October 9, 2020
Back in August, the Attorney General’s office sent several healthcare provider associations a letter concerning PPE fees. The letter addressed in-network healthcare providers charging additional PPE fees and stated:
“It is the Office’s position that charging patients an additional fee for PPE constitutes illegal balance billing when the charges are assessed in connection with in-network services covered by the patients’ health plans.”
As the Attorney General’s position addressed in-network providers only, CSDA President Dr. Tam Le and staff have since met with the AG and his staff to seek clarification on the out-of-network issues. We received a follow-up letter (click here to access the letter) on October 2, 2020 with the following guidance:
Out-of-network providers are not limited to what they can charge patients by contract fee schedules and, as a result additional PPE charges are likewise not limited. Additionally, dentists providing services to patients who do not have insurance would not be limited in what they could charge patients, including PPE charges.
What does this mean? We continue to advise you to check your provider contracts and review the terms of your participation agreements before charging for PPE. We also recommend that you inform patients of any additional charges prior to their appointment (click here to access a poster). Please note: It is unethical to only charge uninsured patients or only seek reimbursement for insured patients to address the costs of PPE.
For further guidance please review the ADA’s COVID-19 Coding and Billing Interim Guidance on PPE. This document provides information on billing for PPE as well as a listing of the dental plans currently providing financial assistance during this time. Should you decide to re-negotiate your fee schedules, the ADA has also developed a guide on Handling Contract Negotiations.
New Haven Dental Association Fit Test
The New Haven Dental Association (NHDA) successfully offered N95 fit tests to its member dentists and their clinical staff. Below is a link which provides steps to take to do a similar program with your office or members of your component society.
New Haven Dental Association Fit Test
Resources to Extend or Reuse N95 Respirators During Supply Chain Challenges
Difficulties in sourcing Personal Protective Equipment (PPE) during the COVID-19 pandemic continue, making it important for dental practices to conserve their supplies, especially N95 respirators. The ADA has developed helpful resources to assist dentists in determining when and how to extend the use of N95 masks/respirators while maintaining appropriate infection control.
The definitions of extended use v. reuse, and links to strategies to optimize the supply of N95 respirators, decontamination and reuse of N95 respirators, and guidance on reprocessing respirators are provided in this helpful resource.
Download the Extending the Use of
N95 Fit Test Information
Want to learn more about fit tests and seal checks for N95 masks?
Download ADA Guidance
List of fit check resources:
CT Department of Labor
- Dynamic Dental Services: Howard Pactovis (www.dynamicdentalsafety.com or 855.674.2337)
- Concentra Occupational Health: 866.944.6046
- Velocity Urgent Care in Rocky Hill: 860.372.4990
- Contact your local Hospital or Fire Marshall for additional contacts
N95 Respirator Training
ADA's Risk Assessment
FDA removes Emergency Use Authorization for some KN95 masks
The U.S. Food and Drug Administration has removed its Emergency Use Authorization for several KN95 masks, which are made in China, after they failed to meet a minimum particulate filtration efficiency of 95% in National Institute for Occupational Safety and Health testing. Read more
Obtaining appropriate PPE
Have you contacted your local health department to ask for PPE? Although the quantity, type, and quality may differ from town to town, it’s worth placing a call to request supplies! Click here for local health department contact information.
The ADA has no authority over supply production or distribution, and therefore recommends that each individual dentist contact their personal distributor, perhaps daily, to secure whatever supplies are available. There is no overarching strategy to access needed PPE, as the pinch point is supply vs. overwhelming demand. Click here for the list of the authorized dealers on the FDA website.