REGULATORY AGENCIES AND LAWS

1. REGULATORY AGENCIES AND LAWS Affecting the Practice of Dentistry Cheryl H. DeVore, RDH, MS, JD

2. State Dental Boards • Purpose of these Boards is to protect the public/consumer of dental services • Enforcement authority for compliance with the Practice Acts, including licensing, monitoring and disciplinary action • Authority to promulgate policy and rule • Apply Sanctions for non compliers

3. STATE DENTAL BOARD Cont… • Authority over all licensees/certificate holders • Dentists • Dental hygienists • Other auxiliaries/dental radiographers

4. STATE DENTAL BOARDComposition • Appointed positions • Generally for 5 to 7 years • Representatives of Licensee groups and a consumer

5. STATE DENTAL BOARDProcess and Procedure • Regular meetings open as public forum • Regular business including review of investigations of complaints filed • Hearings held, due process and sanctions imposed

6. State Dental Practice Actregulations affecting practice • State Law • Administrative Law • Board policy statements

7. State Board’s Sanctions • Public reprimand • Probation • Suspension • Revocation • (in some states) imposing financial sanctions/fines

8. STATE ENVIRONMENTAL PROTECTION AGENCY(EPA) • In Ohio-covers both small and large generators of waste • Dental practices are considered small quantity generators of infectious waste material

9. DEPARTMENTS OF HEALTH • In Ohio, has responsibility for general radiation protection standards • Scope in Ohio……”applies to all facilities that receive, possess, use, store, transfer, install, service or dispose of any source of radiation for which registration by its handler is required under rule 3701-71-02 of the Ohio Admin. Code”

10. DEPARTMENT OF HEALTH CONT….. • Radiation records must be maintained showing dates of receipt, transfer and disposal of all sources of radiation. • Inspections are done usually about every 5 years. Inspections may include the sources of radiation and the source’s shielding and surroundings. • When dental practice ownership or radiography equipment transfer to new owner must be registered. Fines imposed for failure to timely register.

11. OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) • State and Federal OSHA exists • Congress created the Federal Agency in 1970 to protect workers from hazards in the workplace • In 1986, focus turned to health care settings, including dentistry. • OSHA has the power to adopt safety and health standards and to enforce them with both inspections and fines.

12. OSHA Cont…… • Generally an inspection is triggered by a complaint • Even though OSHA is authorized to protect the health and safety of employees not patients in a dental practice, a patient complaint would probably give OSHA cause to believe that the safety or health of an employee may be at risk.

13. FEDERAL TRADE COMMISSION (FTC) • Historically, there were laws preventing professional advertising. • Goldfarb v. Virginia State Bar and Bates v. State Bar of Arizona lifted the restraints on such professional advertising. • Professional Ethical codes and State Dental Practice Acts still may require that advertising meet certain requirements.

14. Examples of Advertising that may be a Problem • Advertising that misrepresents the qualifications of the dentist's); ie “specializing” when they are not a certified specialist • Advertising that tends to mislead the public; ie. “pain free dentistry”, “HIV free office” • Laudatory comments • Clearly mailing General Dentistry (Ohio)

15. STATE CIVIL RIGHTS COMMISSION • State Civil Rights Commission and Equal Employment Opportunity Commission • These agencies enforce the state and federal anti-discrimination legislation respectively. • By law these agencies must respond to complaints they receive about alleged discriminatory practices and conduct an investigation of all complaints.

16. ADDITIONAL STATUTORY REGULATIONS AFFECTING THE PRACTICE OF DENTISTRY • The Americans With Disabilities Act • Insurance Law particularly laws regarding fraud) • National Practitioners Data Bank (Health Care Quality Improvement Act of 1986) • Health Insurance Portability and Accountability Act of 1996(HIPAA)

17. Americans With Disabilities Act • Title I and Title III • “Otherwise qualified” as it relates to employees in hiring, promotion or firing • “Essential Job Functions” • “Reasonable Accommodation” • Physical barriers to care/Psychological barriers to care.

18. Insurance Fraud • Codified in the Dental Practice Act (Ohio) • Waiving of Co-Pays • Fraudulent reporting of care • Medicaid (check validity of card)

19. National Practitioner’s Data Bank • Covers all types of healthcare providers • A healthcare provider may query the Data Bank at anytime about themselves, but may not query about another • Malpractice carriers may not query the Data Bank • Some groups, like Malpractice carriers, are required to report to the Data Bank