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Ohio State Dental Board Implements Teledentistry Rules

Ohio law defines “teledentistry” as the delivery of dental services through the use of synchronous, real-time communication and the delivery of services of a dental hygienist or expanded function dental auxiliary pursuant to a dentist’s authorization.[1] The law requires a dentist who desires to provide dental services through teledentistry to apply for a teledentistry permit from the Ohio State Dental Board (“OSDB”).[2]

Pursuant to the mandate under Ohio Revised Code 4715.436, the OSDB is implementing the following teledentistry permit rules and requirements (to be set forth under Ohio Administrative Code Chapter 4715-23). These regulations, which were subject of a public hearing on February 19, 2020, are effective on May 30, 2020.

  1. A dentist wishing to provide services through teledentistry must apply to the OSDB. There is a $20 application fee for a teledentistry permit. The application must contain the following: (1) The address where dental services will be provided through teledentistry; (2) The name and license or registration number of each dental hygienist or expanded function dental auxiliary who will perform dental services through teledentistry when the dentist is not physically present and the location where they will provide these services; and (3) A description of all equipment used to establish and maintain synchronous, real-time communication during the provision of dental services through teledentistry. Any description must include manufacturer name and model number. Other general permit requirements are found in OAC 4715-23-01
  1. Requirements on the proper and approved continuing education courses for a teledentistry permit can be found in OAC 4715-23-02
  1. When services are provided under a teledentistry permit and the patient is not examined in person by the authorizing dentist, informed consent must be obtained before the placement of interim therapeutic restorations or the application of silver diamine fluoride. Guidelines on how to obtain informed consent are detailed in OAC 4715-23-03
  1. Equipment requirements (which can be found in OAC 4715-23-05):
    • All equipment used to provide dental services through teledentistry must comply with HIPAA, HITECH, and all other applicable state and federal laws and regulations.
    • All equipment used for providing dental services through teledentistry must be utilized in a space dedicated to providing dental services through teledentistry. This space may also function as a space in which dental services are provided when the dentist is physically present.
    • Authorizing dentists must ensure that all data connections and storage (including cloud storage) used in the provision of dental services through teledentistry are encrypted.
    • High definition intraoral cameras must be used to provide dental services through teledentistry.
    • A microphone must be utilized to allow verbal communication between the dentist, patient, and staff during the provision of dental services through teledentistry.
    • A digital x-ray machine capable of producing high definition images that can be immediately transmitted to the authorizing dentist during the patient’s appointment must be available while providing dental and diagnostic services through teledentistry.
    • All patient records must be transmitted, transported, handled, stored, protected, and secured in compliance with HIPAA, HITECH, as well as all state and federal laws and regulations. 
  1. An authorizing dentist who is providing dental services through teledentistry may not at any time have more than a total of three dental hygienists and expanded function dental auxiliaries working under the dentist’s authorization. An authorizing dentist must remain attentive and available to attend to the health and safety of all patients regardless of whether the dentist is physically present or not physically present with the patient. If an authorizing dentist supervises any dental hygienist or expanded function dental auxiliary on the same day as the authorizing dentist authorizes any dental hygienist or expanded function dental auxiliary to provide dental services through teledentistry, the authorizing dentist should not have more than a total of: (1) four dental hygienists practicing clinical hygiene under the supervision of the authorizing dentist, or three dental hygienists providing dental services through teledentistry; or (2) two expanded function dental auxiliaries practicing as expanded function dental auxiliaries under the supervision of the authorizing dentist, or three expanded function dental auxiliaries providing dental services through teledentistry, except that the total number practicing under the supervision of the authorizing dentist shall not exceed two. Additional authorization regulations are found in OAC 4715-23-06.

Please contact a BMD healthcare attorney if you have any questions regarding these new teledentistry regulations and how you may utilize them within your practice, any general telehealth rules, or any other general healthcare questions.

Provider Relief Funds – Continued Confusion Regarding Reporting Requirements and Lost Revenues

In Fall 2020, HHS issued multiple rounds of guidance and FAQs regarding the reporting requirements for the Provider Relief Funds, the most recently published notice being November 2, 2020 and December 11, 2020. Specifically, the reporting portal for the use of the funds in 2020 was scheduled to open on January 15, 2021. Although there was much speculation as to whether this would occur. And, as of the date of this article, the portal was not opened.

Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.

HHS Issues Opinion Regarding Illegal Attempts by Drug Manufacturers to Deny 340B Discounts under Contract Pharmacy Arrangements

The federal 340B discount drug program is a safety net for many federally qualified health centers, disproportionate share hospitals, and other covered entities. This program allows these providers to obtain discount pricing on drugs which in turn allows the providers to better serve their patient populations and provide their patients with access to vital health care services. Over the years, the 340B program has undergone intense scrutiny, particularly by drug manufacturers who are required by federal law to provide the discounted pricing.

S.B. 263 Protects 340B Covered Entities from Predatory Practices in Ohio

Just before the end of calendar year 2020 and at the end of its two-year legislative session, the Ohio General Assembly passed Senate Bill 263, which prohibits insurance companies and pharmacy benefit managers (“PBMs”) from imposing on 340B Covered Entities discriminatory pricing and other contract terms. This is a win for safety net providers and the people they serve, as 340B savings are crucial to their ability to provide high quality, affordable programs and services to patients.

DOL Finalizes New Rule Regarding Independent Contractor Status, But Its Future Is In Jeopardy

On January 6, 2021, the Department of Labor announced its final rule regarding independent contractor status under the Fair Labor Standards Act. As described in a prior BMD client alert, this new rule was fast-tracked by the Trump administration after its proposal in September 2020. The new rule is set to take effect on March 8, 2021, and contains several key developments related to the "economic reality" test used to determine whether an individual is an independent contractor or an employee under the FLSA.