A renowned speaker in the Dental Community, Dr. Eric S. Studley has lectured throughout the country on the subjects of Insurance Planning, Risk and Practice Management, Ergonomics, Ethics and Case Acceptance. Recognized for his industry knowledge and outstanding ethical standards, Dr. Studley has consistently been the #1 disability producer in the USA with Guardian and Berkshire Life Insurance Company of America. Dr. Studley owns a national full service insurance brokerage firm specializing in dentists. Dr. Studley is an Associate Clinical Professor at New York University College of Dentistry, as well as a G.P. Director in the Department of Cariology and Comprehensive Care. He is also the Director of Ergonomics and the Director of Practice Management at the dental school and is responsible for the development of, and presentation of practice management skills to dental students. Dr. Studley is also a speaker for the American Dental Association’s practice management program for dental schools throughout the country. He has published articles in dental journals. In 2009 he coauthored a Practice Management Textbook for new dentists entitled “Dental Practice - Get in The Game”. This lecture will make the participants aware of the proper ergonomic techniques that should be used in the practice of dentistry. Using the proper techniques increases efficiency and reduces disabilities.

Welcome back to another exciting year with the Middlesex County Dental Society. Hopefully everyone had a fun and relaxing summer. I am excited about our upcoming year and serving as your president. I know that with the support of the amazing board of MCDS we will have a stellar 2015-2016 year. Dr. Devang Modi, our education coordinator and President-Elect has put together a great year of speakers. Our first meeting will be on the fifth Tuesday of September, September 29 at the Pines Manor. Dr. Eric Studley will be speaking on Ergonomics in Dentistry, something we can all benefit from and gain pointers to use in our practice.
Writing the President’s Message is one of the most daunting tasks of being the president, I feel like I am back in school writing a paper for class. But I have had my first message drafted in my head since last October when my husband and I visited the American Dental Association headquarters in Chicago. As a member of the ADA one can visit and tour the association building and get a glimpse behind the scenes as to the operation of the ADA. My husband and I both found the scientific research and labs to be the most fascinating aspect of the tour. We got to meet the research coordinator and the senior vice president of science and learn how the ADA goes about testing the products that we will eventually be using in our practices. I also got a small thrill out of seeing the board room where the executive board of the ADA holds their meetings. Knowing that the President of the ADA last year was from New Jersey added to the excitement of being there. This member benefit, being able to visit and tour the ADA headquarters, is something I highly encourage all our members to take advantage of. I felt proud to be a part of this organization and proud to tell those I encountered in Chicago that I was on the board of the Middlesex County Dental Society, what in my mind is a highly competent, supportive and great group of dentists to be working with.
I am looking forward to serving as the MCDS president and having the opportunity to share this journey with our membership along with the support of an incredible board of past, present and future leaders of MCDS.

Attendance: Drs. Desai, Bernstein, Rosen, Krantz, Modi, Fernandes, Kahn, Schambra, Silverstein, Satwah, Weiner, Ashmen, Simos, Tauk, Marlene Glickman
Acceptance of 4/15/15 Minutes- vote unanimous.
Treasurer’s Report-Amit Vora
See detailed report on page 3.
Education Coordinator’s Report-Sanjeev Satwah
Dr. Devang Modi on behalf of Dr. Sunny Satwah
A new education journey begins on September 29, 2015 (5th Tuesday) when Dr. Eric Studley will speak about “Ergonomics for Dentistry.” The audience will learn about the proper ergonomic technique to be used in every day practice to increase efficiency and reduce fatigue and disabilities. All 2015-2016 speakers have been confirmed until March 2016. We are still waiting confirmation from a couple of speakers and sponsors for the Tuesday evening course in April and a full day course for 2016. All necessary paperwork has been submitted to the NJ State Board of Dentistry for obtaining an approved CE course codes for 2 credits. The October 13, 2015 MCDS Board meeting will take place at JFK Medical Center since the NJDA Board room is not available at this time. Phyllis at NJDA has been informed of Officer’s night for MCDS will be on January 19, 2016. Life Membership list was not available at this time.
NJDA Trustee Report-Mitch Weiner
Dr. Mitch Weiner expressed his desire to run for NJDA Secretary. Daniel Krantz made a motion and it was seconded by Dr. Ira Rosen. All were in favor.
Executive Secretary’s Report-Marlene Glickman
51 people have registered so far for the OSHA course at JFK hospital.
NJDA Council Reports:
Annual Session-Dr. Nainesh Desai
Information on NJDA’s recent annual session is still being analyzed. I will submit my report after the next council meeting on May 21st.
Dental Benefits- Dr. Devang Modi, Dr. Antoinette Tauk
The next meeting is scheduled for 5/13/2015. Details will follow in the next newsletter.
Membership-Dr. Genevieve Fernandes, Dr. Nima Mir-Madjlessi
Our next Council on Membership meeting is scheduled for Thursday May 14th. Details will follow in the next newsletter.
Peer Review-Dr. Sandy Goldstein
There were no new cases assigned or mediated in April.
Committee Reports:
Mentor-Dr. Nima Mir-Madjlessi
Our 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 June 30, 2015 at JFK Hospital in Edison NJ.
Two CEU credits will be awarded to the Dentists & staff members attending these 2-hour seminars. These seminars are available as a member benefit of MCDS.
A very big “Thank You” to Dr. Devang Modi for arranging all our room accommodations for the MCDS-OSHA-Mentor programs at JFK Hospital in Edison, NJ. The next OSHA recertification course will be held on October 15, 2015 at St. Peters hospital.
New Dentist Committee-Dr. Sanjeev Satwah
The residency fair at the annual session was well attended. We are focusing on the upcoming New Dentist Conference this fall.
Membership Hospitality Committee-Dr. Genevieve Fernandes, Dr. Deborah Brown
Monthly email blasts are being sent out by Dr. Genevieve Fernandes with reference to upcoming courses and holidays. Dr. Deborah Brown will coordinate with our Facebook editor to update our Facebook page periodically.
Hygiene Study Club-Dr. Alyssa Bernstein
The Central New Jersey Dental Hygiene [CNJDH] Study Club met on Wednesday May 6, 2015 at the Crowne Plaza Hotel in Edison. The speaker was be Dr. Cohen and the lecture was “How to Diagnose Dental Symptoms” Two CEU credits were awarded to the 25 hygienists that attend this meeting. The next CNJDH meeting will be on Wednesday September 16, 2015 at the Crowne Plaza Hotel in Edison. 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 contact Marlene Glickman, our Executive Secretary for MCDS, at 732-764-MCDS(6237) for additional information and registration in advance for the program.
MCDS Study Club-Dr. Genevieve Fernandes, Dr. Nima Mir-Madjlessi
We will have our next MCDS study club meeting in October. Details will follow in an email blast from Dr. Genevieve Fernandes.
New Business
Dr. Devang Modi discussed that our September general meeting will fall on the fourth Tuesday of the month on 9/29/15. Also we have a commitment of a minimum of 70 people for our general meetings at Pines Manor, Edison, NJ.
Dr. Danny Kracke proposed that a dentist be allowed to come to our general dental meeting only if he or she is a member of ADA, unless he or she has been invited by the MCDS board. The fee for a non-MCDS member to attend our general meeting is $50. All were in favor.
Good & Welfare
There will be no MCDS reception at the next year’s annual NJDA convention.
Respectfully Submitted, Dr. Genevieve Fernandes, Secretary

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Governmental and Public Affairs

COGPA Meeting (Joint Meeting with NJDPAC) June 24, 2015 Assembly Campaign Update- There will be some tight races in the NJ Assembly this fall. It is expected that turnout will be very low. As a result, outcomes will be all about party operations and the ground game in getting voter turnout.
Out of Network Legislation Update- This legislation is making very little progress at this moment. It is more likely than not that dentistry will be kept out of the bill, but not a guarantee. It is expected that dentists that perform work in a hospital ER or OR setting like Oral Surgeons will unavoidably be bound by aspects of this legislation should it go forward.
Paid Sick Leave Legislation- This is dead legislation according to Governor Christie. After it is likely passed by the NJ legislature, he will veto it. After that, the bill will be in limbo until the next (likely Democratic) Governor is inaugurated in January 2017. At that time, it is almost a given that we will see paid sick leave bills and increase in the minimum wage bills passed and signed.
Dental Director/Office of Oral health Legislation Update- This bill is going nowhere now that Rutgers has pulled it’s support. We are still interested in having the bill move and are re-aligning our strategy. NJ Budget- The Democrats have proposed and will pass a budget that has a one time 15% surcharge on corporate taxes (a tax on a tax!!!) in addition to a millionaire’s tax (likely to be based on gross revenues that exceed $1million), which many member dentists could be affected by. Governor Christie will most certainly remove these additions before he signs the budget but keep in mind that the next governor, if Democratic working in conjunction with a Democratic legislature, will sign a budget that contains these taxes and surcharges. Corporate Practice and Aspen Dental Settlement in NY- The NY state AG has reached a settlement with Aspen Dental concerning Aspen setting illegal production goals for dentists and hygienists. Aspen has also been investigated and fined by the AG in Pennsylvania and Massachusetts in recent years for dubious business practices. The cumulative effect of these settlements weakens the potential for corporate dentistry’s expansion into NJ as it is clearly on the radar of state attorney generals.
Affiliate Carrier Clauses/Network Rental Laws · Dental plans and third party leasing organizations often lease their participating provider networks to other dental plans without the knowledge of the dentist. It is often not clear until after dental services have been completed, which creates confusion for the dentist and the patient. This is having a direct impact on some NJ dentists. The Council will explore the extent of the impact of this issue on our member dentists before deciding whether to take a legislative approach on this matter.
Policy Types Identified on EOB’s (new Policy Idea)- This would involve dental carriers specifying on their EOB’s as to whether a plan was a traditional indemnity plan or a self-funded plan governed by ERISA so as to guide dentists and their front desk staff whether the Assignment of Benefits and the Non-Covered Services Bills would apply. The Council decided that before legislation is introduced on this matter, we would try to establish a dialogue with all of the major carriers to see if they would be willing to change their EOB’s so as to comply with our vision.
The Council decided not to pursue the following 3 policy ideas due to lack of perceived impact on NJ dentists: Dentist Designation/Rating
· Dental payers have begun rating network dentists on provider directories in an effort to provide additional information to consumers. Cigna tried to implement this in NJ a few years back but stopped pursuing due to negative pushback from NJ participating dentists. No other insurance companies have initiated similar rating systems so we don’t see any need to move forward with any legislation on this matter. Inadequate Notice to Providers when Carriers Change Policies
· Dental benefit plans change processing policies and provider manuals without giving sufficient notice to dentists.
Deferred Compensation Programs and Medicaid · As a means of improving provider participation in Medicaid programs, state Medicaid agencies can create mechanisms to allow dental Medicaid reimbursements to be deposited in individual retirement accounts.
Minutes from the 8/4/15 Meeting
Prescription Monitoring Program Reform - Effective Nov 1, 2015. Dentists must access and review the PMP for new patients to whom Schedule 2 drugs are written. Dentists, hygienists and Registered Dental Assistants are the only office members who can access the PMP. The NJDA secured amendments to the legislation to established a more favorable environment for complying with the law’s provisions. Additional legislation now requires that you can only give a patient no more than a 7-day supply of a drug that you dispense in your office.
NJ Center for Oral Health Legislation – NJDA is no longer partnering with Rutgers or the NJ SDM to advance this bill as Rutgers has decided to oppose this legislation on the pretense that the Legislature does not have the authority to require Rutgers to do anything by statute. We hope to advance another version of this bill by the next legislative session (which starts in January 2016). As you may recall, Rutgers has decided to oppose this legislation which they formerly supported and urged the NJDA to advance. New Language has been drafted and conversations are being had at the staff level on a potential revision, introduction and strategy with the sponsors.
Board Violation Expungement Legislation - This legislation will have to expand beyond just dentistry and involve professions governed by NJ licensing boards. Taking Bipartisan approach to sponsorship working with Asm. Gusciora (D) and Asm. Rible (R) and Senators Gill (D) and Kean (R). We will advance this in the next legislative session as well. Presently, NJ licensing boards do not have the ability to expunge or sunset violations of licensees even though that opportunity exists in the criminal justice system.
EOB Reform- NJDA reps met with Delta Dental reps to discuss more EOB transparency to inform dentists and staff whether a patients’ dental plan is a traditional indemnity plan or one that is self-funded and governed by ERISA laws, in which the Assignment of Benefits Law and the Non-Covered Services Law do not apply. Delta requested that NJDA draw up a mock EOB with language that we would find acceptable. NJDA Council on Governmental and Public Affairs members felt this initiative should be prioritized given the time saving it would provide to our membership in every day practice. If we are unable to move this forward in a timely fashion with the carriers in a dialogue format, the NJDA Council will consider advancing legislation that would mandate EOB transparency on this matter.
Licensing and Child Support (A. 4497)- Bill would allow licensees to obtain and /or keep their licenses even if they are behind in their child support payments. The NJDA Council is monitoring the legislation but took no position on the bill.
Medical Records Fee Limitations (S. 1171)- This bill puts limitations on what offices can charge patients for record request copying and mailing. Dentistry has had these parameters set by the NJ State Board of Dentistry many years ago. The bill is redundant for dentistry in NJ and only brings the physicians in alignment with dentistry. The NJDA Council took no formal position on the bill.
CDHC (Community Dental Health Coordinator) Issue and NJ-AAP- The pediatricians have partnered with some Monmouth County dentists for a pilot fluoride varnish program. The pediatricians want in on ACA pediatric dental money and want to advance an auxiliary title called the Community Dental Health Coordinator who can provide these services in a pediatrician’s office. Currently, NJ has no educational pathway towards obtaining such a title and the title is not recognized in NJ either but the NJ-AAP is aggressively pursuing this initiative. The Council vehemently opposes the direction NJ-AAP is taking and is monitoring attempts to increase their presence in our theater.
Dental Benefits Update- Council on Dental Benefits 9/9/15 meeting may be held at the FQHC in Lakewood with State Senator Singer (R), a ranking member on the Senate Health Committee, scheduled to attend. The Council on Dental Benefits has not yet decided to formally move its September meeting.
Micro MOMs (Mission of Mercy) and RAM (Remote Area Medical)- Delta of NJ wants to do a similar program in NJ to the one they do annually in Connecticut. The NJDA Council discussed targeting veterans for delivery of free care instead of making it a program open to all comers. This will be passed on to the NJDA Board and Delta Dental to see if a collaboration is feasible. The cost and administrative burdens would have to overwhelmingly come from Delta and not the NJDA, whose role would be to help garner support and volunteers for the program.
Membership and Target Legislation-An internal membership study showed that there is a strong correlation between PAC contributions and member retention in the NJDA. The NJDA Council will brainstorm on legislative ideas and initiatives to develop marketing opportunities with the Council on Membership to appeal to key demographic sectors within the NJDA membership.
“Corporate Dentistry” Legal issue - NJDA Executive Director Art Meisel was invited to join an ADA advisory group that was exploring joint model legislation with representatives from DSO’s and that the ADA working group has stopped trying to develop model legislation on that matter.

Recent Alerts from the NJDA

ALERT: Governor Christie signs prescription monitoring legislation into law Governor Christie signed prescription monitoring legislation into law to help curb the abuse of prescription drugs and heroin. Click here to read the legislation.
Effective November 1st, all prescribers of controlled dangerous substances (CDS), including dentists, will be required to check the NJ prescription monitoring program's website (PMP) prior to prescribing CDS to any new patients and quarterly for existing patients to whom CDS are prescribed.
NJDA successfully secured amendments to the legislation that allows dentists to assign dental hygienists and registered dental assistants to check the PMP on behalf of the dentist.
ALERT: Horizon Requirement - DEA and CDS licenses Horizon Dental requires Drug Enforcement Agency (DEA) and Controlled Dangerous Substances (CDS) licenses for oral and maxillofacial surgeons, prosthodontists, endodontists and periodontists to participate in its dental networks, effective June 17, 2015. There is no DEA or CDS requirement for other applicants provided there is no history of loss, restriction, suspension or denial of such a certificate for cause.
ALERT: The End of the Swipe-and-Sign Credit Card Convert to EMV by October 2015! As of October 2015, any business that is not equipped with the right hardware to perform EMV payments risks being liable for fraudulent and counterfeit card transactions. Visit www.tinyurl.com/emvoctober to continue reading the article.
ALERT: Your Server May Lead to HIPAA Violations On July 14, Microsoft will stop providing support for Windows Server 2003, leaving it vulnerable to security breaches. This could lead to a violation of HIPAA as explained by the ADA here: www.tinyurl.com/hipaaADA HTI, one of NJDA's Endorsed Business Associates is working with individual dental practices to upgrade their systems. For a free consultation, you can contact them via email: [email protected] or phone: (973) 889-0030 Option 1.
ALERT: N.Y. Attorney General Announces Settlement with Aspen Dental Management Following an investigation, the New York Attorney General concluded that Aspen Dental Management "did not merely provide arms-length, back-end business and administrative support to independent dental practices" but "developed what amounts to a chain of dental practices technically owned by individual dentists but which, in violation of New York law, were subject to extensive control by Aspen Dental Management." In a settlement, Aspen agreed to "overhaul the way it does business in New York" and to pay $450,000 in Civil Penalties. To see a copy of the announcement, visit www.tinyurl.com/aspensettlement
INFORMATION: Why you need to know about PCI DSS and Breach What is PCI DSS (The Payment Card Industry Data Security Standard), and what does it mean to be PCI-compliant? What is a breach? What do you have at risk in case of a breach? Visit www.tinyurl.com/PCIBreach to learn the answers to these questions, and how you as a merchant can protect your data from a breach.

ADA DENTAL SNIPPET: BITEWING IMAGES– ADDRESSING THE CDT CODE AND TECHNOLOGY CONUNDRUM

Today, extra-oral imaging devices are capable of acquiring similar diagnostic information to that seen on multiple bitewings. This image may also capture additional information, all by a single exposure captured on one extra-oral receptor. How does a dentist document this procedure – is it a bitewing or bitewings, an extra-oral image, or what? Before answering the question let’s look at the definition found in the ADA’s online Glossary of Dental Clinical and Administrative Terms (http://www.ada.org/en/publications/cdt/glossary-of-dental-clinical-and-administrative-ter#b): Bitewing radiograph: Interproximal radiographic view of the coronal portion of the tooth/teeth. A form of dental radiograph that may be taken with the long axis of the image oriented either horizontally or vertically, that reveals approximately the coronal halves of the maxillary and mandibular teeth and portions of the interdental alveolar septa on the same image.
With all this in mind, there is more than one CDT Code to consider –
D0270 bitewing – single radiographic image
or
D0250 extra-oral – first radiographic image
Both are consistent with the glossary definition, but is one more appropriate than the other? It depends. A bitewing (e.g., D0270), with the film or receptor placed in the oral cavity, is the well-known method for imaging posterior teeth. But what about patients who are not able to accept placement of an intra-oral film or receptor? D0250 is more appropriate since the imaging media would be extra-oral as specified in this code’s nomenclature. Some may disagree, saying the bitewing nomenclature does not limit it to intra-oral imaging. No matter what CDT Code is selected by the dentist, the choice must be supported by information and images placed in the patient’s records. There is a more elegant and specific solution on the horizon – a new code in CDT 2016 that dentists may use on patient records and claims – but we will have to wait until January 1, 2016 before using it.
D0251 extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.
The addition of D0251 is one of three interrelated changes to the extra-oral imaging codes in CDT 2016. As illustrated below: D0250 is revised to clarify the procedure’s scope and methodology so there is no overlap with D0251 and it is no longer a “…first...” image procedure; D0260 is deleted as it becomes redundant by the D0250 revision. Multiple D0250 images are documented on a claim using the “Qty.” (Quantity) field on the service line.
D0250 extra-oral – first 2D projection radiographic images created using a stationary radiation source, and detector. These images include, but are not limited to: Lateral Skull; Posterior-Anterior Skull; Submentovertex; Waters; Reverse Tomes; Oblique Mandibular Body; Lateral Ramus.
D0260 extraoral – each additional radiographic image
CDT Code maintenance requests from ADA members prompted these coming changes, and exemplify the importance of member participation in the CDT Code maintenance process. For information about this and other CDT Codes, and how the CDT code set is maintained, go online (http://www.ada.org/en/publications/cdt/), email ([email protected]), or call ADA Practice Institute staff at 800-621-8099