mark Schambra
Dr John Ruel has been confirmed for the 2011-2012 CE year for Tuesday evening lecture and a full day course on Wednesday.
Dental Hygiene Study Club-Alyssa Bernstein
The Central New Jersey Dental Hygiene [CNJDH] Study Club met on Wednesday September 29, 2010 at the Crowne Plaza Hotel, Rte 27 South, Edison NJ and was sponsored by the Middlesex County Dental Society. The speaker was Dr. Jim Albani, speaking on cone beam imaging for implants.
Two CEU credits were awarded to the 25 Hygienists that attend this meeting. The next CNJDH meeting will be on Wednesday November 10, 2010 at the Crowne Plaza Hotel in Edison. The speaker will be Annabelle Bacchione a registered dental hygienist and nutritionist. She will be speaking on nutrition and digestion. Two CEU credits will be awarded for this seminar. This CNJDH study club is available to our hygienists as a Dentist-member benefit of MCDS. Please see the registration form included in the newsletter for information on the upcoming speakers and to register your hygienist.Please contact Marlene Glickman, the Executive Secretary for MCDS, at # 732-238-1255 for additional information and registration in advance for the program. Thank you. In addition one of the lectures for next year is open to doctors and hygienists, Hahn Diagnostics is presenting on marker pathogen analysis for perio. They will only present to the hygiene study club if there is at least 10 doctors present. Please consider attending this lecture. Thank you.
New Business
A motion was made by Dr Rosen to maintain the current MCDS dues structure for 2011. This passed unanimously.
Our next continuing education coordinator will be Dr. Devang Modi
Good & Welfare
Dr. Mark Vtiale became a Fellow of the American College of Dentists. On October 9th, Dr Scott Galkin married his fiancée, Dana. Dr. Carmen Cicalese and his wife Amy had a baby girl
Respectfully Submitted, Nainesh Desai, Secretary

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NJDA Noteworthy News

-Two members of the NJDA Partners sponsorship program were in attendance; Kuwata Pan Dent, a full service dental lab with hands on owners and years of activity in dental education; and Group Financial Services, with expertise in opening and buying practices.
-The Committee to review endorsed programs met and reviewed TDIC. TDIC offers malpractice insurance in New Jersey only to NJDA members. They concluded that the malpractice insurance service was excellent.
- The Board was asked to consider the endorsement of B. C. Szerlip as NJDA's endorsed health insurance broker. B.C. Szerlip has been providing all forms of insurance to dentists for over 30 years. Mr. Burton Szerlip reported that the company prides itself on its service and assistance to the dental community. He discussed health insurance rates as benefits vs. cost. With the high cost of hospitals, labs, medication, etc. more and more people will have to share in cost sharing. The expanded coverage in President Obama's health plan has caused rates to increase, however, reimbursement rates are not going up. B.C. Szerlip has sponsored many of our programs and has made an arrangement between Szerlip and NJDA to co-share proceeds on 10% gross revenue. One person at B.C. Szerlip will be dedicated to all NJDA business, although there will be other employees also working with NJDA members.
- Dr. Michael Messana received emails from Fred Leviton, VP & COO of the National Foundation of Dentistry for the Handicapped (DDS) and Barry Raphael, Chair of the Donated Orthodontic Services (DOS). The DDS has been working with the American Association of Orthodontists on developing an access program for low-income kids, very similar to the DDS program. Five states have been selected to participate in this pilot program, New Jersey being one of them; $50,000 has been budgeted for this. As with DDS, dentists must commit to seeing a certain number of people. The motivation is CE credits.
- Dr. Mark Vitale (MI) was approached by iMedicor, a communication website. Focus groups, including members of the Council on Dental Benefits and Delta Dental are evaluating the website. It provides instant a HIPAA compliant communication portal so that professionals can share information with each other and insurance companies. Electronic records are coming soon and he felt this could be an easy transfer into electronic records or to piggyback on to practice management.
-Membership and Annual Session
Tricia DeCotiis reported that members paid to date are 4,596 which is 11 down from last year, this time. We do have applications that have not been processed to date. Yesterday she started her visits to the general practice residency programs and they will continue through November. The Post Graduate Lunch and Learn has been set up as well at the NJDS. UMDNJ Alumni Association, TDIC and NJDA will be exploring partnering with each other to increase membership/business for all involved. The quarter year dues letter will be going out shortly to non-members offering membership for the remainder of 2010 for free.
Stan Orenstein, AnnMarie Varga and Tricia DeCotiis met with Roy Childers to develop an online dues payment program which we are hoping to have available for payment of 2011 dues.
Annual Session booth sales are moving along. To date, we have sold 46 booths out of an available 96. We have also sold five table tops. Benco is again sponsoring the High tec Vendor Fair and Henry Schein will do the glass classroom. NJDA is working on marketing and promoting the convention in Long Branch primarily to the new dentists and/or up to age 45. They feel they need to sell the show to them and are asking for component involvement. They are asking each component rep on the Annual Session Council to go to their component and market this show to its members. The Council Sub-committee for Speaker selection will meet on September 16, 2010 to establish the 2011 speaker line-up.
-Communications and Dental Education: Mr. Eric Elmore announced that we now have a Face Book button on our web page. The GKAS fan page has 290 fans, including doctors, hygienists, sponsors, mayors and legislators to name a few. In putting in our name, type New Jersey Dental Association, not NJDA. If you do, it will come up National Juvenile Delinquent Association. We have photos of the last convention, the golf outing and the new location in Long Branch. There are two discussion groups, one on fluoridation and the other on Access to Care. One simple goal is to promote good things for everyone to see. He reported that regarding Give Kids A Smile, the School Nurses Association has renewed its interest so they can promote it in their schools. Presentation schedules have been set. Union County Dental Society will meet October 7th. The Latino Association of the American Diabetes Association will meet on November 13th. He will be talking to the 2011 Partners Program over the Fall and Winter months. All current Partners are very happy with the program. The intent is to grow the Partners program slowly; with two or three new companies in the next year. He reported that Benco, one of our newer partners, had its worst quarter but still had a 3% increase in sales just among its NJDA members. Mr. Elmore is distributing a list of CE courses by some of the partners. Registration for the Weekend Study Group programs are filling up quickly. This is the first time we did not put out a brochure or put it in the Advocate. The form is on the NJDA website.
A question was raised on whether or not NJDA could send out all component emails. To do this for all components would be very time consuming for NJDA staff. It was suggested that component trustees, secretaries and/or executive secretaries be given instructions on how to get email addresses to components. Most important is that fact that when you send out a blast email, the emails are put in the bcc: field, not the to: field.
-Governmental and Public Affairs: Mr. James Schulz reported that Governor Christie has recently issued Executive Order 40 which eliminates more than 60 boards and commissions that were created under previous Governors' Executive Orders. Additionally, he has just release findings from all state departments as to the status of the more than 800 boards and commissions which presently are constituted under state law. The aim of these reports is to recommend which boards, if any, should be eliminated, preserved or retooled to (1) reduce the size of government, (2) improve the effeciancy of government and (3) reduced the regulatory burden in this state. The Division of Consumer Affairs, which presently has 45 licensing boards, has recommended reducing that number to 16. However, in the proposal, the State Board of Dentistry is preserved as a stand-alone board. This is something Mr. Schulz has worked hard on with the Governor's office since Christie first came into office. Moreover, there has be a recommendation made that the State Medical Examiner, merge into the State Crime Lab for efficiency purposes since their missions are similar. This may have some impact on the NJDA's DVIT, who works closely with both agencies. Additionally, the Department of Health recommended that the Public Health Council be eliminated. Appointments under this Governor have been purposely slow since it is uncertain which boards and commissions will ultimately stay. However, there is some indication that the Governor may appoint an individual to the State Board of
Dentistry who is close to him, but nothing has been finalized yet. Drs. Dolinsky and Hall appointments have recently expired. Mr. Schultz attended a meeting in Perth Amboy with the Mayor of Perth Amboy and Senator Joe Vitale to discuss federally qualified health centers and their impact on the private practitioner in those communities. The dentists from Perth Amboy feel that the FQHC is draining patients from their offices. Mr. Schulz attended to see how, if at all, the NJDA could assist. Most of those dentists who attended the meeting are not NJDA members.
The NJ dental labs have once again become very aggressive with regard to the foreign dental labs issues. Senator Loretta Weinberg introduced a Senate version of legislation which would require dentists to disclose what materials crowns and other dental devices are made of prior to installing them into patients and then give the patients the option of not have that device or appliance used on them. NJDA is opposed to the bill and has offered amendments which are more workable and place the oneous on labs to disclose at the doctor's direction.
On October 7th, the Senate Health Committee will hold a public hearing at dental school to highlight the need to complete the dental school's special needs and pediatric pavilion. NJDA will be invited to testify on this issue. It is expected that other dental health related bills will also be heard by the committee at that time. No word on the agenda yet.
Mr. Schulz reported that he, Dr. Kahn, Mary Moskal and Art Meisel met with Tom Considine, Commissioner of Banking and Insurance and formerly top lobbyist for MetLife for years. From that meeting he felt that change was coming, there would be more transparency and that it was felt the patient should know in advance what is best and what the coverage limits are.
-House of Delegates: The next meeting is scheduled for November 10, 2010 at the Pines Manor in Edison.
-Executive Directors Report: Mr. Arthur Meisel reported on the ongoing lawsuits. On the Blue Cross/ Blue Shield suit, a draft of a settlement agreement was written and we returned it with revisions. We are waiting for a response. With the Met Life and Aetna suit, we are waiting to see whether we will be in State or Federal Court. The Judge will decide; she will hear oral argument tomorrow. When the Judge makes her decision, 30 days after that decision, we will file a motion for summary judgment. On the suit involving tooth whitening services by an entity, Beach Bum Tanning, there was no report at this time.
Mr. Meisel also reported about a letter received by the State Board concerning advertising of credentials. The Attorney General's office will review the matter.
Mr. Meisel reported that with respect to the issue concerning General Supervision and Mid-Level Provider, that he was going to try to visit all the component societies. He has been to Monmouth-Ocean, Central and Middlesex and tonight he will be at Southern. He wants to be sure everyone hears the same message the same way.

MIDDLESEX COUNTY DENTAL SOCIETY PROPOSED BUDGET FOR 2011