State Board of Dentistry- December 14, 2012 Report
Attended by Michael Kaner, DMD FAGD, Shawn Casey, DMD and April Hutcheson, Executive Director.
Report of Prosecutorial Division
1) First Case involved a consent agreement for a dentist who pled guilty to insurance fraud. It was a case initiated by United Concordia after it found that his level of billings for scalings far exceeded his peers. He was billing for 4 quadrants of scaling in a single visit when in fact he was only doing a prophylaxis. He was sentenced to pay $13,000 in restitution and a $5,000 penalty (fine). The Board recommended a civil penalty of $6500 and a three year suspension of his dental license with one year active and two years of probation.
2) The second case was also a consent agreement filed by a patient who was treated by the dentist over a 20 year period. During this period, only four (4) radiographs were taken. In addition there was a failure to document whether oral was screened and a failure to list the amount and type of local anesthetic used. The Board agreed to a one year suspension of his dental license stayed in favor of probation, a civil penalty of $2500 and a remedial ethics course and monitoring by the Board for a term of one year . The Board felt this was appropriate based on no prior history of discipline.
3) This case involved a dentist who was previously on licensure probation when the incident occurred. The prior incident involved treatment for a patient. The offense today was for self-prescribing controlled substances for himself and his wife. He had ordered the controlled medications which were shipped to his house and he was audited by the Drug Enforcement Administration (DEA) and admitted it. He had a prescription for some of the medications but was ordering for himself. The dentist was evaluated and found to have no impairment. The consent agreement was that he would;
a) No longer prescribe controlled substances for himself or his wife. The dentist stated that he had the medications delivered to his house to prevent theft at his office.
b) A 30 day suspension which is active and then he may petition for probationary status.
c) Remedial education regarding prescription writing
d) Pay the cost of the investigation which was $4700.
The Board felt a mitigating factor was that his wife was suffering from cancer and the time of the offense.
A newsletter for Jan-Feb 2013 has been submitted. Among the topics will be an article on checking your Continuing Education requirements by Mar 31, 2013 which is the deadine for CE compliance. Other notices will alert dentists that ALL licensed employees in the office must have a current license and that license must be prominently displayed in the office.
Other articles will detail nuances about CE requirements and how credit can be given. For instance, a graduate student in a post-doctoral program is exempt from the CE requirement. They are not ‘technically’ exempt but if audited, a letter from the residency program can be used for CE credit. Also, those who do anesthesia office inspections will be given CE credit in the amount of 2 CE hours for every six office inspections.
Lastly authors of dental articles will be eligible for CE credit.
The Budget office will be speaking to the State Board at the March 2013 meeting.
The Board discussed how the periodontal portion of the NERB examination is required for a Pennsylvania dental licensee applicant, starting with the NERB exam in 2013. The perio portion has become an optional part of the NERB and the Board wanted applicants to know that it is required for licensure in the Commonwealth.
The issue of temporary licensure for donated services was discussed. One Board member discussed Oregon which allows dentists and hygienist to gain a temporary license IF they are licensed in another state, are in good standing in that state. They can then get a 5 day temporary license to do volunteer dentistry.
On November 30, 2012 a special meeting was held to discuss the issue of corporate dentistry in Pennsylvania. Presentations were made by St. Joseph’s Health Ministry which operates a hospital dental van and by the CEO of Aspen Dental describing their Dental Management Service model that they use for their facilities. This allowed the Board members and those in attendance to gain knowledge of the models in use should the State Board decide to revisit the issue of corporate ownership of practices or change their policy regarding it.
1) Teeth whitening- The Board is waiting to see the results of the FTC case against the NC Board of Dentistry before proceeding
2) Botox- The Board is gathering reports from other states to see how they regulate the use of Botox by dentists. As one Board member noted, these are issues that have, “been on the radar” for several years.
Sleep Apnea treatment by dentists. Is it in the scope of practice? If a dentist receives a diagnosis and treatment plan by a physician, can they then treat it and fabricate an appliance. The Board Counsel noted the law is pretty clear that diagnosing sleep apnea is NOT within the scope of practice of dentists but measuring for and fashioning an appliance to treat it is in the scope of practice.
The Board is looking at developing a policy to clarify this and to avoid any misunderstandings.
Currently a dentist who practices on a lapsed licensed can be punished with a civil penalty of $100 per month of practice on the lapsed license as is allowed in the statute. The Board is investigating the possibility of trying to change that to change the penalties associated with practicing on a lapsed license.
Board members had concerns that they were bound by law to only penalize $100/month of violation and they were dealing with lapsed license violations on a regular basis. One of the Board Prosecutors who brings the disciplinary cases before the Board stated that if you increase the penalties, there would be less flexibility in terms of community service. Pennsylvania is in the position where community service dentistry can be done in lieu of cash penalties. Another Board member expressed concerns that sending people who broke the law to do community service is something that ,”we want to move away from. “
The attorney stated that it was a “paper violation” but that same Board member stated that it sent the wrong message and didn’t elevate the profession.
ELECTION OF BOARD CHAIR
With the term of Chairman Phil Siegel expiring and him not being reappointed to the SBOD, an election was held for his successor. Three candidate were nominated and seconded, Current Secretary Mariellen Brickley-Raab RDH, Dr. Lisa Deem and Dr. Doug Marinak. Each spoke of their qualifications before the vote.
Dr. Marinak spoke of his nine years on the Board, chairing various committees and his mission to be the voice for the profession. He lives locally, ten minutes from Harrisburg so accessibility is a plus for him.
Dr. Deem is a Dean at Temple Dental and has both a DMD degree as well as a JD (law degree). She stated that she has been on the Board for 5 years, never missed a vote and never abstained. She has contacts with NERB and chaired many committees at Temple, striving for a consensus.
Ms. Brickley-Raab has been a hygienist since 1975 with a varied career that brings a lot to the Board. She stated that she has worked with the developmentally disabled, geriatrics, mobile dentistry and volunteered in clinics. She has been a Board member since 2002 and has the experience to be the Chair. In addition, she is currently a student in Masters of Public Health program.
All the candidates answered questions regarding advocacy and what they perceived to be the single most important issue facing the Board.
The vote resulted in a three way tie with each receiving five (5) votes after the first two rounds. It was decided to continue the election at the next Board meeting in January, 2013.
Michael Kaner DMD