AADOM Featured Company: DOCS Education
AADOM Featured Company is a 30-minute live, interview-style presentation sharing the company’s mission, product/service, and best practices for office managers.
Video Description:
New to or curious about sedation protocols?
With over half of dental offices in the United States utilizing some form of sedation, from nitrous oxide to IV sedation, staying competitive means staying educated.
Discover how you and your team can lead the charge in patient comfort while significantly boosting your practice’s bottom line.
Learn how DOCS Education’s offerings can help you transform patient care by implementing proven systems for managing anxious patients, streamlining certification requirements for your team, and creating protocols that increase patient flow. Featuring a comprehensive membership program, hygienist and assistant N2O training programs, and the tools and resources you’ll need to become your doctor’s most valuable asset in growing a sedation-focused practice.
free training course and blogs
learn more about DOCS Team Membership
learn more about nitrous oxide certification training for team
why to train your team in sedation flyer
7 Ways for Sedation Dental Offices to Avoid Legal Jeopardy
Navigating national dental guidelines, federal policies, and state-specific regulations can be daunting, even for the most experienced dentist and their teams.
However, adhering to the relevant laws and regulations is critical for avoiding legal issues and penalties and, ultimately, maintaining patient trust.
Thankfully, DOCS Education has a regulatory expert who can help you stay up to date on the legal landscape, protecting you and your practice from costly (and avoidable) regulatory mistakes.
David Palmer, Esq. is an attorney licensed in the Commonwealth of Pennsylvania. Having spent time in private and corporate practice, he specializes in compliance, contract negotiation, insurance regulations, and healthcare as legal counsel for DOCS Education.
1. Utilize the Prescription Drug Monitoring Program
The PDMP (prescription drug monitoring program) is an electronic database that tracks controlled substance prescriptions. Its purpose is to prevent substance abuse, elevate patient care, manage risks, and provide clinicians with warning signs about controlled substance prescriptions.
When to use PDMPs?
- Only viewing a patient’s prescription record for medical reasons
- Reporting on a patient’s prescription record
The PDMP is not just a database but a crucial clinical support tool that aids in decision-making. It plays a significant role in ensuring patient safety, confirming records’ accuracy, providing lifesaving information, and addressing safety concerns. As dental professionals, using the PDMP enhances your commitment to patient care.
It’s important not to dismiss a patient based on PDMP information. Doing so can adversely affect a patient’s safety, resulting in missed opportunities and potentially lifesaving information.
Key Point: Dental boards can audit PDMP records and searches via a user ID.
2. Become Knowledgeable on Relevant DEA Requirements and Updates
You must have a DEA registration if you order, prescribe, distribute, or administer controlled substances. This process registers the “person” at their place of business or professional practice.
A separate registration is required at each principal place of business or practice, so you’ll need a DEA registration at each location where you practice, including working in multiple states, along with a state license to practice in each state.
Key Point: Each location that deals with controlled substances needs its own DEA registration. It’s vital to keep apprised of DEA updates and how they can impact you and your practice, such as the MATE Act of 2021 and the substance abuse and disorders training. This Act requires all practitioners to undergo an eight-hour training on the treatment and management of patients with opioid and other substance use disorders. This course is required for any doctor seeking an initial or renewal DEA registration.
The opioid training requirement is a separate requirement from state requirements. Be sure the specific organization that can conduct this training is compliant. (AMA ADA CERP)
3. Consistently Maintain Accurate Drug Recordkeeping (21 USC 827)
In short, clinicians and their office managers must take an initial complete inventory when first engaging in the distribution of controlled substances. This inventory must be taken at least every two years after that, and it’s recommended to do this at least once a year, if not every six months, to catch issues as early as possible.
If you don’t use controlled substances often, you can audit this information less frequently. However, every six months is ideal. Under DEA regulations, patient records must be kept for two years, although we recommend keeping them for four years.
Key Points
- Keep a running drug logbook—a complete and accurate record of each substance administered and disposed of prescribed by you. Each controlled substance needs its own inventory page with the relevant information, further described in Palmer’s course.
- Be sure to record dispensing daily and use a separate dispensing page for each day and for each controlled substance.
- Drugs administered in the office should come from YOUR inventory pursuant to DEA registration. Do not prescribe to a patient to pick up from the pharmacy and bring into the dental office to circumnavigate DEA registration and regulations.
Determine if your office will tally inventory at the beginning or close of each business day.
4. Follow Drug Disposal Guidelines
Disposing of controlled substances can be done via two primary methods:
- Using the services of a reverse distributor that the DEA authorizes to collect and destroy medication that, for any reason, you cannot use.
- Contact DEA’s local diversion field office for disposal recommendations.
Minor losses or inventory discrepancies do not need to be reported to the DEA, but “theft or significant losses” must be reported on Form 106. When in doubt, err on the side of caution and report losses, as continuing patterns of loss, even those of seemingly insignificant quantities, could be considered significant by the DEA.
Numerous violations of DEA recordkeeping exist, so be sure your records comply with all federal, state, and local regulations. Yes, dental offices have been fined for these violations!
5. Adhere to HIPAA Regulations
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a set of rules and a crucial safeguard for patient privacy and security. It restricts the use and disclosure of an individual’s health information to all covered entities. As dental professionals, it’s your responsibility to respect and protect patient privacy by strictly adhering to HIPAA regulations.
Furthermore, any business associates or staff who work in your dental office and perform work or services for you are regulated under HIPAA. Examples are a third-party administrator, CPA firm, attorney, or a consultant performing record reviews. HIPAA rules generally require that covered entities (you) enter into a contract with a third party to protect their patients under HIPAA laws and regulations.
6. Respond Responsibly to Online Reviews
With the widespread use of the internet and social media platforms, patients can share their experiences with healthcare providers and facilities. Patient online reviews require you and everyone associated with your practice to be vigilant about HIPAA-compliant
responses. Your practice cannot disclose any patient identifying information, including confirming that the reviewer is a patient.
Key points in staying out of legal jeopardy when responding to patient’s online reviews include:
- Not stating the patient’s name. (protected HIPAA info)
- Keep the response general and avoid “you” specific language.
- Focusing on your brand and practice goals.
- Remain positive and avoid getting defensive—it’s a bad look and will give potential patients a negative impression.
- Offering to discuss offline and in private. (This is the easiest, safest, and most effective way to respond.)
Key Point: Responding to online reviews improperly can violate laws at both the state and federal levels. Violations include improper responses to online reviews and the unauthorized disclosure of personal identifying information about patients on social media. Ensure you receive documented authorization if you share identifiable patient information on any social media platform.
Each state dental board has specific requirements. You need to check in with your state to ensure you follow regulations specific to you.
7. Follow the “Standard of Care”
The Standard of Care includes sedation recordkeeping requirements, personnel training requirements for administering sedation, monitoring, documentation, training and use, and recovery documentation. Palmer’s course reviews these items in detail.
In Conclusion
Ensuring compliance with the latest dental regulations and guidelines is crucial to every dental practice.
With the expertise of DOCS Education’s regulatory specialist, David T. Palmer, Esq., dentists and their teams can rest assured that they are always up to date on federal, state, and local regulations, thereby avoiding costly legal issues and penalties.
By prioritizing patient safety and diligently adhering to all regulations, dental practices build a trustworthy reputation and safeguard themselves from potential legal issues and penalties.
DOCS Education members with specific questions or who need further clarification are encouraged to contact David Palmer directly at Regulations@docsedu.com.
David T. Palmer, Esq. joined DOCS Education this year to assist sedation dentists as they navigate state regulations and compliance, while also serving as liaison to facilitate a knowledge-driven relationship between dentists and their governing boards. He is uniquely qualified, drawing on a regulatory background that began right out of law school.
Mr. Palmer is a 2015 graduate of The University of Toledo College of Law, served as President of the Law Fraternity, Phi Alpha Delta, attended Indiana University of Pennsylvania, and has a B.A. in Psychology. As a resident of Pittsburgh, PA, he is barred in the Commonwealth of Pennsylvania.
