Jay M. Goldberg, D.D.S.
My messages this year have highlighted the need for watchfulness and participation in the political arena, especially those items which regulate our practices. PDA members can follow the association’s activites at the PDA website (www.padental.org) Federal matters may be monitored at http://www.ada.org/2036.aspx
In the Newsbriefs section of this issue, you will see updated information about Philadelphia legislation that has or will affect dentists as employers.
On June 14, PDA members from across Pennsylvania, along with spouses and dental students, converged in Harrisburg to lobby our state legislators. I am pleased to inform you that, on behalf of all Pennsylvania dentists, ‘WE’ made our presence felt in the Capitol that day. Thanks to the efforts of our PDA staff and lobbyists, nearly one hundred of ‘US’ were organized into small groups and met with Representatives and Senators in an effort to ‘INFORM’ them of the pending important issues that are affecting the quality of dental care for all Pennsylvanians and the dentists that serve them. We spoke of the need to require care for the special needs patients, the needs of those on medical assistance and restoring funding for the donated dental services programs. We also informed our legislators that only 30 percent of graduating dental students choose Pennsylvania to be their home. Why, you may ask, did ‘WE’ leave our practices on a Tuesday to participate in this annual event? Well, consider what we dentists and our patients are facing now: insurance companies imposing arbitrary fees on non-covered services, or not allowing assignment of benefits as a non-participating dentist and restricting the freedom to choose by our patients. ‘WE’ were there . . . proving our point, and ‘WE’ were heard loud and strong! My wife, Paula, and I were pleased to participate, along with Doctors Thomas W. Gamba, Saul N. Miller, Andrew J. Mramor, Sylvan Morein and Thomas P. Nordone. We shared a bus ride to and from Harrisburg with our colleagues from the Second District, dental residents and dental students from the University of Pennsylvania and the Kornberg School of Dentistry. My thanks to all who attended.
On the federal level, here are just two regulatory items that may affect our practices.
HIPAA/HITECH. In this age of increasing oversight, it is important for dentists who are covered entities (those who utilize electronic transmissions for third-party payment processing) of the Health Insurance Portability and Accountability Act (HIPAA) to be vigiliant and certain they are in compliance. ADA News recently reported that the federal government is taking new, more aggressive steps to enforce the health privacy act and investigate and prosecute violations.
In the past, HIPAA enforcement was driven by complaints filed by individuals. However, under the Health Information Technology for Clinical and Economic Health Act (HITECH), included as part of the president’s American Recovery and Reinvestment Act of 2009, the Office for Civil Rights (OCR) also has the authority to conduct compliance reviews and launch investigations. Plus, state attorneys general now have the authority to bring civil action on behalf of state residents for HIPAA violations. OCR has already begun conducting training courses on investigative techniques and prosecuting potential violators; and the attorneys general in Connecticut and Vermont have already brought enforcement actions under HIPAA.
The HITECH Act significantly increased the civil monetary penalties that OCR may impose on covered entities that violate HIPAA. (Learn more about the HITECH Act online at www.ada.org/news/4843.aspx).
The Health and Human Services (HHS) website provides summaries of various resolution agreements between the federal government and covered entities that were investigated for HIPAA violations (www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/index.html) The OCR website lists reported breaches that involve 500 or more individuals. (www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html)
For those dentists who are covered entities, it is important to know that the breaches were reported by hospitals, student health centers, offices of health care practitioners, insurance companies and other covered entities. The information was taken from paper records, laptop computers, emails, portable electronic devices, mailings, computer hard drives and other means of storing and transmitting information. The information was compromised through theft, computer hacking, unauthorized access, loss, improper disposal and other types of breaches.
The Office of Civil Rights provides information about HIPAA at www.hhs.gov/ocr/privacy/hipaa/ understanding
The ADA offers a guide for dentists to familiarize themselves with the requirements under HIPAA. The ADA Practical Guide to HIPAA Compliance: Privacy and Security Kit provides a step-by-step plan to help prepare and implement a HIPAA compliance program for a dental practice, and it also includes sample forms, policies, procedures, risk assessment questions, checklists and workforce training guidelines. The kit contains the manual, CD-ROM and update service through 2013. The cost is $225.00 for ADA members and $337.50 for nonmembers and is available online at www.adacatalog.org or members may call 1-800-947-4746 (ADA Catalog #J594).
Americans with Disabilities Act Amendments. On March 25, 2011, the Equal Employment Opportunity Commission (EEOC) finalized new regulations pertaining to the Americans with Disabilities Act Amendments Act of 2008 (ADAAA). The ADAAA expanded the scope of the term “disability” to include more major life activities, thus causing increased responsibilities for employers.
ADAAA regulations apply to all private, state and local government employers with 15 or more employees.
Congress found that persons with many types of impairments – including epilepsy, diabetes, multiple sclerosis, major depression, and bipolar disorder – had been unable to bring ADA claims because they were found not to meet the law’s definition of “disability.” As a result of the ADAAA and EEOC’s new final regulations, it will be easier for individuals to demonstrate that they meet the definition of “disability.” The only type of impairment that cannot form the basis of a claim is one that is both “transitory and minor.” The regulations state that a condition is considered transitory if it lasts, or is expected to last, less than six months. However, the defense against a claim in this case must be proved by the employer, and the transitory nature is not relevant as to whether someone suffers from an actual disability.
Employers who may be affected by the ADAAA, can read more information online at http://washlaborwire.com/2011/03/27/eeoc-publishes-final-ada-regulations/
Long gone are the days when dentists could put up a sign, open the office and proceed to “drill and fill” for our patients. Federal and state legislation affects some of us sometimes and all of us sometimes. However, our state and national associations continue to advocate for ALL of us ALL the time. Watchfulness, vigilance and activism are now part of our standard operating procedures as we advocate for the profession on Capitol Hill and throughout the country. I ask you to consider becoming part of that advocacy. Support our grassroots efforts. Get in-volved as a contact dentist for state and local legislators. The amount of time and talent you contribute can be as much or as little as you wish. Please contact me at philcodent@aol.com and I will be happy to direct you to the appropriate state or national staff member so you, too, can join our efforts to advocate for dentistry and for our patients.
General Information, Questions, Comments: info@philcodent.org
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