FYI

Dentist blog from Delta Dental

Tag: COVID-19 (Page 1 of 5)

Your dental policy brief: Current issues and updates in the news as of October 12

From the Medicare debate to three-year dental degrees, FYI brings you the biggest dental policy stories.

1. Vaccine mandate unlikely to apply to dental offices, according to CMS

Following President Joe Biden’s COVID-19 vaccine mandate for health care workers at hospitals and other health care settings, the Centers for Medicare & Medicaid Services has issued a statement suggesting that the mandate won’t directly apply to dental offices, as these are not regulated under Conditions of Participation. CMS is expected to issue an interim final rule later this month that will outline the vaccine requirements for applicable participating providers and facilities. Although the mandate will likely not apply to dentists, the mandate will apply to full-time employees of Delta Dental because the company is a federal contractor.

2. Medicare dental benefits would not kick in until 2028, according to Congress’ plan

Under Congress’ planned expanded Medicare coverage, dental benefits would not kick in for recipients until 2028, according to legislative text that was released by the House Ways and Means Committee. Beneficiaries would receive vision and hearing care in 2022 and 2023, respectively, according to the plan. The Congressional Budget Office estimated in 2019 that adding dental, vision and hearing coverage to Medicare would cost about $358 billion, with $238 billion for dental care.

3. Roseman second U.S. university to offer 3-year dentist training

Beginning in 2022, the College of Dental Medicine at Roseman University of Health Sciences in South Jordan, Utah, will become the second institution in the country to shorten its dental degree program from four years to three. The change is intended to reduce the cost of dental education, said the Roseman University dean in a news release. Roseman follows the University of the Pacific Arthur A. Dugoni School of Dentistry in San Francisco, which first offered a three-year program in 1942.

4. New CDC training resource outlines infection prevention in dental settings

The Centers for Disease Control and Prevention Division of Oral Health has released free online training on safe care in the dental office and the principles of effective infection prevention and control. Foundations: Building the Safest Dental Visit is a self-paced training designed for dental health care personnel and others. The CDC partnered with the Organization for Safety, Asepsis and Prevention for the training, and OSAP will provide three hours of continuing education credit for completion.

5. October deadline to apply for COVID-19 provider relief funding

The deadline to apply for the fourth phase of the Health Resources and Services Administration’s Provider Relief Fund is Oct. 26. The fund allows eligible dental service providers to apply for payments made for health care-related expenses or lost revenue attributable to COVID-19. The agency is hosting a series of webinars on how to navigate the application portal and is also assisting providers with a Provider Support Line at 866-569-3522 from 9 am to 11 pm ET, Monday through Friday. The American Dental Association has also published a FAQ addressing dentists’ questions about applying for the funding.

Your dental policy brief: Current issues and updates in the news as of September 13

From dental groups advocating for mandatory vaccines to a significant court ruling against a dentist seeking to recover business losses from COVID-19, FYI brings you the most important policy update news.

Here are the five biggest stories from the past month:

1. Groups advocate for mandatory vaccines

Several dental organizations, including the American Dental Hygienists Association, the American Dental Education Association and the National Dental Association, are advocating for mandatory COVID-19 vaccinations for oral health care workers, students and residents. The participating organizations issued a statement September 1. The American Dental Association was not among the organizations to sign the statement but “strongly encourages” all members to get vaccinated. On September 9, President Joe Biden mandated vaccines or weekly testing for all federal workers, businesses with over 100 employees and health care staff.

2. Dentists aren’t insured against COVID-19 financial losses, say high courts

COVID-19-related losses do not trigger insurance coverage for businesses, including dental practices, the Eleventh Circuit Court of Appeals ruled on August 31. In the case, a Georgia-based dental practice filed a claim with its insurer to recover lost income after the business canceled dental procedures at the beginning of the pandemic. The Eleventh Circuit ruled that the incurred losses did not meet the qualifications of “physical loss or damage” required for a successful claim. 

The Eleventh Circuit is the second federal appeals court to make such a decision, joining the Eighth Circuit in its similar July 2 ruling in favor of the insurer.

3. ADA reviews CDT for use beyond claims administration

The ADA has created a new taskforce to enhance and reposition the CDT code for clinical documentation, administrative transactions and data exchange or interoperability.

“The advent of data analytics, the need to measure outcomes and the emergence of artificial/augmented intelligence all necessitate the repositioning of CDT for uses beyond claims administration,” said Randall Markarian, DMD, council chair and leader of the new taskforce.

4. California looks to protect health data by urging businesses to report breaches

California dental offices must report health care data breaches and comply with state and federal privacy laws, California Attorney General Rob Bonta reiterated in a bulletin written in response to a large number of recent unreported ransomware attacks.

Bonta stressed the importance of training staff on data security, maintaining a data back-up plan and using the latest security patches and virus protection software.

5. The ADA continues its push for dental coverage for all adults on Medicaid

The American Dental Association is pushing for dental care to become a required part of Medicaid coverage for adults in all 50 states. Along with nearly 130 organizations, the ADA sent a letter to Congress urging lawmakers to support and advance the Medicaid Dental Benefit Act.

The latest COVID-19 guidelines in the dental office

From the rise of the delta variant to issues about vaccination, the past few months have seen questions arise about the best ways for dental practices to adapt.

The latest recommendations from the ADA

On July 13, the American Dental Association (ADA) released updated recommendations for office procedures during COVID-19. Key points of the update include:

Delta variant prompts renewed recommendations on masks, vaccination

Concerns about the spread of the delta variant have prompted the American Dental Association to release a new fact sheet.

With the release of the document, the organization strongly reiterates its previous recommendations of:

  • Being vaccinated against the virus. The ADA recommends vaccinations in dental settings (California is the only state where vaccines for health care workers, including dental staff, are currently required). When recommending the vaccine to patients or staff who are resistant, the ADA offers a toolkit of ideas on how to address their concerns.
  • Using personal protective equipment in office settings. Monitor staff for appropriate implementation of PPE. Advise dental staff members to wear additional personal protective equipment (PPE) as appropriate, such as surgical masks or N95 masks, full face shields or goggles with side shields to ensure an environment that is as safe and healthy as possible for patients and the dental team.
  • Practicing social distancing. Avoid close contact with others by keeping six feet of distance whenever possible.

Consistent guidelines

Overall, the ADA and the Centers for Disease Control and Prevention‘s guidelines remain consistent throughout the rise of the delta variant. The guidance from each organization provides thorough, detailed patient management and facility information to consider before, during and after dental appointments.

How to manage office safety throughout the pandemic

The advent of the delta variant reinforces the importance of proper implementation of COVID-prevention tactics.

Successful guideline adherence and low infection rates in dental practices may be the primary reasons why dentists were largely exempted from recent federal COVID-19 requirements for health care settings mandated by OSHA, according to the ADA.

Guidance documents create no new legal obligations and don’t change or establish compliance responsibilities. As always, you need to use your best professional judgment when making decisions for your practice.

“Staying current with recommended safety protocols is important to building the safe environment for patients to seek care and the dental professionals delivering that care,” said Dr. Daniel Croley, Delta Dental’s chief dental officer.  “While following these recommendations is an individual practice choice, we encourage all dentists to adhere to these new guidelines to prevent the introduction of COVID to anyone seeking or delivering dental care.” 

How COVID-19 brought challenges and solutions to dentistry for seniors

Times of crisis call for creative solutions, and that’s never been more evident than during the COVID-19 pandemic. Innovative dentists have sought to adapt many aspects of their practices, but especially those involving the most vulnerable segment of our population: older adults.

New challenges for seniors’ oral health

For many seniors, even before the advent of COVID-19, physical limitations, systemic disease, cognitive decline and dependence on caregivers could all lead to an overall decline in oral health. What’s more, the pandemic worsened many of these same problems while presenting new ones.

“COVID-19 laid bare weaknesses in our elder care system,” said moderator Stephen K. Shuman, DDS, MS, in a webinar on pandemic-related disruptions in oral health care hosted by the Gerontological Society of America.

Some of the challenges in oral health care for seniors during the pandemic have included:

  • Reduced access. Early in the pandemic, many dentists’ offices shuttered, and even when they reopened, fear of COVID-19 led many older adults to delay or entirely forego visits to the dentist’s office. Nearly half of U.S. adults reported delaying dental care due to the COVID-19 pandemic during the spring of 2020, and the increased risk posed by COVID-19 to seniors likely exacerbated the problem among older adults.
  • Reduced care. In long-term care facilities, daily brushing, flossing and other routine care tasks were sometimes put on the back burner as COVID-19 diverted staff members to provide more urgent care to those affected or at risk. Proper oral care could also be challenged by staff members’ fears about the potential for oral transmission of COVID-19. Staffing shortages in facilities and on oral care teams made the situation worse. Georgia and Minnesota reported staffing shortages in long-term care facilities of more than 25% during the pandemic, and a recent poll from the ADA Health Policy Institute found that more than 80% of owner dentists who are currently hiring consider recruitment of dental hygienists and assistants to be extremely or very challenging at this time.
  • Psychosocial problems. The loneliness, anxiety and depression caused by shelter-at-home orders could themselves worsen oral health among older Americans.

Solutions in oral health care for seniors during the pandemic

Just as the COVID-19 presented new problems, it also created potential for positive long-term change.

Teledentistry and teletriage

Through necessity, many dentists began refining techniques for the use of teledentistry and teletriage.

Some companies began implementing or built up their existing “pandemic teledentistry.” Teams used cloud-based electronic health records and taught long-term care facility staff how to take useful images of patient mouths and send them to centrally located dentists.

At the height of the pandemic, 24.8% of responding dentists reported they were conducting remote problem-focused evaluations through virtual technology or telecommunications, according to polling from the American Dental Association’s Health Policy Institute.

Some innovative dentists used what they referred to as assisted, or guided, oral hygiene during the pandemic. They used the latest audio and video technology to guide a patient or caregiver as they carried out oral hygiene on a regularly scheduled basis. Some caregivers, such as Michael J. Helgeson, DDS, of Apple Tree Dental, saw the technology as a key way to maintain dental health care for seniors during the pandemic when in-person care wasn’t possible.

Mobile dentistry

While the pandemic restricted mobile care in some cases, its primary advantage of reducing the need to transport at-risk seniors also caused it to emerge as another possible solution.

Many dentists were already accustomed to setting up mobile units in long term care facilities even before the pandemic. Mobile dentistry helps reduce the potential for stress and confusion caused by moving older patients or those with dementia. With the latest mobile equipment deployed to long-term care facilities, dentists are able to perform simple extractions, restorative work and more in a timely manner. As in many dental offices, mobile units often add an external dental suction that uses ultraviolet light and filters to remove pathogens from the air.

How to support your senior patients through the pandemic

COVID-19 presented extraordinary challenges to your senior patients. The new solutions that helped maintain health care for older adults during the pandemic are likely here to stay.

To support your senior patients throughout the pandemic:

  • Communicate with patients. Oral health care should never be placed on the back burner, and maintaining good communication with your patients is one of the most crucial keys to emphasizing the importance of oral health. As always, keep in mind the systemic relationship between oral health and overall well-being. Use empathic listening and compassionate care to encourage the maintenance of oral hygiene routines among your senior patients throughout the pandemic.
  • Consider adopting new approaches. Teledentistry can now connect oral health care providers with older adults remotely when patients are unable to visit a dental clinic or if there are restrictions on dental providers visiting residential facilities. The use of mobile dentistry during the pandemic likewise bodes well for its future implementation as a solution for the needs of seniors in long term care facilities for whom transport is an issue.

Your dental policy brief: The 5 biggest stories as of August 4, 2021

From mask mandates to Medicare promises, it’s been a busy month for dental news and policy updates. Here are the five biggest stories from the past month for you to peruse.

1. Vaccine mandates become a reality for California and VA dentists

Starting August 9, health care workers in California, including dentists and staff, will be required to show proof of COVID-19 vaccination or submit to regular tests if unvaccinated. Full compliance is required by August 23. Additionally, on July 26, the Department of Veterans Affairs (VA) announced that dentists who serve Veterans must get fully vaccinated within eight weeks. The VA mandate covers Title 38 health care personnel, including dentists and other patient-facing workers.

2. The American Dental Association updates its guidelines

On July 13, the American Dental Association updated its pandemic procedures for offices to help fight COVID-19. Hazard assessments are encouraged, pre-appointment screenings are still necessary, and dentists are encouraged to exercise their best judgment when setting a safety plan for their practices.

3. Senate Democrats’ proposed budget would add dental coverage to Medicare

On July 13, Senate Democrats agreed to pursue a $3.5 trillion reconciliation bill that would add dental coverage to Medicare. Medicare serves almost 63 million members, so this could mean an influx of senior citizen patients if the bill passes.

4. Paycheck Protection Program (PPP) loan forgiveness deadline coming due

If you received a PPP loan last year, be sure to apply for forgiveness before the next deadline passes you by in September. Under the program’s rules, borrowers who don’t apply for forgiveness within 10 months of the end of the covered period will need to begin making payments to their lender.

5. Department of Health and Human Services bans balance billing

At the beginning of the month, the Department of Health and Human Services prohibited balance billing, effective January 1, 2022. The new rule, “Requirements Related to Surprise Billing; Part I,” applies to dental plans embedded in medical plans, but not to standalone dental.

Don’t miss the deadline for PPP loan forgiveness

Did your practice get a loan through the Paycheck Protection Program (PPP)? The deadline to apply for forgiveness is fast approaching. Without forgiveness, your loan will become permanent, and you’ll be responsible for payments and interest.

PPP loans automatically convert to standard 1% interest loans if you don’t apply for forgiveness within 10 months of the covered period for spending the money.

If you applied when the program launched in April last year, your deadline falls in mid-July. If your loan had a 24-week covered period, your deadline will be in September.

Your business is eligible for full loan forgiveness if you met the program’s criteria such as maintaining employment and compensation levels and spending at least 60% of loan funds on payroll expenses. For more on applying for forgiveness, review the terms and instructions from the Small Business Administration.

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