Securing PPE supplies for dentistry : PDA has taken a multifaceted approach to securing more personal protective equipment ( PPE ) supplies for member dentists and their team . We have routinely requested of DOH officials that they appropriate a proportionate supply of PPE to dentistry when states receive supplies from the Federal Emergency Management Agency ( FEMA ), which declared that dentistry is No . 4 on its priority list for distribution of supplies . We have also requested that officials at the Pennsylvania Emergency Management Agency ( PEMA ) consider the needs of dentistry when determining the allocation of supplies with their federal counterparts . PDA has asked key lawmakers in the Pennsylvania General Assembly to intervene on our behalf to urge the administration and PEMA to earmark supplies specifically to dentistry . Our friends at the Capitol have expressed a commitment to helping PDA so that dentists have adequate PPE supplies to keep their practices open .
Addressing PPE costs with the Department of Insurance and Attorney General ’ s Office : In June , the Pennsylvania Insurance Department released a notice to insurance companies advising them on actions that may be taken with health care providers , including dentists , who are changing for the increased costs of personal protection equipment ( PPE ). The department recommended that insurers consider making a referral to the Office of the Attorney General under certain circumstances and inferred that health care providers should not be charging any PPE costs to patients . PDA communicated its concerns to the department and the Office of the Attorney General , citing the additional cost dentists are incurring to be in compliance with CDC guidelines and government ’ s PPE mandate . PDA has provided information on PPE costs and insurers ’ policies related to reimbursement . It is our understanding that charging for PPE is not considered price gouging so long as the fee is reasonable and providers are not violating the terms of their PPO contract .
PDA OFFERS THE FOLLOWING ADVICE TO MEMBERS :
Review the terms of PPO contracts for compliance .
Only charge a reasonable fee when applicable .
Retain invoices and other documentation on PPE purchases .
Most patients are unaware of how much dentists now have to spend on PPE . Discuss any PPE charges prior to treatment and make note of patients ’ consent in their record . The ADA ’ s Patient Return Resource Center provides valuable tips for communicating with your patients .
Consider posting a notice regarding your office policy on PPE charges in your lobby or front desk .
Review ADA ’ s COVID-19 Coding and Billing Interim Guidance on PPE , including all payer programs and policies . PDA recommends following the ADA guidance regarding charging for PPE and getting reimbursed for it by third party payers .
Advocating for Medical Assistance providers to the Department of Human Services ( DHS ): PDA communicated its concerns about the increased costs for PPE due to the COVID-19 pandemic and requested that DHS and the managed care organizations ( MCOs ) with which they are contracted provide adequate reimbursement to Medical Assistance ( MA ) providers . The Office of Medical Assistance Programs ( OMAP ) at DHS had advised MCOs not to use a specific code for PPE , but to use value-based assessments and adjustments to fee structures to help MA providers . DHS advised PDA to tell members that they should speak directly to the MCOs ’ dental directors about PPE reimbursement .
PDA asked that DHS consider making MA coverage for teledentistry permanent even after the Governor ’ s emergency declaration is rescinded . DHS is supportive of continuing teledentistry indefinitely and will soon issue a new Bulletin providing more detail .
PDA also requested that DHS consider expanding coverage to include diagnostic testing ( specifically for COVID-19 testing ) and vaccines ( specifically for COVID-19 and HPV ). DHS expressed support but cautioned that policy changes from DHS is dependent on whether the State Board of Dentistry believes the administration of tests and vaccines fall under dentists ’ scope of practice . PDA is pursuing this issue through legislation and / or regulation .