-
-
Update from the Department of Health and Hospitals! -
Regulations, Laws and Guidelines Affecting
Louisiana Dental Practices -
Sales Tax Exemption Revenue Ruling
|
|
 | |
 | |
|
|
Visit the LDA's GRASSROOTS ACTION CENTERThe LDA's Grassroots Action Center, powered by VoterVOICE, allows members to communicate directly with their elected officials about the issues most important to dentistry. Become a dental advocate. Participate directly in the LDA's lobbying efforts by visiting the Grassroots Action Center today. CLICK HERE! General Supervision
The 2006 Legislature passed the LDA's general supervision bill, meaning that the statutory provisions became effective upon the governor's signature on June 29, 2006. The changes to the Dental Practice Act allowing for general supervision that were approved by the 2006 LDA House of Delegates (HOD) also included changes to the Louisiana State Board of Dentistry's rules. The new rules pertaining to general supervision that were approved by the HOD should be published in the Louisiana Register and effective on July 20, 2006. Click here to download a copy of the bill (Act 744) or here for a copy of the general supervision rules. Effective January 1, 2007, Medicaid will begin accepting the new 2006 American Dental Association (ADA) Claim Form from providers who submit hardcopy claims to Medicaid for prior authorization and payment of dental services. In addition, Medicaid will continue to accept the 2002 ADA Claim Form and the 2002, 2004 ADA Claim Form through April 1, 2007. Effective April 2, 2007, the 2006 ADA Claim Form will be required when submitting hardcopy claims to Medicaid and will be the only dental claim form accepted for prior authorization and payment of dental services. Effective April 2, 2007, all 2002 ADA Claim Forms and all 2002, 2004 ADA Claim Forms received by the Medicaid Dental Prior Authorization Unit or Unisys will be returned to the provider unprocessed. All providers who submit hardcopy dental claims will be responsible for submitting the 2006 ADA Claim Form effective April 2, 2007. No exceptions will be made. In preparation, providers who submit hardcopy claims to Medicaid should order the 2006 ADA Claim Forms from the ADA or their dental supplier as soon as possible. Providers who use dental software to print hardcopy dental claims should contact their software vendor as soon as possible in order to obtain the 2006 dental software. Providers who use a third party contractor (billing agent) should provide their contractor with a copy of this message. Dental providers should check this website (www.lamedicaid.com) periodically for new updates on this topic. ATTENTION DENTAL MEDICAID PROVIDERS: Effective November 1, 2006, certain services in the EPSDT Dental, Adult Denture and Expanded Dental Services for Pregnant Women Programs will receive rate increases. Also, several additional services will be made payable and policy revisions related to several existing dental services will occur. Complete information regarding the rate increases, new additional codes and policy revisions will be placed on the following website prior to November 1, 2006: www.lamedicaid.com (links entitled “New Medicaid Information”, “Billing Information” and “Fee Schedules”.) Medicaid will work diligently to ensure that all changes are in place by November 1, 2006. However, in the event that a delay is unavoidable, we remind you that dental providers are required by Medicaid to bill their usual and customary fees. Providers who bill their usual and customary fees will not be required to manually adjust their claims should a claim recycle be required as Medicaid will automatically adjust the claims. If a dental provider does not bill their usual and customary fees and a claim recycle is required, the dental provider will be responsible for all necessary claim adjustments. Should you have any questions related to this matter, you may contact Unisys Provider Relations by calling (800) 473-2783 OR (225) 924-5040. ***************************************** As posted in the LDA’s 2006 Legislative Update, Louisiana’s Dental Medicaid Program received a $14.8 million increase during the 2006 Legislative Session. The Louisiana Department of Health and Hospitals (DHH) has not yet released an effective date for the rate increase. LDA will update our web site at www.ladental.org and e-mail members as soon as we are notified of the effective date. However, to prepare for the increase, Terri Norwood, Medicaid Program Monitor with DHH, has made the following recommendation: Dental providers are required by Medicaid to bill their usual and customary fees. Providers who bill their usual and customary fees will not be required to manually adjust their claims should a retroactive rate increase occur as Medicaid will automatically adjust the claims that are involved in the retroactive rate increase. If a dental provider does not bill their usual and customary fees and a retroactive dental rate increase occurs, the dental provider will be responsible for all necessary claim adjustments. To reach Norwood, call (225) 342-9403. Donelon says DOI Will Inspect Some Allstate Insured Properties Commissioner of Insurance Jim Donelon will send Department of Insurance staff to inspect the properties of 18 policyholders in Jefferson, Orleans and St. Bernard Parishes who complained to the Department that their homeowners insurance was improperly canceled. To date, the Department has received 386 complaints from Allstate policyholders regarding the cancellation of their homeowners policies. The cancellations come following the sunset of Emergency Rule 23, a policyholder protection measure put in place by the Commissioner of Insurance following Hurricanes Katrina and Rita. Emergency Rule 23 did the following: (1) Suspended the right of any insurance company to cancel or non-renew properties in Louisiana that sustained damage as a result of the hurricanes until December 31, 2006, as long as the property owners paid their premium. (2) Required insurers to complete a physical inspection of the subject property no earlier than December 1, 2006 or 30 days prior to the cancellation or non-renewal of a policy after the sunset of Emergency Rule 23. (3) Required insurers to send a preliminary letter to the policyholder advising them of the specific damage to the property that still remained that would entitle the insurer to cancel the policy due to "a material change in the risk being insured." The homeowner had 30 days to respond to the company and provide documentation that repairs had already been completed or were in the process of being completed, thereby negating any cancellation. By close of business Monday, the Department had received 180 complaints against Allstate regarding homeowner policy cancellations. Of those 180 complaints, Department staff selected 18 complaints (or 10%) where policyholders stated they had been back in their homes at the time of the alleged home inspection by Allstate. Commissioner Donelon directed Allstate to provide proof of inspections on those 18 homes by the close of business yesterday. After reviewing the documentation from Allstate this morning, Donelon said he has serious reservations about the validity of Allstate's inspection program. "I do not believe Allstate has provided me with sufficient documentation to validate the inspection of these homes," Donelon said. "My staff will visit these 18 properties, conduct interviews with each of the homeowners and photograph their property as part of this Department's investigation of Allstate. Should our findings show that Allstate misrepresented the inspection program, I will impose severe penalties against the company," Donelon added. Commissioner Donelon said in the meantime the Department is conducting a one-on-one investigation of every complaint it receives against Allstate. Department staff are in contact with Allstate officials twice daily, providing the company with the name and policy number of each policyholder who has registered a complaint. So far, of the 182 complaints worked to date, the Department has been successful in having Allstate reinstate homeowners insurance for 76 policyholders. Of the remaining 106 complaints handled so far, Allstate’s present position is that the company does not have the proper documentation to render a final decision. The Department is working with the homeowner to get that proper documentation to Allstate in order to compel reinstatement where deemed appropriate. Commissioner Donelon said homeowners receiving a premium refund with their cancellation should hold the check and not cash it until they get final word as to whether or not they will be reinstated. If any homeowner feels they have been improperly canceled by Allstate or any other insurance company, they should call the Department of Insurance at 1-800-259-5300. -30- For more information, contact Amy Whittington at 225-342-1429 LDA's Recap of the 2006 Legislative SessionThe Louisiana Legislature wrapped up its 2006 regular session and adjourned sine die on Monday, June 19, 2006, at 6 p.m., after sending Gov. Kathleen Blanco a $26.7 billion state operating budget. The following is a breakdown of the LDA’s primary legislative priorities for the 2006 Session and the resulting actions. SUPPORT increased funding for dental EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) component of Medicaid. Largely in response to DAP-PAC contributions, personal visits from DAP-PAC Treasurer Dr. Edward “Don” Donaldson and LDA’s grassroots lobbying efforts, lawmakers approved a $14.8 million increase for the program. (The $14.8 million includes state funds and the federal match.) SUPPORT funding for the Louisiana State University School of Dentistry. The LDA lobbied to maintain the $31 million in appropriations in HB1 dedicated to funding faculty salary increases for higher education. The LSU Health Science Center New Orleans also received an additional $15.5 million. SUPPORT reinstating $50,000 to the Office for Citizens with Developmental Disabilities (OCDD) for Louisiana’s Donated Dental Services program. OCDD has asked the National Foundation of Dentistry for the Handicapped for report materials to process a new contract. PASSED HB 70, provides for immunity of health care providers during a declared state of emergency anywhere in the state. Any health care provider who in good faith voluntarily renders emergency care or first aid to assist persons injured as a result of the emergency whether the aid is rendered in the area subject to the declaration of emergency or elsewhere shall not be civilly liable for causing the death of, or injury to, any person or damage to any property except in the event of gross negligence or willful misconduct. Signed by the Governor, effective August 15, 2006. PASSED HB 93, revises the Dental Practice Act to institute emergency-related provisions for the Louisiana State Board of Dentistry (LSBD) and addresses the strong preferences of dentists and dental students to move state to state and obtain licenses more easily. The LSBD will accept passage of a regional/national clinical licensing exam (as opposed to previously only accepting it’s own exam). All Louisiana candidates for licensure who take a national or regional exam will pay the exam fees directly to the administering examining agency – thus allowing students the mobility they want and are willing to pay for. The LSBD will also employ dentists or dental hygienists (i.e., examiners with experience administering the regional exams) licensed in any state or territory of the United States to conduct clinical licensing exams. Signed by the Governor, effective August 15, 2006. PASSED HB 153, creates the Prescription Monitoring Program (PMP). A PMP collects certain data elements of certain prescriptions from all dispensers, maintains that centralized database (under the Louisiana Board of Pharmacy), and then uses that data for such purposes as allowed under the enabling statute (such as the identification of individuals addicted to prescription drugs). The LDA monitored the legislation to ensure that the portion of the proposed legislation remained that stipulates that an authorized practitioner who dispenses or distributes no more than a 48-hour supply of such substances to his/her patients will not be considered a dispenser and will therefore not be affected by the proposed legislation. Enrolled on June 19, 2006. PASSED HB 302, allows retired dentists to practice at community health care clinics for no remuneration. Signed by the Governor, effective August 15, 2006. PASSED HB 453, provides, relative to emergency assistance during disasters, a limitation of liability for health care providers under certain circumstances except under gross negligence and provides for the licensing of certain health care providers. Signed by the Governor, effective August 15, 2006. PASSED HB 693, transferring the authority to issue licenses for controlled dangerous substances from the Department of Health and Hospitals to the Louisiana Board of Pharmacy, including promulgating rules and regulations for a fee schedule and administrative and enforcement exceptions. Enrolled on June 16, 2006. PASSED HB 846, temporary registration of health care professionals. During a declared state of public health emergency, any board or commission placed within the Department of Health and Hospitals has the power to issue temporary registrations to health care providers licensed, certified or registered in another jurisdiction of the United States whose licenses, certifications or registrations are current and unrestricted and in good standing in such jurisdictions. Signed by the Governor, effective June 2, 2006. FAILED HB 1228, provides an exemption to the medical malpractice cap. PASSED HB 1394, provides for general supervision of dental hygienists in private practice. (State law already provides for general supervision in public facilities.) This means that hygienists under certain conditions could provide limited services to patients under the guidance of a licensed, supervising dentist in accordance with a treatment plan approved by the dentist without the dentist being physically present in the facility. An amendment to this bill also restricts insurers ability to apply the most favored nations clause in provider contracts. Signed by the Governor, effective June 29, 2006. PASSED HCSR 3, requests the House Committee on Health and Welfare and the Senate Committee on Health and Welfare to study the scientific, health, technical, economic and related issues in order to evaluate the feasibility of mandated community water fluoridation. Enrolled on June 19, 2006. PASSED SB 615, creates the Mercury Risk Reduction Act, as amended provides for proper handling and recycling of dental amalgam (as described in the ADA Best Management Practices or BMPs) without limiting its use as a highly effective dental restorative material. Signed by the Governor, effective June 2, 2006.Thanks to all the LDA members who used the LDA Grassroots Action Center powered by VoterVOICE on our web site to help lobby for or against the bills that impacted dentistry. Grassroots participation is essential to the LDA’s lobbying efforts, and all members are encouraged to use this service in the future. VoterVOICE makes it quick and easy for you to have your voice heard in the Louisiana Legislature! For contact information on your legislator or on other bills that were introduced during this session, go to www.legis.state.la.us. A very special thank you to all of our members who contribute to LADPAC and DAP-PAC! Your money is helping support candidates and political activities that benefit our profession.
HIPAA is Here! What's All the Hype About HIPAA? LDA members are hearing a lot of hype about HIPAA lately. Though not offered as legal advice, the following information, supplied by the American Dental Association, is intended to help answer some of the most common questions asked by LDA members about HIPAA. The LDA has made reasonable and diligent efforts to ensure the accuracy of this information; however, the LDA makes no warranties thereof and is not responsible for any loss, actual or potential, resulting from reliance on the content of this article. Members needing additional information about HIPAA should consult with their own attorney, call the ADA, or visit the HIPAA content area of the ADA website. What is HIPAA? HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. The federal law includes a special section aimed at reducing the administrative costs of health care. As a practical matter, HIPAA imposes new restrictions on the management of patient information within a dental office. In part, HIPAA requires the use of a standard format by health plans and dentists who transmit health information electronically. This rule applies to dental practices that submit or receive electronic transactions, even through a vendor or clearinghouse, as well as those practices that submit paper claims to a billing service for conversion to electronic transactions. Dentists who utilize solely paper transactions are not subject to this requirement. Compliance with the HIPAA rules for electronic transactions was required by October 16, 2002. For more information on the electronic transaction rules, visit the special website set up by the Centers for Medicare and Medicaid Services. Privacy protection is also an important component of HIPAA. Although HIPAA does not require that dental offices be soundproofed, as was often rumored in the past, it does require certain safeguards for sensitive patient information. The deadline for compliance with the HIPAA privacy rules was April 14, 2003. The privacy rule applies to the same group affected by the electronic transactions rule. If you do not utilize electronic transactions, then you are not subject to this deadline. Member dentists who are affected by the privacy rule may find the ADA's Privacy Checklist helpful in their preparations for compliance with the new law. As the compliance deadlines approached, dentists began to receive solicitations to purchase HIPAA compliance products. Many of these vendors work outside the dental profession, and the products they offer can be quite expensive. LDA members have reported receiving offers to purchase compliance aids as costly as $900. As a more affordable alternative, the ADA recommends its own HIPAA Privacy Kit and HIPAA Privacy Seminar (available on video) to assist members in their efforts to comply with the new law. The Privacy Kit can be purchased for $125 through the ADA catalog. The kit will include an update once the HIPAA Privacy Rule is finalized by the federal government. "The ADA has the expertise to point out in a dentist-friendly manner what's important for us to know," says ADA president Dr. D. Gregory Chadwick. "This kit has been created by people who understand a dental office." UPDATE! The ADA now has a special HIPAA Hotline established for your HIPAA questions. Members can simply call the ADA's toll-free number and ask for extension 2899. Last updated 2/14/07 |