GSOMS Newsletter |
January 2010 |
In this issue!
From the President
Board of Dentistry Update
From the Emory Division of Oral and Maxillofacial
Surgery
Update On The Dental Medicaid/Peachcare Program
Download newsletter to read off-line
From the President
Dear Colleagues,
As we close out one year and roll in another the Georgia Society has faced a number of challenges and come through tempered and ready to move forward. Changes in the state funded programs, continued efforts to meet our obligations for anesthesia and the ever present battle against apathy and discord are hurdles but not blockades to our objectives and goals. With even larger changes in the American healthcare system looming, we must maintain our vigilant post and keep perspective on putting the health and well-being of patients first.
I would be remiss if I did not thank all of the officers and committee chairs for their efforts in 2009 and look forward to finishing out our tenure with a successful spring agenda and program. Details of exact speaker and venue will be shortly forthcoming so please keep tabs with the GSOMS as we nail down the particulars. There is a great effort to make it a relevant and engaging event to bring ones referrals and further our business relationships. Additional thanks goes to Hank and Leslie Boulter for their work on our behalf through the year as well.
One of our most pressing issues is the daunting task of anesthesia re-evaluation. We have gone through several permutations and finally have settled on a "buddy" honor system to find each of your evaluators. If you have not been evaluated and are unsure of your next step...please contact Leslie at GSOMS and we will clarify what can be done to assist you in getting it done. We are fast approaching AAOMS's deadline but will have a large push as we get closer throughout this administration and into Dr. Roser's group of officers.
Reductions in Medicaid re-imbursement have taken a large step in the wrong direction for Georgia's oral and maxillofacial surgeons. We have been proactive in our efforts to meet with the representatives of Doral here in Georgia..but the response in terms of actual progress has been less than stellar. We will continue efforts with the GDA and with other avenues to get our point across for the surgeons who treat this population of patients. The Georgia Board is also still making progress on the issues revolving around requirements for conscious sedation and for General Anesthesia permits in the state. Our position paper drafted by myself and Dr. Perciaccante several years ago seems prescient in terms of the changes that have been advocated and are at a precipice. Stay tuned with the society and we will do our best to keep you informed of the changes through Dr. Stacey and his updates from the board. I hope that the rest of you are excited about the possibilities of the new year and we will continue to forge ahead with our main focus being patient care and our primary purpose to be an advocate for Georgia's residents and Oral and Maxillofacial Surgeons.
Have a Prosperous and fulfilled New
Year
Antwan Treadway, DMD
President, GSOMS
Board of Dentistry Update
By Barry C. Stacey, DMD
Dental licenses are up for renewal by December 31. Renewal is online on the Secretary of State website which is sos.georgia.gov/plb and click on license renewal. You must renew your dental license first and then your general anesthesia permit. Remember that at least 40 hours of continuing education is required and random audits will begin in February, 2010.
On January 8, 2010, there will be a public hearing in Macon to discuss the revised rules for anesthesia permits prior to a vote by the Board to adopt. If you would like to review these revisions, use the same website listed above, then click on the Dental Board and then Proposed & Recently Adopted Rules. If you have comments, please feel free to attend the hearing.
From the Emory Division of
Oral and Maxillofacial Surgery
Successful Committee On Dental Accreditation (CODA) Site Visit
The Emory Oral and Maxillofacial Surgery program received no recommendations
at its recent site visit on December 1st, 2009. Representatives from
the committee included Dr. George Kushner (Chair) and Dr. Michael Lehnert.
The site visitors personally commented on the strengths of the program -
a large and varied patient population, strong didactic curriculum, and a
dedicated and diverse full and part time clinical faculty.
Dr. Roser Leads Third Mission
Trip To Nicaragua
Dr. Steven Roser led a third consecutive successful mission trip to Managua,
Nicaragua as part of the Healing the Children Organization. With surgeons,
anesthesiologists, nurses, physician assistants, and administrators from
Emory and Columbia Universities, the group treated 57 patients with Cleft
Lip andPalate
over 6 days.
Dr. Roser states, “Our volunteer medical and surgical healthprofessionals travel at their own expense. They treat patients and share their expertise with host country health professionals during procedures and in-service sessions. Other volunteers provide postoperative care, transportation, organize patients, and document activities. The work is grueling, but rewarding. Many surgeons report feeling a renewed commitment to their profession and new certainty that what they do is worthwhile.”
OMFS Alumni Receive Awards At Annual AAOMS Meeting
Four alums of the Division of Oral and Maxillofacial Surgery were presented
with awards by outgoing president Dr. Lynn White, himself an Emory OMFS
alumni, at October's 91st Annual Meeting of the American Association of
Oral and Maxillofacial (AAOMS) Surgeons in Toronto. "I don't recall
ever seeing that many graduates of one program among the awardees in one
year," said Dr. Stephen Roser, Chief of Emory OMFS. "It was a
testament to the strength of our residents' foundation when they leave Emory."
Dr. Wayne Tipps received the Presidential Achievement Award in recognition of important, long-standing contributions by AAOMS fellows and members. As Dr. White stated, “Wayne Tipps is the OMS’s OMS. His efforts on behalf of the specialty at the national, regional, state, and local levels reveal his passion for oral and maxillofacial surgery and the patients he treats.” Dr. Tipps established a private practice in Chattanooga, TN, in 1972, and is affiliated with most of the major hospitals in the area.
The
Committee Person of the Year was Dr. Richard Joseph. In addition to the
private practice in Jacksonville, FL, he started after leaving Emory, Dr.
Joseph is a Clinical Assistant Professor, Department of Oral and Maxillofacial
Surgery, University of Florida College of Dentistry at Jacksonville; serves
on the faculty of the Department of Oral and Maxillofacial Surgery, Shands
Hospital, Jacksonville; and is Chief of Oral and Maxillofacial Surgery at
Baptist Medical Center, Jacksonville.
Dr.
Robert Hale, Class of 1989, accepted the Humanitarian Award for Fellows
and Members. Commissioned in the US Army Reserves in 1977, Dr. Hale was
called to active duty in 2003, serving in Kuwait and Afghanistan before
returning to his Los Angeles-based private practice. Shortly thereafter,
he left private practice to serve in the US Army Dental Corps, and is
currently Commander-Designee of the US Army Dental and Trauma Research
Detachment and Craniomaxillofacial Consultant to the Armed Forces Institute
of Regenerative Medicine. He is presently assigned to the US Army Institute
of Surgical Research in San Antonio as Director of Craniomaxillofacial
Research.
Dr. Deepak Krishnan received the AAOMS/OMSF Faculty Educator Development
Award, a recognition designed to encourage promising young surgeons and
faculty members to continue careers in academia. Dr. Krishnan is an Assistant
Professor at the University of Cincinnati College of Medicine.
In
addition to these recent awards, it is worth noting that The AAOMS Political
Activist Award, given in recognition of outstanding grassroots efforts and
support of legislative issues at the state and federal level, was re-named
the John F. Freihaut Political Activist Award at last year's annual meeting.
Dr. Freihaut, who completed his Emory OMFS residency in 1980, was a long-time
member of the organization's Political Action Committee and had been an
advocate of patients' rights in the Georgia and federal legislatures for
most of his career until passing away two years ago after a long battle
with colon cancer.
The Robert A. Bays Annual Lectureship Reminder
All
GSOMS members are cordially invited to the first “The Robert A.
Bays Lecture” in honor of the Division’s past chair of more
than 17 years. The lecture will take place on Thursday January
21st, 2010 at the Emory University Hospital Auditorium (on the 2nd Floor)
at 7:00 – 8:00 AM. Dr. Richard Haug, one of the pre-eminent speakers
on Oral and Maxillofacial Trauma will present the inaugural lecture,
entitled “Gunshot Wounds To the Face”.
Update On The Dental Medicaid/Peachcare Program
November 23, 2009
Dear GDA Member:
Subject: Update On The Dental Medicaid/Peachcare Program
After three years’ experience of Care Management Organizations (CMOs) administering the dental Medicaid and PeachCare for Kids programs, the GDA continues to have serious concerns about the direction these programs are headed. Since the inception of the program, the GDA has been a vocal advocate for the dentists’ ability to provide access to dental care to the recipients of these two programs. The role of the CMOs appears to be one of putting up obstacles to that care.
In recent months the GDA reported on several independent audits that confirmed numerous inconsistencies and errors in data reported to the Department of Community Health (DCH) by the CMOs specifically calling into question the reliability of the provider network capacity. Ongoing and draconian changes to the program by the CMOs create doubts about whether children will have access to dental care. Recent fee cuts to the program by WellCare range from 14 to 51 percent making it difficult for some dentists to continue to provide services. Many of the latest changes to the dental Medicaid/PeachCare programs call into question whether the State of Georgia is receiving the product (dental services) that it is paying for. The State of Georgia pays a per-member per-month insurance premium to the CMOs to provide medical and dental care to its recipients. Just like any other insurance company the CMOs assume the risk of providing the care to these insureds for the insurance premiums they receive. The state has paid the premiums yet the CMOs have implemented so many changes to the program that the ability for children to access care continues to diminish. In fact, Dr. Jerry Dubberly, DCH Medicaid Director, reported that Georgia’s HEDIS dental score for 2009 is at 56%, an 8 percent decline from the 2008 score. This reinforces our concern that the state is paying for services that many consumers may not be receiving. Even though the GDA questions the appropriateness of using the HEDIS score as a marker, their own marker shows a decline.
At a time when roadblocks are being thrown up to children seeking care and dentists’ fees have been cut by 14 to 51 percent, it is worth nothing that WellCare’s Expense Ratio has continued to increase for the past four years and has gone from 12.4 percent in 2004 to 14.3 percent in 2008. Mr. Steve Pollock, President of Doral Dental, stated that Doral has not reduced their administrative fees for the Georgia Medicaid program for the past three years, even though dentists’ fees have been cut substantially and patient services have been reduced. It should also be noted that the three CMOs have sub-contracted the dental portion of the business which means that the WellCare administrative cost added to the Doral administrative cost probably accounts for 20 to 24 percent of every premium dollar paid by the state.
Within the last 60 days the GDA President and GDA staff have met with various representatives including legislators to discuss the seriousness of our current situation. GDA staff met with Michael Minor, Chief Operating Officer GA Region for WellCare, and Steve Pollock, CEO and President of Doral Dental, Inc. We requested a meeting with Department of Community Health Commissioner Rhonda Medows and were referred to Dr. Jerry Dubberly with whom GDA staff and the GDA President met. On Friday, November 20, the GDA met at the GDA Office with advocates from Healthy Mothers Healthy Babies, Families First, GA Council on Developmental Disabilities, Voices for GA’s Children, GA Rural Health Association, and other advocacy groups to educate these organizations on the impending crisis.
We are frustrated that despite all of our diligence working on your behalf and on behalf of the children of Georgia there are no quick fix solutions. What we have learned is that our voices and the voices of dentists don’t count. What does count are the voices of the patients. Commissioner Medows is not hearing from the children and their parents that they are not receiving care. We know that the State of Georgia has no additional funds and will probably propose a 1.86 percent across the board fee cut in the 2011 Fiscal Year Budget. We also know that the State of Georgia is paying premiums for services that are not being delivered and that the CMOs are not likely to change any of their policies unless forced to do so.
WHAT CAN YOU DO?
- Go to the GDA website and download the documents listed below and use them to talk to your legislators. The message to legislators: The state is paying for services that the CMOs are not allowing dentists to deliver. Download the documents on the website www.gadental.org listed under Medicaid Action: ADA Comparison of Medicaid Fees by State; Comparison of WellCare Fees with the recent cuts; Letter to Commissioner Rhonda Medows; Doral Dental, Inc. presentation to the GDA Board of Trustees; Children’s Dental Medicaid Program: A Crisis Brewing; Executive Summary: Georgia’s Dental Medicaid and PeachCare Programs Recent Audit Reports.
- Encourage any patients who are Medicaid/PeachCare recipients to convey any issues or concerns about their experiences in accessing dental care to the Department of Medical Assistance Office of Constituent Services, whether you treat Medicaid patients or not. Get this message out into the community so patients who do not present to your office know where to file a complaint. Please convey this information to your office staff as well. Specifically the Commissioner believes that children are not having difficulty in receiving care and she has requested that DCH be notified of problems accessing dental care. Please ask your patients that are having problems accessing dental care to contact the Office of Constituent Services, 404.656.4495 or constituentservices@dch.ga.gov .
- Email the GDA at chandler@gadental.org and keep us informed of any feedback you get from your patients, legislators or other contacts willing to help solve this critical lack of access to dental care for Georgia’s children.
Kent H. Percy, DDS |
Martha S. Phillips |