GSOMS Newsletter |
Winter 2011 |
In this issue
From the President
Healthcare Plans
Update from Georgia Health Sciences University
News from the Emory Division of Oral and Maxillofacial Surgery
Board of Dentistry Report
Anesthesia Update
Georgia Specialty Licensure in Oral & Maxillofacial Surgery
We have had two excellent meetings this year with outstanding speakers. The Spring meeting reviewed temporomandibular joint dysfunction and current management. The Lake Oconee meeting had the largest turnout that we have had in recent years. Dr. Carlson gave an excellent presentation on Saturday of the current findings in treatment of bisphosphonate related osteonecrosis of the jaws. Col. Hale made us aware of the extensive injuries sustained by our military men and women in the line of duty. From the information presented we were informed of the challenges faced by the military to develop new procedures and technology for reconstruction of severe facial burns and maxillofacial injuries.
Our upcoming year is going to be filled with some challenges. The specialty licensure issue will need to be addressed by our Society to ensure the opportunities we have for expanding and developing practices that meet future needs of patients. Healthcare legislation that is occurring at a rapid rate over the next couple of years will require our close attention and input as we move forward in this arena.
I am very proud of the success of the Anesthesia Evaluations for our state and everyone’s efforts and commitment in meeting the deadline. We have a 97.7% completion rate.
With the current economic climate in our country it is very important we continue to make every effort to advance our Specialty with contributions to OMSPAC, REEP, and the OMSF. I encourage everyone to contribute.
I wish to thank Hank and Leslie for their tireless efforts and assistance in their coordination and planning for the meetings along with maintaining the administrative operations for the Society.
I look forward to working with each of you this year and I am available if you have any questions or concerns.
Have a great Holiday Season,
Dr. W. Jones Phillips
GSOMS President
Healthcare Plans
By Glenn Maron, DDS
Healthcare Chair
Where are we now and where are are we going?
The complex world of medical and dental insurance continues to spiral downward. The economy associated with the goals of implementing the Obama healthcare plans has lead to insurance companies continuing to find ways to decrease their re-imbursements. One major issue facing Oral and Maxillofacial Surgeons is the issue of 2nd procedure payments. There has been a tradition of insurance companies paying 50% for 2nd procedure, 25% for the 3rd etc. This has been based on the theory of multiple procedure reductions. These reductions of the payment of subsequent procedures are a very common occurrence in the medical insurance industry. This concept was first implemented by Medicare and then followed by many third party payers. Payers consider the payment for a procedure to include the pre-operative time, intra-service time, and post-service time. The feeling is that there is only one pre-service period and one post-service period per operative session regardless of the number of procedures rendered during that operative session, therefore they reduce the payment of all subsequent procedures to deduct the pay for pre-service and post-service time that would have normally been reimbursed if that procedure was rendered alone. It is felt that these rules should not apply to many OMFS procedures and although there are individuals fighting these rulings, according to AAOMS, there is no current “agenda” for any national intervention on the part of AAOMS. Additionally, those individuals who have been fighting these coding issues are having very little success.
Where does this leave us? I have recently been sent a case from one of our surgeons here in Georgia who had these rules applied to 3rd molar extractions where the 50% reduction was applied to the 2nd tooth and 25% to the 3rd and 15% for the 4th.Please take note of any unusual bundling on your claims, and forward the EOB to us for evaluation as we are currently trending this matter.
On a brighter note the law is in now in place, which stipulates we no longer have to take an insurance company adjustment on any claim that is deemed a non-covered procedure.This has resulted in the insurance companies sending out letters requesting surgeons to waive their right to bill for these procedures. The wording is confusing at best as illustrated below in an excerpt from one such letter.
Covered services are those that are covered under a dental benefits plan, including services that are sometimes, but not always covered, such as when they are contractually limited by frequency. Annual maximum, waiting period and/or subject to a benefit allowance as an alternate procedure.
Payment policy: Benefits are determined based on the contracted dentist's submitted fee or the maximum contract allowance, whichever is less. For example:
- When a benefit amount is paid, based on an alternate procedure, the patient's payment responsibility is the remainder of the dentists' submitted fee or the maximum contract allowance, whichever is less, for the service actually provided.
- A covered service provided after the patient's annual maximum has been reached is still considered to be a covered service. Our payment and the patient's payment portion are based on the dentist's submitted fee or the maximum contract allowance, whichever is less.
We strongly recommend that you review all such contract modifications carefully prior to signing anything.
Update from Georgia Health Sciences University
Dr. Mark R. Stevens
Professor and Chairman
Department of Oral & Maxillofacial Surgery
Georgia Health Sciences University
We have finally moved into the new College of Dental Medicine, and it is incredible! I repeat the offer to anyone interested in getting a personal tour of the School; please let us know if you are visiting the Augusta area so we can set one up. The operating rooms are starting to take form and look as high tech as any hospitals’ OR. The Department of Oral and Maxillofacial Surgery is in the process of accrediting the three Operating rooms as a stand alone facility. The faculty continues to work hard with the addition of 20 new undergraduate students in this year’s undergraduate class. Dr. Salqueiro is in the process of taking the OMFS Oral Board exam this year and we wish him great success. Dr. Ferguson and Dr. Getter continue to receive outstanding acclaim on their ”Intravenous Sedation” course, especially with the incorporation of the “Simulation Center” here at GHSU. Dr. Kao is busy with the undergraduate second year class, especially, teaching them how to administer local anesthetics on live patients.
The residents and interns are progressing well and working hard. We have several papers accepted for publication: “Can a single Lag Screw with an Arch Bar be used in Anterior Mandible Fractures” and “Benign Myoepithelioma of the Floor of the Mouth with Mandibular Involvement: A case report and a review of the literature”. Several of the residents and faculty were also contributors in Dr. Bagheri’s new book; “Current Therapy in Oral and Maxillofacial Surgery”. We are in the process of possibly putting on a Continuing Education Course of “Bone Harvesting “using cadavers next spring, anyone interested in the Society please let me know.
We presently have two rotating guests in the Department, Dr. Jaepil Chang who is an OMFS from Korea who is performing “cutting edge” bone research in the Department of Oral Biology, and Dr. Sami Alsherhry who is an intern from Saudi Arabia. We have a nice group of competitive applications for next year’s residency positions although, the two interns this year Dr. Barber and Dr. Diprisco are two excellent internal candidates and have a good chance of staying here at GHSU. The faculty and I wish everyone the best and a happy and healthy upcoming Holiday Season.
News from the Emory Division of Oral and Maxillofacial Surgery
By Martin Steed, DDS
Emory School of Medicine
Dr. Steven Roser receives 2011 AAOMS Humanitarian Award
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Dr. Steven M. Roser received the AAOMS Humanitarian Award during the opening ceremony of 93rd Annual Meeting, Scientific Sessions and Exhibition of the American Association of Oral and Maxillofacial Surgeons, September 14, 2011 in Philadelphia, PA. The award is presented in recognition of association fellows and members who have committed significant time and effort to improving the quality of life for the public.
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Faculty Promotions |
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Drs. Martin Steed and Gary Bouloux were promoted to Associate Professors of Surgery within the Department of Surgery. Dr. Steed was also recently appointed as a board examiner for ABOMS. |
Multi-Center Clinical Trial Investigating TMJ Arthrocentesis Headed by Emory |
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Dr. Gary Bouloux, director of research for Oral and Maxillofacial Surgery, is PI of a multi-center study funded by the OMS Foundation that is evaluating the efficacy of either corticosteroid or hyaluronic acid in reducing pain and improving jaw opening function after arthrocentesis for temporomandibular joint dysfunction. |
The Robert A. Bays Annual Lectureship Reminder
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All GSOMS members are cordially invited to the third annual “Robert A. Bays Lecture” in honor of the Division’s past chair. The lecture will take place on Thursday February 23rd, 2012 at the Emory University Hospital Auditorium (on the 2nd Floor) at 7:00 – 8:00 AM. Dr. Robert Hale, an Emory Alumni, and past resident of Dr. Bays’ will present. |
Board of Dentistry Report
By Barry Stacey, DMD
Board of Dentistry Liaison
LICENSE RENEWAL
This is a renewal year for your dental license and anesthesia permit. C. E. requirements are a minimum of 40 hours during 2010-2011. At least 20 hours must be taken onsite. Your BLS and ACLS must be current to renew.
BOTOX
In 2005, the Georgia Board of Dentistry requested advice from the Attorney General’s office concerning whether the giving of botox injections by dentists is within the scope of dentistry. A memo was issued by the AG’s office and posted on the GBOD website. The conclusion was that a dentist is not authorized to perform procedures, such as botox injections, which are not incidental to the performance of a dental operation. In a Court of Appeals of Georgia case in 2001 that was cited in the 2005 memo, a “dental operation” was defined as one pertaining to a tooth or teeth. The full memo is still posted on the website if you wish to review it.
Earlier this year, a case came before the Investigative Committee of the GBOD and the full Board was asked to review the memo on Botox. In May, 2011, the GBOD approved a memorandum reversing the 2005 memo. The reversal stated that a “dental operation” should correctly be interpreted to mean an operation performed by a dentist, and that the opinion of the GBOD is that the injection of botox and dermal fillers to treat conditions in the head and neck area for cosmetic and/or therapeutic purposes is clearly within the scope of dentistry when performed by a dentist who can demonstrate the necessary education, training, and experience.
The AG’s office subsequently notified the GBOD that it was exceeding its statutory authority and advised the Board to withdraw the memo approved in May. The GBOD then requested a meeting with the AG himself to give an educational presentation on the contemporary scope of dentistry in the areas on facial cosmetic procedures.
This meeting was held in Atlanta on November 10, 2011. Both the Attorney General and his Chief Deputy were present. Dr. Vincent Perciaccante gave an excellent presentation representing the Emory OMS program. Dr. Mark Stevens represented the GHSU OMS program. The meeting was very positive in that the AG’s office appeared to understand that dentists are routinely trained to administer Botox and dermal fillers and also perform surgical facial cosmetic procedures.
However, the AG still has concerns about the legal authority for dentists to perform these procedures based on the past opinions issued by the AG’s office and the Court of Appeals of Georgia. He has asked for research into the language of the law in other states that allow the unrestricted performance of these procedures. It may be necessary to change the Georgia Dental Practice Act to allow these procedures to be performed with a dental license, according to the AG.
Anesthesia Update
By Antwan L. Treadway, DMD
Anesthesia Chair
As we get ready to move into the new year we have for the most part completed each of the required anesthesia evaluations dictated by the AAOMS. The Georgia Society and its members have done the job over the last five years. I cannot thank enough those who worked with us to accomplish the task and helped to make the overall goal a success. Special thanks to Vinnie Percciacante, Glen Maron, Barry Stacey and Steve Roser who helped a great deal in navigating this course. Since we first laid out the program in 2006 the number of those practicing sedation and anesthesia has grown. The GSOMS agrees with AAOMS that self-regulation is an important component to providing anesthesia to our patients and the general oral and maxillofacial surgery practice model. Our specialty has been assailed from several different quarters and the vigilance to maintain our right to be surgeon/anesthetist is of paramount importance. Measures like specialty licensure may be of aid to us in this fight and I urge all of us to revisit the issue and check out Dr. Perciaccante’s proposal to be moved forward to the board.
There are a few exams that still need to be done and the first round of renewals in the five year cycle will come due in 2012. Please remember that this is an AAOMS mandated renewal and different from the State of Georgia requirements (the state does not require re-examination of facilities or practitioners at this time).
A few weeks ago The GSOMS executive staff sent out the names of those who will be required to renew in 2012. We will continue as a committee to find those who are willing to re-evaluate and keep the vital job of self-regulation intact.
Please check your mailboxes to make sure that you are not one of the renewals in the coming year. If you are then please contact Leslie Boulter or myself and we will make arrangements for your re-examination.
Georgia Specialty Licensure in
Oral & Maxillofacial Surgery
By Vincent Perciaccante, DDS
Task Force & Specialty Licensure, Chair
An interest in establishing a specialty licensure has been brought up to the Executive Committee of the Georgia Society of Oral & Maxillofacial Surgeons (GSOMS). As a result the Society President, Dr. Jones Phillips, has appointed a task force to look into this issue. It is worth noting that the American Dental Association’s Council of Dental Education and Licensure has recommended that states implement specialty licensure.
Specialty licensure and methods of implementation were extensively discussed with the membership at the August meeting at Lake Oconee. The membership was overwhelmingly in favor of establishing a specialty license. Taking comments from the membership into account, the task force has written a draft for a Society position paper on specialty licensure. The concept of specialty licensure was presented to the Board of Trustees of the Georgia Dental Association (GDA), as we feel their support in this endeavor will be beneficial. At that time the GDA informally indicated support for the concept, pending review of a position paper and further discussion. They did voice reluctance to consider support if establishing the license required opening the dental practice act. Currently the Georgia Board of Dentistry (GBOD) and the GDA are in talks with the Office of the Attorney General, in regard to another matter involving some interpretation of the existing dental practice act. We will see over the next few months how that issue plays out, prior to finalizing our position paper on specialty licensure, bringing it to the membership of the GSOMS for approval and finally releasing it to the GDA and GBOD.