Section 1557 of the Affordable Care Action: Limited English Proficiency & Language Access Plans

Section 1557 of the Affordable Care Action: Limited English Proficiency & Language Access Plans

We have received a number of support calls from dental offices regarding the Section 1557 compliance.  If you accept Medicaid, Medicare Advantage and/or received funding under the HITECH Act, please read this letter carefully.

Section 1557 of the Affordable Care Act protects individuals from discrimination in health care based on race, color, national origin, age, disability and sex including pregnancy, gender identity, and sex stereotyping.

With 23 million Americans having a limited English proficiency (LEP), the government indicates there is an urgent need for language access services in health care settings in order to ensure that all patients receive accurate as well as culturally competent care.  Without meaningful access, medical errors may result in diagnoses due to misunderstandings in communication. This is dangerous for the patient and is an expensive liability for the provider.

The effective date of the final rule was July 18, 2016 and October 16, 2016 for posting requirements.

Although it is not required to have a Language Assessment Plan in place, development of this policy makes compliance less complicated.  The Plan clearly states how your practice complies and the resources that are in place to assist individuals with Limited English Proficiency.  The Plan also addresses how you assist individuals with disabilities such as communication with deaf individuals.

We must identify qualified interpreters for the languages most likely to be encountered.  Each state identifies the top 15 non-English languages.  For example, Tennessee’s is 111,267 Spanish while Kentucky is 48,275 Spanish.  The second non-English language in Tennessee is Arabic 7,880 while Kentucky is Chinese 4,565.  

A bilingual employee may be helpful in providing interpretation; however, having some proficiency in a second language is not equivalent to being completely bilingual.  This distinction is critical in order to ensure meaningful communication.  If your team member is qualified to interpret, please add interpretation to the individual’s job description.  Interpreting may take the employee away from regularly assigned duties and having this built into the job description may avoid staff problems.

If you engage an interpreter, you cannot charge the patient for the interpreter’s fees.  You must enter into a Business Associate Agreement to comply with the privacy provisions of HIPAA. 

There are video-remote services available.  However, if you utilize this type of service, you must ensure real-time, full-motion video and audio over a dedicated high-speed, wide-bandwidth video connection or wireless connection in order to deliver high-quality video images that do not result in time lags and blurry images.

Keep in mind that blind and deaf individuals come under Title III of the Americans with disabilities Act.  In addition to interpretation, technology must be accessible.  For example, if you are using patient-facing electronic technology such as an online appointment system or online payments, such services should be available to individuals with disabilities.  An exception is if such accessibility is an undue financial or administrative burden.  

You must post the nondiscrimination statement and taglines in the top 15 non-English languages of the state in your office and on your website. The top 15 non-English languages are available at https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Appendix-A-Top-15.pdf.

Copy and paste the non-discrimination notice and tag lines according to the languages of the state. The non-discrimination notice is available at http://www.hhs.gov/civil-rights/for-individuals/section-1557/translated-resources/. The tag lines are available at http://www.hhs.gov/civil-rights/for-individuals/section-1557/translated-resources/.  These notices go in every significant publication.  Small publications can be limited to the top two non-English languages.

If you have 15 or more employees, you must have a grievance procedure in place and a designated compliance coordinator.

Key documents such as the patient registrations, consent forms, Notice of Privacy Practices and others should be available in regularly encountered languages.

The Office of Civil Rights enforces compliance.  Additionally, an individual or entity may bring a civil action to challenge a violation.

We hope this information provides insight on the requirements for language access plans.  We realize it is yet one more thing practices must do to keep up with compliance. The American Dental Association has excellent resources available for members.

If you need assistance with this area of compliance and would like us to complete the paperwork for you, please contact our office. We can put together your plan and outline the resources necessary on your behalf including translation of your documents.  

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Understanding Business Associate Agreements

Understanding Business Associate Agreements

Understanding Business Associate Agreements

By Olivia Wann, JD

A critical component of a dental office’s HIPAA compliance program is obtaining business associate agreements from their business associates. A business associate is a person or an entity that provides services for the covered entity (dental office) involving protected health information (PHI) and electronic protected health information (ePHI).

Examples of business associates include electronic claims vendors, information technicians (IT), practice management software companies, appointment confirmation companies, marketing companies, trainers, consultants, bookkeepers, accountants, lawyers and others.

A business associate may also be a subcontractor that creates, maintains, or transmits PHI on behalf of another business associate.
In order to be in compliance with HIPAA, the dental office and the business associate must enter into a contract known as a “business associate agreement” to ensure the business associate is properly safeguarding PHI and adhering to HIPAA regulations.

Business associates are now directly liable under HIPAA’s regulations. Non-compliance can result in civil and criminal penalties for improper uses and disclosures of PHI including improper safeguards of ePHI. According to the Ponemon Institute, business associates' average cost from a data breach is $1 million.

It is not unreasonable to inquire of the business associate if they maintain HIPAA policies and procedures and whether they have recently conducted a thorough and detailed security risk assessment and training of their workforce.

As such, dental offices require business associates to implement appropriate physical, technical, and administrative safeguards. These safeguards are meant to prevent unauthorized access, use or disclosure of PHI, including implementing requirements of the HIPAA security rule with regard to electronic PHI. This applies to the business associate’s sub-contractors.

Carefully review existing relationships with independent contractors to determine if a current business associate agreement is in place or if the agreement must be revised. The agreements should reflect the most current HIPAA language. As of Sept. 22, 2014, dental offices qualifying as covered entities were required to have these contracts in place with all of their business associates. Matter of fact, if the dental office is audited randomly, the Office of Civil Rights will check whether or not these agreements are in place.

Additionally, business associates are responsible and liable to the dental office for the activities of their subcontractors who have entered into a business associate agreement with them.
In working with professional companies, the vendor may provide their own business associate agreement for the dental office. This raises concerns for dentists who are not familiar with reading such content. Is the agreement pro-business associate and not pro-dentist?


According to the Department of Health and Human Services, the business associate agreement must include the following:


• Establish the permitted and required uses and disclosures of protected health information by the business associate. This places limits on how the information is used and ensures the information accessed for the intended purpose.

• Clarify that the business associate will not use or further disclose the information other than as permitted or required by the contract or as required by law.

• Require the business associate to implement appropriate safeguards to prevent unauthorized use or disclosure of the information, including implementing requirements of the HIPAA Security Rule with regard to electronic protected health information.

• Require the business associate to report to the covered entity any use or disclosure of the information not provided for by its contract, including incidents that constitute breaches of unsecured protected health information. Such compliance may help avoid fines for non-compliance and prevent legal action.

• Require the business associate to disclose protected health information as specified in its contract to satisfy a covered entity’s obligation with respect to individuals' requests for copies of their protected health information, as well as make available protected health information for amendments (and incorporate any amendments, if required) and accountings.

• To the extent the business associate is to carry out a covered entity’s obligation under the Privacy Rule, require the business associate to comply with the requirements applicable to the obligation.

• Require the business associate to make available to Department of Health and Human Services (HHS) its internal practices, books, and records relating to the use and disclosure of protected health information received from, or created or received by the business associate on behalf of, the covered entity for purposes of HHS determining the covered entity’s compliance with the HIPAA Privacy Rule.

• At the termination of the contract, if feasible, require the business associate to return or destroy all protected health information received from, or created or received by the business associate on behalf of, the covered entity;

• Require the business associate to ensure that any subcontractors it may engage on its behalf that will have access to protected health information agree to the same restrictions and conditions that apply to the business associate with respect to such information; and

• Authorize termination of the contract by the covered entity if the business associate violates a material term of the contract. Contracts between business associates and business associates that are subcontractors are subject to these same requirements.”

Information regarding the business associate agreements is available at www.hhs.gov along with sample language for business associate agreement provisions.

The Department of Health and Human Services stresses that reliance on sample language may not be sufficient for compliance with State law, and does not replace consultation with a lawyer or negotiations between the parties to the contract.

In reviewing numerous corporate business associate agreements, we caution dentists when agreements minimize the corporate group’s damages to a mere monthly value of the service they are providing. Therefore, the question in these instances is what if there is a breach and resulting claims that costs thousands to millions of dollars, has the business associate disclaimed responsibility in a binding contract? Check with your attorney familiar with healthcare law. Additionally, inquire of your professional liability insurance carrier to determine if you need data breach protection. Additionally, review any indemnification clauses as well as the agreed jurisdiction.

It is highly important to set aside time to audit the business associate agreements currently in place and determine which agreements must be obtained or revised. Maintain copies of business associate agreements for six years.


Compliance is an ever evolving area of practice management and component of owning a business in the dental industry. Take the time to make sure your business associate agreements are on file.

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Olivia Wann founded Modern Practice Solutions, LLC in the year 2000 focusing on compliance issues. She started her law practice is 2012. Reading this article does not imply legal advice or constitute an attorney-client relationship. To contact Olivia, please email her at Olivia@oliviawann.com.

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How to Dispose of Dental Anesthetic Carpules

How to Dispose of Dental Anesthetic Carpules

How to Dispose of Dental Anesthetic Carpules
By Olivia Wann


Modern Practice Solutions, LLC is receiving numerous calls regarding disposal of pharmaceutical waste, particularly dental anesthetic carpules. The American Dental Association recently published an article, “Stericycle Contracts: Read the Fine Print – Dentists Question Business Practices,” in the ADA News June 20, 2016 edition. Dentists are looking for affordable options for waste disposal rather than being bound to expensive contracts.

In managing dental anesthetic carpules, first we must recognize how to distinguish the waste:

Carpules with Visible Blood: These carpules are classified as biohazardous sharps waste and must be placed in a sharps container for proper medical waste disposal.

Empty, Unbroken Carpules: Carpules that contain no remaining anesthetic or aspirated blood can be placed in the trash for general waste disposal (Check with local and state regulations. We verified disposal of empty carpules with the State of Tennessee. Tennessee agrees that best practice is to dispose of in sharps; however, it is not required providing the carpule contains no blood and no anesthetic). Note: Minnesota considers this waste as hazardous pharmaceutical waste.

Carpules with Anesthetic: These carpules are disposed of as pharmaceutical waste and transported to a medical waste incinerator.

An affordable option is Sharps Compliance, Inc. as well as other vendors that provide pay-as-you-go type solutions. Sharps Compliance, Inc. provides the TakeAway Environmental Return System which is a good choice for small dental offices. Visit http://sharpsinc.com/pharmaceutical-waste to learn more about the program.

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New Overtime Rules - Time for Dentists to Get into Compliance

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New Overtime Rules—Time to Get into Compliance  

By Olivia Wann, JD

The dilemma of whether an employee is salary or hourly continues to perplex employers.  Perhaps you have classified your office manager as salary exempt meaning no compensation for overtime because he or she is serving in a managerial capacity.  Maybe the hygienist was also classified as exempt “salary.” The hygienist on a daily rate never had to track hours worked and was paid a daily rate whether they worked 8-hours a day 4-days a week or the occasional 6-days a week.

Salary exempt must meet a standard salary level and the standard duties test in order to qualify for exemption from overtime.  According to the Department of Labor, job titles never determine exempt status under the FLSA. Furthermore, receiving a particular salary, alone, does not indicate that an employee is exempt from overtime and minimum wage protections.[1]

The overtime rules have changed the working environment with the new rules that go into effect December 1, 2016.  It is highly important that you as an employer carefully review how these changes affect your practice.  Compliance managers must update their handbooks, job descriptions and recalculate compensation accordingly.

The Fair Lair Standards Act ensures minimum wage and overtime pay protections for most employees covered by the Act.  Some employees are considered “exempt” from these protections.  Exempt employees are a classification of employees exempt from overtime.  Non-exempt are employees subject to payment of overtime. Perhaps you have used the term “salary” to refer to an employee not subject to overtime pay.

In order for executive, administrative and professional employees to be exempt from overtime, each of the three tests must be met: 

1)  the employee must be paid a set salary amount  that is not subject to reduction because of variations in the quality or quantity of work performed which is the “salary basis test;”

(2) the amount of salary paid must meet a minimum specified amount referred to as the “salary level test”; and

(3) the employee’s job duties must primarily involve executive, administrative, or professional duties as defined by the regulations, known as the “duties test.”

The weekly salary threshold changed from $455/week ($23,660/annual) to $913/week ($47,476/annual).  Therefore, employees classified as exempt and clearly engaged in exempt related work cannot earn less than $913 a week or the $47,476 a year.

Employers are permitted to use nondiscretionary bonuses and incentive payments (including payment of commissions) to satisfy up to 10% of the standard salary level.

If the employee is classified as “salary,” the employer cannot reduce the individual’s compensation for working less than 40 hours. For example, if it snows at 10 AM and the office closes for the remainder of the day, the salary exempt employee cannot incur a pay reduction.  

Although hygienists do not meet the professional exemption status, employers may pay the hygienist a salary as non-exempt. As a non-exempt salary paid worker, the hygienist is eligible for overtime and must track his or her work hours.

Is the office manager salary exempt? In addition to the compensation requirement, the employer must determine if the primary job duties meet the executive, administrative, and professional employee exemption in addition to the standard salary level.

To qualify for the administrative exemption, the employee’s primary duty must be performance of office or non-manual work directly related to the management or general business operations of the employer or the employer’s customers, or in our scenario, the employer’s patients.  The salary exempt employee must exercise discretion and independent judgment regarding significant matters.   Likely a small dental office’s office manager does not meet this test.

The professional exception includes associate dentists, not hygienists. To satisfy the executive exemption, the salary exempt employee’s primary duty consists of managing the enterprise and regularly directs the work of two full-time employees or the equivalent. A large practice or an operations manager managing multiple locations meets this job duties description.

According to the United States Department of Labor, here are your options for responding to the changes in overtime rules:

  1.  Raise salaries to maintain exemption
  2.  Pay current salaries, with overtime after 40 hours a week
  3.  Reorganize workloads, adjust schedules or spread work hours
  4.  Adjust wages[i]

The standard salary level requirement shall be updated automatically every three years. 

Please adjust employer’s handbooks and job descriptions accordingly.  If you need assistance with your human resource management, please contact Olivia Wann at olivia@oliviawann.com.


[1] Wage and Hour Division, United States Department of Labor, Guidance for Private Employers on Changes to the White Collar Exemptions in the Overtime Final Rule, May  18, 2016, Page 2, https://www.dol.gov/whd/overtime/final2016/general-guidance.pdf Accessed on June 18, 2016.



[i] Wage and Hour Division, United States Department of Labor, Guidance for Private Employers on Changes to the White Collar Exemptions in the Overtime Final Rule, May  18, 2016, p. 5, https://www.dol.gov/whd/overtime/final2016/general-guidance.pdf Accessed on June 18, 2016.

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Handheld X-Ray Unit & Monitoring

Handheld X-Ray Unit & Monitoring

It seems like a handheld X-ray unit is the way to go . . . is it?

Maybe yes . . . probably no

By Kevin Christian, LLC

Airbex Nomad Handheld X-ray Units have many advantages, and many disadvantages.  
Let me start with the disadvantages.

Cons:
1)   You must get the state’s approval for use prior to purchase.  This is unlike the normal protocol which calls for declaring a purchased unit to the state within 10 days.  With the handheld, you must contact Robert Young, the Device Manager for the Division of Radiological Health.  He will send you a letter requesting more information about your facility, the use and training procedures for the unit, the security against theft, etc.

2)     You will have to begin using film badges – both whole body badges and ring badges.  The most popular NVLAP approved companies for dosimetry are LandauerGlobal Dosimetry, and Radetco.  Film badge expenses can run over $1000 per year depending on the office, so keep that cost in mind when you purchase.

3)     These units are portable, handheld, and weigh about as much as a half-gallon of milk . . . so 
they can – and have – been dropped.

4)   They run on batteries.  One client told me that they had to recharge after an FMX.

5)     They have to be locked up after every use.

6)     On busy days, during peak demand, a bottleneck can form for everyone needing the unit at the same time.

7)     There is an FDA warning about units purchased overseas, so make sure you are certain about your supplier.

8)     These units are still illegal in some states (Alabama, for example), and were illegal in Tennessee up until recently.  There is also legislation afoot in many states that would make it illegal to have only one handheld unit in an office to serve all of the X-ray needs.

9) They are around $9,000, or roughly 2x the cost of a standard unit.

Pros:

1)     These devices are great if you have surgical privileges at a hospital that does not have an X-ray unit.

2)     They are ideal for trauma or triage scenarios.

 3)     They are perfect companions for mission trips where a laptop, a sensor, a Nomad, and several back-up batteries could set you up for a day or two of dentistry in the jungle.

4) They are great for military use.

I hope this helps clarify the issue in your mind as you decide whether a Nomad is right for you. – Kevin Christian 
To contact Kevin:  
radiationphysics@comcast.net

A word from Olivia Wann:  Please give Kevin Christian a call to assist you with your inspections.  If you are one of our subscribing clients, we will add NOMAD specific information to your OSHA Manual.  For economical dosimetry service, contact our friends at ProEdge (888) 843-3343.  Remember - you must train your staff on the use of the NOMAD  Please see training video at https://www.youtube.com/watch?v=UF1bL-nt0H4 and contact the manufacturer for support materials.

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Infection Control Breaches in a Dental Office by Olivia Wann

Infection Control Breaches in a Dental Office by Olivia Wann

As consultants in the dental OSHA and infection control compliance world, we are keenly interested in the promotion of safe dental care and a safe working environment. 

There has been documented transmissions of infectious agents including patient-to-patient in dental settings between the years 2003 and 2015.  According to CDC, there have been reported breakdowns in basic infection prevention procedures including unsafe injection practices, failure to heat sterilize dental handpieces between patients, and failure to monitor autoclaves. 

The Centers for Disease Control and Prevention (CDC) released the Summary of Infection Prevention Practices in Dental Settings - Basic Expectations for Safe Care.  This document is available at http://www.cdc.gov/oralhealth/infectioncontrol/guidelines/.

According to CDC, this highlights the need for comprehensive training to improve the understanding of underlying principles, recommended practices, their implementation, and the conditions that have to be met for disease transmission.

Our attention was stolen by the recent infection control outbreak related to a pediatric dental office where there were confirmed cases of infection linked to M. abscessus caused by contaminated water used during pulptomies.  

 As a result, the CDC published Notes from the Field: Mycobacterium abscessus Infections Among Patients of a Pediatric Dentistry Practice – Georgia 2015.

As if these reports were disturbing enough, the Association for Professions in Infection Control and Epidemiology (APIC), published an immediate release April 11, 2016 indicating that handwashing gets skipped a third of the time in outpatient healthcare: study.  According to the paper, despite having policies in place to prevent infections, staff in outpatient care facilities fail to follow recommendations for hand hygiene 37% of the time.

Time and time again, the issue comes down to training.  “Why do we have to do training again this year?”  Have you heard this comment from a well-meaning team member?  In light of the recent publications, we truly understand the need to provide training.  Training is an opportunity to not only learn new things, but also a time to issue important reminders of things we’ve learned in the past.  Policies are only as good as they are followed. 

Schedule your onsite inspection and risk assessment for a third party opinion of how well your practice is adhering to the infection control guidelines and OSHA regulations.  This allows our consultants to identify the gaps in your compliance program and to provide a custom fit training program that meets the needs of your team.  Call today to reserve your onsite services.  Telephone (931) 232-7738 or olivia@oliviawann.com.  

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How to Pass the Bar the First Time!!!!

How to Pass the Bar the First Time!!!!

Suggestions on Passing the Bar…The 1st Time

By Olivia Wann

I graduated from the Nashville School of Law December 2011 and took the bar in February 2012. I was practicing law by May 2012.  

I attended law school at night for four years.  Recently I read that the Nashville School of Law had a mere 28% pass rate for the most recent bar exam.  


I compiled the proceeding notes following my exam and shared them with a class.  I hope bar applicants surfing the Internet find this helpful.  You CAN pass the bar the first time!!!! 

Take at least 6 weeks off of work (especially if you have a demanding job that does not allow studying at work).  Some students do fine with 2 – 3 weeks, but I did not want to risk not having adequate time to review 4 years of material.

Study 8 AM to 4:30 PM like the bar testing is conducted. We were so accustomed to being up late due to our school schedule that many of us were “groggy” mid morning and early afternoon. You need to have your game on – during the entire 8 hour day.

Review the Barbri website to understand how to navigate the site and use the tools. I personally did not use AMP (black letter law) as I could have…. although it is excellent.  I did not have enough time to work all of it in plus I didn’t know it was available prior to the formal review.

Barbri’s Convisor was my Bible. I went through with different colored highlighters to ensure I went through the material several times. I especially studied the tips ….Tips are truly key areas where questions come from.

I used the StudySmart software which I found KEY.  The software grades your progress and compares you to your peers. I used it on my laptop between my formal study and on my iPhone. Thus, if you score a 60%, it may be an 80% when compared to everyone else that day.

Warn your friends and families that you will not accept dinner invites, parties, functions, gatherings, etc. during your 6 weeks of study.  You can do all that after the bar….much happier.

Understand there are two correct answers and you must choose the correct statement of law, rather than a correct statement of fact even if it sounds weird.

When the Barbri outline said to do two essays on a topic, I reviewed all of them to understand what graders are looking for. Length is not the gem – quality statements are. Using the computer was helpful because I could move my sentences around as I was thinking through the answers.

Your Barbri books should be well-used….new looking books make non-use apparent.  Don’t worry about selling your books. Focus on passing!

Stay on the Barbri schedule.  However, if you dislike a presenter for that day so badly you cannot concentrate, then resort to reading the written material provided.  There were probably only 1 or 2 that I found difficult to follow.  Most of them are absolutely amazing.

Do all the paper Barbri tests (and Kaplan) because the bar multi state is paper and you don’t want to be too accustomed to the electronic method.

Don’t assume that just because you made A’s and B’s that you’ll pass. You have to pay your dues studying.  Using the StudySmart software, you can isolate the topic you are weak in and spend more time mastering the questions.  Read the black letter law – or go through the AMP on that topic. You have to nail it.

Set your watch to 12 so that it’s easier to gauge your time because the test starts on the half hour –great tip from a presenter.

I also wrote down a little grid of question numbers I wasn’t sure of – I colored the bubble and moved on, but had adequate time to review the questions I was concerned about. Some students discourage this because they feel their first guess is correct, but this was a tip shared by a presenter and may have worked for me.

When you don’t know the answer, don’t stress. Wastes valuable brain energy. Put your pencil down a few seconds. Focus. Pray –whatever you have to do to re-group and relax.

Avoid the negative people the night before the bar exam. You don’t need to hear people saying they are not ready, they can’t do it, they need more time, etc. I watched a comedy the night before the multi state. If you don’t know the material the night before, you’re in trouble.

We stayed at the hotel where the test was administered. Don’t try to save $20 bucks and have to worry about driving, parking and where you’re going to eat lunch.

My husband had my lunch ready in my hotel room the first day. Eat protein and a little starch and caffeine….or at least, that’s what I did. Don’t drink too much liquid, or food that you are not used to eating…..

The second day, my husband had my lunch ready even though we had to check out. I ate in the car parked away from the test site so I could rest mentally.

Everybody’s “clicking” of the notebook computers will be distracting...bring ear plugs.

Prayer, meditation, exercise….good luck charms….whatever works for you to get in your happy place and find a sense of peace.

The night before:  Remember --I watched a comedy. If you don’t know the material the night before, you are not ready to take the bar. Relax. Laugh.

Remember:  Preparation is the key to confidence. 

All my best!!! Olivia Wann   Olivia@oliviawann  (931) 232-4529

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Radiation Requirements for Tennessee by Kevin Christian

Radiation Requirements for Tennessee by Kevin Christian

Navigating the myriad of regulations that govern a dental office can be daunting.  And the last thing anything wants is to be out of compliance without even knowing it.  My name is Kevin Christian, and I am the TDA endorsed private X-ray inspector in the State of Tennessee.  I want to take a second to help you avoid some of the common pitfalls that dentists often fall into when purchasing X-ray equipment.

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What Can Unlicensed Dental Assistants Do in Tennessee?

What Can Unlicensed Dental Assistants Do in Tennessee?

Our office receives numerous questions from dental offices inquiring about the scope of duties for dental assistants in Tennessee.  Dental Assistants must practice within the scope of duties outlined by Tennessee Rules governing the practice of dental assistants.  The dental assistant is required to stay up to date on these rules and maintain a current license and certifications. You may renew at www.tennesseeanytime.org

The below information is a guideline adapted from RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS as set forth by the Tennessee Board of Dentistry.  Please visit the website at http://www.state.tn.us/sos/rules/0460/0460-04.20120319.pdf

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Disposal of Hazardous Waste in a Dental Office

Disposal of Hazardous Waste in a Dental Office

It was common years ago for health care facilities to flush unused pharmaceuticals down the toilet or dump it down the drain.  The Environmental Protection Agency (EPA) conducted studies and identified numerous pharmaceutical compounds in our nation’s rivers, lakes, streams and drinking waters.

Despite the complexity of waste management, dental offices must evaluate the types of wastes generated and dispose of such waste properly. According to Universal Waste and Hazardous management at Healthcare Facilities in Tennessee, “the lack of a viable environmental compliance program can obviously be used as evidence of a lack of intent to comply.

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Tennessee - Dental Records Rule

Tennessee - Dental Records Rule

We receive a great deal of calls to our office inquiring what to do with old paper records in storage.  Typically the dental office has long since transitioned to a computer and now fully digital. 

Old records are stored in dentist's houses, basements, storage buildings or within the dental office. This is particularly a problem when a new dentist is taking over the practice and wonders what to do with records of patients he or she may never see as patients.  Selling dentists and dentists in practice for a long time should carefully review the regulations. 

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OSHA's New Pictogram Labels

OSHA's New Pictogram Labels

As we move into the new year and implement our goals for our practices, don't forget OSHA's new requirements. 

OSHA updated the requirements for labeling of hazardous chemicals under its Hazard Communication Standard. As of June 1, 2015, all labels will be required to have pictograms, a signal word, hazard and precautionary statements, the product identifier, and supplier identification.  Please see the picture provided. 

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Everything is Bigger in Texas: HB 300 & HIPAA

Everything is Bigger in Texas:  HB 300 & HIPAA

Everything is bigger in Texas….even their version of HIPAA regarding medical records privacy.

Texas Legislature adopted House Bill 300 known as HB 300 effective September 2012 which amended the Texas Medical Records Privacy Act. HB 300 significantly expanded patient privacy protections compared to the federal counterpart outlined in the Health Insurance Portability and Accountability Act of 1996 known as HIPAA.

This article briefly explores the more restrictive requirements to provide insight regarding necessary updates for covered entities located in Texas as well as entities that conduct business there.

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OSHA Online Resource for Hospitals

OSHA Unveils Its New Online Resource for Hospitals and Health
Care Entities

Learn more visit here:  https://www.osha.gov/dsg/hospitals/index.html

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Lawyers and HIPAA

Lawyers and HIPAA

How Lawyers Who Serve As Business Associates to Covered Entities Align their Law Practices with HIPAA

HIPAA is certainly not new. Hospitals, medical and dental practices, and other covered entities[1]have been grappling with HIPAA for years now. Ask any healthcare worker about the topic and likely you will receive negative feedback.   No doubt such a response relates to the ongoing challenges of HIPAA compliance which includes ongoing training, voluminous policies and procedures, never ending documentation, complicated risk assessments and convoluted risk management plans.

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HIPAA: Risk Assessment & Risk Management Plan

HIPAA: Risk Assessment & Risk Management Plan

The woes of HIPAA compliance....

HIPAA requires a thorough and accurate risk assessment of your data's security.  As HIPAA consultants, we collaborate with your Practice Administrator and your IT professionals to answer questions such as:

a)  Does the IT System Analyst conduct periodic security evaluations and continuous monitoring?

b)  What method of access control is (are) used (e.g., identity-based, role-based, location-based, or a combination?

c) Is there a formal, written contingency plan?

d) Does it address disaster recovery and data backup?

e) If penetration testing has been determined to be reasonable and appropriate, has penetration testing been performed? 

This is just a sampling of the detailed risk assessment we provide along with a corresponding risk management plan.  Call our office today to schedule your risk assessment:  (931) 232-7738

 

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Dental Meeting Planners

It's that time of year when meeting planners are planning content and speakers for dental societies, seminars, state meetings and workshops. 

Modern Practice Solutions is pleased to offer a new course:  The CASH Course.  This class is designed to inspire you and your team members to "unflatten" your practice. 

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$150,000 Fine for Lost Thumb Drive

Recently, an unencrypted USB drive (also known as a flash drive, thumb drive) resulted in a $150,000 fine for a dermatology practice.  The device contained protected health information for over 2,200 patients.  Evidently the device was stolen from the vehicle of one of its staff members.  The practice agreed on a settlement for the fine in addition to a corrective action plan to correct HIPAA compliance issues.

How do you back up your practice data? Is a staff member taking it home? Is it stored in their personal vehicle? Is the information encrypted? 

Conduct an accurate and thorough HIPAA Data Security Risk Assessment.  Good risk management avoids these costly compliance errors.  To view more information about this data breach, go to www.hhs.gov.

Contact Modern Practice Solutions for your HIPAA Data Risk Assessment today.  (931) 232-7738.

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Do You Know How Long Hepatitis C can remain Infectious?

Recent studies indicate that hepatitis C can remain infectious at room temperatures for up to 6-weeks.  Is your practice following the latest infection control guidelines for infection control? CDC also reveals that approximately 3-million adults in the U.S. are infected with hepatitis C virus, particularly the Baby Boomers (born from 1945 through 1965). Of the individuals who are infected, 3 out of 4 have no idea they have it. Once infected, 8 out of 10 people remain infected for life. These numbers are staggering.

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Train employees on the new label elements and SDS format

Effective December 1, 2013

Train employees on the new label elements and SDS format for the new changes made to the Hazard Communication Standard which brings into alignment the Globally Harmonized System of Classification and Labeling of Chemicals.  Please note that this rule requires pictograms on labels as of June 1, 2015 to alert users of the chemical hazards to which they may be exposed.  Each pictogram consists of a symbol on a white background framed within a red border and represents a distinct hazard(s).

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