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ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

FEBRUARY 2012


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VOLUME 30, NUMBER 2 • FEBRUARY 2012

ACTION

on the cover

ACT ION

THE JOURNAL OF THE GEORGIA DENTAL ASSOCIATION

GDA ACTION (ISSN 0273-5989) The official publication of the Georgia Dental Association (GDA) is published monthly. POSTMASTER: Send address changes to GDA Action at 7000 Peachtree Dunwoody Road N.E., Suite 200, Building 17, Atlanta, GA 30328. Phone numbers in state are (404) 636-7553 and (800) 432-4357. www.gadental.org. Closing date for copy: first of the month preceding publication month. Subscriptions: $17 of membership dues is for the newsletter; all others, $75 per year. Periodicals postage paid at Atlanta, GA. Dr. Jonathan Dubin GDA Editor 2970 Clairmont Rd Suite 195 Atlanta, GA 30329

Delaine Hall GDA Managing Editor 7000 Peachtree Dunwoody Rd NE Suite 200, Building 17 Atlanta, GA 30328

FEBRUARY 2012

Your Association is completing an in-depth study of a report by Navigant, the company commissioned by the Department of Community Health to analyze Georgia’s Medicaid program. An initial analysis of the nearly 500-page publication is not encouraging. The top recommendations favor continuing the managed care model that has failed so many dental patients and dentists. Read more about the GDA’s take on the report on page 14.

2011-2012 Georgia Dental Association Officers Michael O. Vernon, DMD, President Sidney R. Tourial, DDS, President Elect Marshall H. Mann, DDS, Vice President James B. Hall III, DDS, MS, Secretary/Treasurer Jonathan S. Dubin, DMD, Editor

GDA/GDIS Executive Office Staff Members Martha S. Phillips, Executive Director Nelda Greene, MBA, Associate Executive Director Delaine Hall, Director of Communications Skip Jones, Director of Marketing (GDIS) Courtney Layfield, Director of Member Services Victoria LeMaire, Medical Accounts Manager Judy Lively, Administrative Assistant (PT) Melana Kopman McClatchey, General Counsel Denis Mucha, Director of Operations (GDIS) Margo Null, Property and Casualty Accounts Manager Patrice Williams, Administrative Assistant Phyllis Willich, Administrative Assistant Pamela Yungk, Director of Membership & Finance GDA Action seeks to be an issues-driven journal focusing on current matters affecting Georgia dentists, patients, and their treatment, accomplished through disseminating information and providing a forum for member commentary. © Copyright 2012 by the Georgia Dental Association. All rights reserved. No part of this publication may be reproduced without written permission. Publication of any article or advertisement should not be deemed an endorsement of the opinions expressed or products advertised. The Association expressly reserves the right to refuse publication of any article, photograph, or advertisement.

other features

sections

10

4

Parting Shots

5

Editorial

6

Letters

8

News and Views

11

Calendar of Events

25

Classifieds

CORPS Program: Enroll Your Staff Today!

12

Dentists Care: Charitable Giving Alive and Well

18

GDA Launches Key Bills in 2012 Legislature

19

Health Care Exchanges: Feds Say Yes, Georgia Says No

20

UBS Offers Guidance on New 401(k) Disclosures

22

GDA Annual Meeting Preview: Amazing in Amelia

23

Alliance Focuses on Worthy Projects, Invites Involvement

Member Publication American Association of Dental Editors

Page 29! It’s a LAW Day update! Plus, see what GDA staffers are monitoring on your behalf. Your Association is seeking a new editor! Page 30 has details.

index of advertisers Note: Publication of an advertisement is not to be construed as an endorsement or approval by the GDA or any of its subsidiaries, committees, or task forces of the product or service offered in the

advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted.

AA Anesthesia, P.C. . . . . . . . . . . . . . . . . . . . . .7

EC Price General Contractors . . . . . . . . . . . .21

PDQ Services . . . . . . . . . . . . . . . . . . . . . . . . .13

AFTCO Transition Consultants . . . . . . . . . . .31

GDA Dental Recovery Network . . . . . . . . . . .11

Dr. Mark Padolsky—TMD Dentist . . . . . . . . .27

Atlanta Age Management Medicine / Dr. Ana Casas . . . . . . . . . . . . . . . . . . .26 Aspen Dental . . . . . . . . . . . . . . . . . . . . . . . . .15

Georgia Dental Insurance Services . . . . . . . .32

Paragon Dental Practice Transitions . . . . . .30

Georgia Academy of Cosmetic Dentistry . . .26

Professional Practice Management . . . . . . .24

Great Expressions Dental Centers . . . . . . . . .9

Shaul Beckman Paige, LLC . . . . . . . . . . . . . .20

Law Office of Stuart J. Oberman . . . . . . . . .17

Southeast Transitions . . . . . . . . . . . . . . . . . .28

Louisiana Dental Association . . . . . . . . . . . .13

UBS Financial Services, Inc. . . . . . . . . . . . . .16

Center for TMJ Therapy . . . . . . . . . . . . . . . . .6 DDD Foundation, Inc. . . . . . . . . . . . . . . . . . . .2 The Doctor’s Safety Net . . . . . . . . . . . . . . . .24


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editorial perspective

Watch or Restore: Doctor and Patient or Third Party Decision?

Jonathan S. Dubin, DMD

A recent article in The New York Times was positioned as an expose’ on dentistry, or on the diagnosis and treatment of caries to be more specific. The article could lead a casual reader to believe that the cost of dental care is partly due to over treatment, or too aggressive diagnosis and treatment. The article seemed to pit a doctor who noted an incipient lesion and chose to observe the lesion over time against those doctors who would remove the lesion and immediately restore the lesion with an amalgam or composite restorative material. The article also quoted a dental insurance executive who made his case for diagnostic codes citing a need to know the severity of a lesion. This leads me to personally believe that the insurance payer might not reimburse the provider or the patient for a lesion if the severity was noted to be incipient. I could be wrong, but my experience with some third party payers has been that they would find a way to not pay a claim if they could. I understand businesses need to produce profits, and there is certainly more profit when money is not paid out. Maybe that is one reason I cannot remember doing an onlay without a insurance company initially denying payment for the procedure. This step then leads me to the process of re-filing with a second request and many times a third request and / or calling a company consultant. Never mind that I feel that an onlay is a more conservative treatment for a tooth where the alternative would be a full coverage crown.

To me, this is a twisted way to pay for care. There seems to be a constant battle of wills going on. A dentist diagnoses and treats a patient to the best of his or her ability and works to prevent future disease and consequences. Meanwhile, a third party wedges itself in between the doctor and the patient and disrupts that relationship. If a patient was noted to have an extremely small cancerous growth, I am fairly certain the choice treatment would be to excise the lesion rather than to observe it for growth. I am not suggesting that a carious lesion is life threatening such as a cancerous lesion could be. I am suggesting that a sound strategy is to remove the lesion and restore said lesion when it is small rather than wait until it is large enough to require a massive restoration (or maybe even wait until it undermines a cusp and requires an onlay!) The treatment direction should be the patient’s choice after discussion with his or her doctor. A patient has the right to seek a second opinion if he or she would like to. I just don’t think that the second opinion should come from a third party payer.

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letters to editor Foundation Marks 27 Years of Supporting Dentists Dear GDA Members, I was thrilled to see the Emile T. Fisher Foundation scholars from Georgia Health Sciences University who attended the GDA House of Delegates in Atlanta in January. And as Dental Dean Dr. Connie Drisko said, “These dental students even stayed for the whole meeting!” It is good that these students recognize the value of organized dentistry, and learned what our House does, just as it is good that GDA dentists recognize the value of supporting a Foundation that exists solely to give deserving students assistance with their dental education. These students hold the future of our practices and our patients in their hands. This year marks the 27th anniversary of our Foundation. Or rather, your Foundation—a past GDA House of Delegates voted to approve $50,000 in seed money to establish this organization. They were guided by visionaries Dr. Jay McCaslin V, the GDA president at that time, and Dr. Emile Fisher, who has devoted his time and talents to growing the Foundation and personally helping scores of students finance their dental educations. Over the years, the Foundation has awarded hundreds of thousands of dollars in scholarships to deserving dental and dental hygiene students thanks to the generosity of Georgia dentists. Currently, the Foundation has a corpus of $1 million after we clawed our way back from $878,000 in August 2009. We have seen improvements in our investment returns after a terrible couple of years, but that would not make a difference without dentist donations. In 2011, GDA dentists donated $44,700 to the Foundation via the GDA dues check-off. Thank you for your incredible support. The Fisher Foundation board of directors voted in 2011 to direct $50,000 to the College of Dental Medicine at

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Georgia Health Sciences University for general dental student scholarships. The Stan Hopkins Scholarship for a dental student was allocated $6,000, bringing the grand total to $56,000. Most of the recipients of these scholarship funds were able to visit the House in January: Jonathan Bookout, Katherine Boone, Rico Bussey, Alie Church, Trisha Hulsey, Jamie Kim, James Maina, Shivani Patel, Worth Straughan, Jason Strever, and Ruby Truong. I want to congratulate these and all the scholars on their accomplishments. You may notice a discrepancy between the 2011 GDA dues check-off amount donated to the Foundation—$44,700— and the dental scholarship disbursement

of $56,000. That is because the Foundation board voted to dip into its corpus to keep the scholarship dollars given for the current year at the same level as in the past few years. The urge is strong to help dental students like the ones who attended the House of Delegates, but this cannot continue without damaging the Foundation. Thanks to those doctors who have already contributed to the Foundation via their 2012 dues statements. If you have not already paid your 2012 dues, I encourage you to include a donation to the Foundation when you do pay. I might also add that the Foundation has initiated secure online giving. If you have only contributed the minimum donation,


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or have yet to contribute, please visit www.gadental.org. Choose the About GDA link, choose Dental Foundation, and commit to an online donation. I especially call on previous Foundation scholarship recipients to step up to the plate and make a donation. But naturally, we solicit donations from everyone! Dr. Jonathan Dubin wrote a wonderful editorial about the Foundation in the last Action. Go read it if you have not. He serves on the Foundation board, and does great work in mentoring GHSU dental students who rotate through the Ben Massell Dental Clinic in Atlanta. He speaks about the importance of relieving the debt burden on dental students and young dentists so they have the freedom to make good choices about how to practice when they start out. Please, do what you can to bolster our Foundation so we can make the foundation of our profession strong. John W. Harden Jr., DMD, President Emile T. Fisher Foundation for Dental Education in Georgia

(L to r): Foundation scholars Katherine Boone, Worth Straughan, James Maina, Jason Strever, Rico Bussey, Jonathan Bookout, Ruby Truong, Alie Church, Trisha Hulsey, Shivani Patel, and Jamie Kim, with GHSU Dental Dean Connie Drisko (third from right) and Associate GHSU Dental Dean Carole Hanes (far right) at the January 2012 GDA House of Delegates.

Letters and commentaries published in GDA Action from member dentists reflect the opinions of the authors and may not reflect the established policy of the Georgia Dental Association. Doctors who wish to share their letters and commentaries about dental issues may contact GDA Editor Dr. Jonathan Dubin at jsdubin@aol.com or Managing Editor Delaine Hall at hall@gadental.org. All letters and commentaries are subject to editing for length and clarity. Submission does not guarantee publication.

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general news Dental Health Day Sees Volunteers Distribute Dental Kits

Thanks to the GDA and Alliance volunteers who traveled to the Capitol on January 9 to distribute 900 dental kits to legislators, staff, and support personnel. This definitely makes a dental impression on decision makers! Joining the volunteers pictured in the Senate Chamber (above)—Dr. Marshall Mann, Jean Harrington, Helaine Sugarman, Dr. Jay Harrington, Dr. Janine Bethea, Dr. Mike Vernon, Dr. Jack Bickford, Molly Bickford, and Dr. Doug Torbush—were Dr. Sarabess Baumrind, Nancy Ferguson, Doug Goldman, Dr. Vivian Hudson, Dawn Hutchinson, Dr. James Kennedy, Dr. Kent Percy, Dr. Richard Sugarman, and Dr. Becky Weinman.

LEGISLATOR OF YEAR

GDA WINS

Rep. Joe Wilkinson

Golden Apple

The GDA was pleased to honor Rep. Joe Wilkinson of Atlanta, who chairs the state House of Representatives Ethics Committee, as the GDA legislator of the year at the January 2012 House of Delegates. Rep. Wilkinson was commended for his role in pushing through passage of HB189 (Caps on NonCovered Services) in 2011 and applauded for his ongoing efforts to promote good oral health to Georgia’s citizens.

The American Dental Association annually recognizes excellence in dental society activities with Golden Apple Awards. The GDA recently won its eighth Golden Apple for “Outstanding Achievement in the Promotion of Dental Ethics” for its LEAP (Law, Ethics, and Professionalism) Program. The award presentation took place at the January 2012 House of Delegates, with President Mike Vernon congratulating instructors Dr. Joe Dufresne, Dr. Jim Reynierson, and Dr. Doug Torbush. Thank you to these doctors for sharing important ethical discussions with dentists and dental hygienists.

ALLIANCE ADA Awards The GDA presented Alliance President Helaine Sugarman and Alliance Past President Molly Bickford with a plaque during the January 2012 House of Delegates to congratulate the dental spouses group for earning a record-breaking 28 legislative, dental health education, and well-being awards. The group earned the recognition during the 2011 Alliance of the American Dental Association Annual Session. “Our dental spouse leaders and Alliance members are outstanding ambassadors of dentistry,” said GDA President Dr. Vernon in presenting the plaque. Dentists and spouses are encouraged to visit www.gadental.org to view a list of Alliance activities, including the dental spouse LAW Day on March 28. All dental spouses are invited to attend on this day and learn about the legislative process.

(L to r) Molly Bickford and Helaine Sugarman, past president and president of the Alliance of the GDA, with GDA President Dr. Mike Vernon. The Alliance was honored for accomplishments in the legislative advocacy, dental health education, and dental family well being arenas.

PEACHCARE Patient Oral Surgery Co-Pays Rep. Joe Wilkinson (l) receives the GDA legislator of the year plaque from GDA President Dr. Mike Vernon. The five-term state representative was honored for his work in passing non-covered services legislation in the state. This award is not presented regularly, but only when a legislator makes a uniquely commendable effort on behalf of dentistry.

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(L to r): Dr. Doug Torbush, Dr. Mike Vernon, Dr. Joe Dufresne, and Dr. Jim Reynierson with the GDA’s eighth ADA Golden Apple, presented for excellence in ethics education.

A final adoption public notice addressing co-payments for the PeachCare for Kids program will go into effect on April 1, 2012. The notice provides details on the new rule that would enact co-payments for PeachCare members age 6 and older. These co-payments would only apply to


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oral and maxillofacial surgery services. Providers may not deny services to eligible patients because of their inability to pay, and should consult Part II Policies and Procedures for OMS for more details. The state Department of Community Health (DCH) is working to coordinate income and tracking requirements with the PeachCare eligibility and MMIS systems to accommodate this requirement. DCH acknowledges collecting co-pays may add administrative work for providers, but notes that most offices already have a mechanism in place to collect co-pays / deductibles for commercial insurance plans. DCH does not believe that collecting co-pays will prevent any children from accessing preventive care, but state officials plan to closely monitor the program for any unintended consequences as it moves forward.

BIOTERROR Free App The Center for Biosecurity has launched the Clinicians’ Biosecurity Resource (CBR) iPhone app, available at no charge

through iTunes.com. CBR provides access to the information clinicians need to recognize disease caused by the most dangerous potential bioweapons and to manage the care of patients who may have been exposed. Those agents include the following pathogens: • Bacillus anthracis (anthrax) • Clostridium botulinum toxin (botulism) • Hemorrhagic fever viruses (Ebola, Marburg, etc.) • Yersinia pestis (plague) • Variola virus (smallpox) • Francisella tularensis (tularemia) In the event of a biological attack, rapid, informed health care response will be critical. During a biological attack, clinicians will have to make diagnoses, initiate treatment, and communicate with patients and families. To support timely NEWS Continued on page 10

Social Media Marketing for the Dental Practice Social media marketing has emerged as a necessary platform for promoting products and services to consumers. Businesses large and small use marketing strategies centered on communication through social media applications such as Facebook, YouTube, and Twitter. Dental practices, which rely heavily on patient relationships for new patient referrals, have the opportunity to increase the frequency and range of their marketing exposure by inviting current patients to “join” their social media campaigns. These patients inform others about the practice and create vehicles for “electronic referrals.” Dentists who attend the GDA Annual Meeting this summer in Amelia Island can learn about social media trends and how to implement a social media marketing strategy in their dental practices. Greg Welch, a social media specialist with Symphony Dental, will discuss on Saturday, July 24, the best practices for positioning your practice in the social media world, including how to protect patient privacy. Some of the topics addressed in his continuing education course will include: • Introduction to social media platforms and a look at trends in social media. • Relevance of social media in dentistry, and why it is not going away. • The difference between practice personality branding using social media and traditional advertising. • Strategies for leveraging social media to generate new patient referrals. • Review of patient privacy guidelines. Registration for the 2012 Annual Meeting, which takes place July 19-22 at The Ritz-Carlton in Amelia Island, Florida, starts in March. Please visit www.gadental.org for meeting details.

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Creating Office Rapport Through Positive Support • Access to community service opportunities • Helpful information and support from the GDA office staff

CORPS membership is a great perk for any office staff member; plus, membership is affordable! Does your office staff have a membership in the GDA CORPS Program? The benefits of membership include: • Ability to apply for an exclusive affinity credit card

• Individual membership: $15 per year • Offices with five or fewer staff members: $60 per year • Offices with six or more staff members: $60 plus $12 for each staffer over five

JOIN NOW!

• Low cost, quality continuing education courses • GDA CE Course Registry • Competitive rates on insurance products and services

For more information, please call (404) 636-7553 or email williams@gadental.org, or visit www.gadental.org for a printable application.

• Free registration for the GDA Annual Meeting

NEWS Continued from page 9

and accurate response, CBR presents optimally organized, succinct information that can be used by all clinicians, including those who may not specialize in infectious disease but will likely play a role in response to a biological attack.

CANDY ATTACK Dentistry and Valentine’s Individuals express love on Valentine’s Day by presenting gifts, including candy. The U.S. Census Bureau tells us that there were 1,177 U.S. manufacturing establishments that produced chocolate and cocoa products in 2009, and there were 409 U.S. establishments that manufactured non-chocolate confectionary products in 2009. The total value of shipments in 2009 for U.S. chocolate and cocoa products was $12.6 billion, while non-chocolate confectionery product manufacturing was

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a $7.4 billion industry. The census bureau estimates that Americans consumed 24.7 pounds of candy per person in 2010. The American sweet tooth is alive and well.

ONLINE COMMENTS Company Lawsuit A company called Medical Justice Inc. is setting aside contracts it provided to 3,000 health care provider clients that theoretically gave those doctors authority over online patient comments. The move came after a complaint was made to the Federal Trade Commission (FTC) alleging that the company is engaging in unethical business practices. The company issued its comment contracts in 2007, recommending that doctors have patients sign them before appointments. Initially, the contracts stated that patients would not post online comments without a doctor’s consent. After revisions, the contracts required patients to give doctors copyright permission to remove posts if patient comments violated

rules set by online review sites. A patient is suing dentist Dr. Stacy Makhnevich of New York for allegedly invoking a Medical Justice contract. Robert Allen Lee claims Dr. Makhnevich overcharged him for a filling in 2010, according to a suit filed in the U.S. District Court for the Southern District Court of New York. He signed a Medical Justice contract with the dentist prior to treatment. After his visit, Lee posted online comments. Dr. Makhnevich allegedly demanded that he remove the comments, sent him $100 invoices for each day the postings remained active, and threatened to sue him for copyright infringement based on the contract, according to the lawsuit. Medical Justice now uses a system that surveys patients about their visits in the doctor’s office. With a patient’s permission, the system uploads the comments to various review sites without the patient visiting the review site. (From the American Medical Association News, January 2, 2012.)


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Upcoming Dental Events MARCH 2012 Mar 7 (Wed): LAW Day— Southeastern District, Ga Dental Society, N. Ga Dental Society. Mar 14 (Wed): LAW Day— Northern District Northern Branch. Mar 15 (Thu): CORPS Visit / GDA Dental Hygiene Student Orientation, Central Georgia Tech, Macon. Mar 21 (Wed): LAW Day— Southwestern District. Mar 23 (Fri): GDA / ASDA By Invitation Mentor Reception, Dr. John Harden Residence. Mar 22-24 (Thu-Sat): Hinman Dental Society Meeting, Atlanta. Mar 26 (Mon): Northern District Executive Council, GDA Office, Atlanta. Mar 26 (Mon): CORPS Visit / GDA Dental Hygiene Student Orientation, West Central Tech, Douglasville. Mar 27 (Tue): GHSU Senior Transition Program (GDA staff to speak). Mar 28 (Wed): LAW Day—Alliance, Northern District Hall County Branch. Mar 30-31 (Fri-Sat): ADA Membership Conference, Chicago.

Apr 17 (Tue): CORPS Visit / GDA Dental Hygiene Student Orientation, Middle Georgia Tech, Warner Robins.

June 16 (Sat): GDA Board of Trustees Meeting, Atlanta.

JULY 2012 Apr 18 (Wed): Northern District CE Meeting, Villa Christina, Atlanta. Apr 18 (Wed): CORPS Visit / GDA Dental Hygiene Student Orientation, Valdosta Tech. Apr 19 (Thu): CORPS Visit / GDA Dental Hygiene Student Orientation, Athens Tech. Apr 21 (Sat): GDA Board of Trustees Meeting, Atlanta. Apr 24 (Tue): CORPS Visit / GDA Dental Hygiene Student Orientation, Clayton University.

July 4 (Wed): GDA Office Closed for July Fourth Holiday. July 19-22 (Thu-Sun): GDA Annual Meeting, Amelia Island, Florida.

AUGUST 2012 Aug 11 (Sat): GDA Board of Trustees Meeting, Atlanta. Aug 16 (Thu): Northern District CE Meeting, Villa Christina, Atlanta. Aug 25 (Sat): Northern District Gala for Smiles, Druid Hills Golf Club, Atlanta.

Apr 25 (Wed): CORPS Visit / GDA Dental Hygiene Student Orientation, Columbus Tech. Apr 27-29 (Thu-Sun): GHSU Homecoming Festivities.

MAY 2012 May 3-6 (Thu-Sun): Ga. Academy of Dental Practice Meeting, Ponte Vedra. May 7-9 (Mon-Wed): ADA Washington Leadership Conference, Washington, DC. May 18-19 (Fri-Sat): GDA Presidents’ Elect Conference, Banning Mills.

APRIL 2012 Apr 4 (Wed): CORPS Visit / GDA Dental Hygiene Student Orientation, Athens Tech. Apr 6 (Fri): GDA Office Closed for Good Friday Holiday.

May 21 (Mon): Northern District Executive Council, GDA Office, Atlanta. May 26-June 2: GDA President’s Cruise to Canada / New England. May 28 (Mon): GDA Office Closed for Memorial Day Holiday.

Apr 10 (Tue): CORPS Visit / GDA Dental Hygiene Student Orientation, GHSU.

JUNE 2012

Apr 10-14 (Tue-Sat): Alliance of the ADA Spring Conference, Stone Mountain.

June 8 (Fri): Finance Committee Meeting, GDA Office.

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dentists care Volunteers in Action: Georgia Dentists Giving Charitable Care Thanks to the GDA dentists who have submitted stories about the charitable efforts they and their colleagues have supported statewide. Charity is not a sustainable health care system, but while the GDA advocates for more common sense dental coverage from the feds and state, GDA dentists are stepping up to care for those who are falling through the cracks. If you know of, or are involved in, a dental charitable care effort, please let GDA Action know the details by emailing Editor Jonathan Dubin at jsdubin@aol.com or Managing Editor Delaine Hall at hall@gadental.org.

Coweta County Church Offers “Mini MOM” Dr. Nancy Carson of Newnan reports that the 183-year-old First Baptist Church of Moreland held an “Impact 2011” community mission project late last year in concert with the Georgia Baptist Convention’s Mobile Heath Ministry. “It was a smallscale version of the Georgia Mission of

Assistant Winona Taylor and Dr. Jeff Cauley chat with a Waycross patient during a charitable clinic in October.

Mercy idea,” said Dr. Carson. Over four days, uninsured and low-income local patients were screened and treated by volunteer dentists in the Mobile Health Ministry’s van and in local dental offices as part of the project, which also included a

community health fair and a collection of items needed by the local elementary school. Kudos to GDA dentists Dr. Carson as well as Drs. Kelley Brummett and Tom Moynahan for providing screenings and preventive and restorative treatments. Persons in the Coweta County area who would like to participate in the church’s next outreach event, or support the event financially or with supplies, may contact the church at http://fbcmoreland.org.

Columbus Church Connects Persons in Need with Care

Dr. David Morton, with assistant Shelley Griffin, during the Kingdom Care clinic in Waycross.

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Dr. Phillip Tully of Columbus reports that Edgewood Baptist Church in Columbus hosted its second annual “Love In Deed” weekend in late 2011. “The weekend was designated to serve others in the community near the church itself, Fort Benning families, and a church associated with Edgewood, Highland Community,” said Dr. Tully. Service projects included a medical and dental clinic for indigent patients. Dr. Tully oversaw the clinic. Dr. Cephas


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Thomason, a pediatric dentist and church member, screened patients prior to the clinic day. On the clinic day, patients were shuttled to Dr. Tully’s office for cleanings and needed care. Volunteers from Dr. Tully’s staff and the dental hygiene educational program at Columbus Technical College assisted Dr. Tully in helping 13 patients. “Everyone was very appreciative of what was done for them,” said Dr. Tully. The care provided had an estimated value of $2,500.

Way Down South Waycross Steps Up with Indigent Care Dr. George Thomas of Waycross highlights another project held in concert with the Georgia Baptist Convention’s Mobile Heath Ministry. The Kingdom Care Dental Clinic was held in Fall 2011, and volunteer dentists screened patients who were then provided care in the Mobile Health Ministry’s rolling unit and local dental offices. Kudos to volunteer dentists Drs. Jeff Cauley, Jon Drawdy, Kim Hood, Jason Lucas, Page Manus, Greg Morris, David Morton, Ralph Proenza, Duane Robert, Matt Smith, George Thomas, and Steve Wilkerson and supporting volunteers who provided care to 168 patients. The services these patie.0nts received were 134 non-surgical extractions, 21 surgical extractions, 159 surfaces of composite restorations, 41 dental cleanings, and 167 x-rays. Kingdom Care is a non-profit, volunteer-based free clinic established in 2006 that provides health care services to working, uninsured residents of Brantley, Charlton, Clinch, Pierce, and Ware counties who have a household income at or below 200% of the federal poverty level and are not eligible to receive Medicaid, Medicare, or other coverage. The clinic is supported by grant funding from the Georgia Baptist Health Care Ministry Foundation, the Healthcare Georgia Foundation, and the United Way of South Georgia. “We were also happy to receive $1,300 from GDA dentists who donated to our clinic when they paid their GDA dues,” said Dr. Thomas.

Send information about charitable efforts in your area to hall@gadental.org! GDA ACTION FEBRUARY 2012

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Medicaid Managed Care Now—and Forever?

State Consultant’s Medicaid Review Favors Managed Care Model Your Association has begun an in-depth study of a newly-released report by Navigant, the company commissioned by the Department of Community Health (DCH) to analyze Georgia’s Medicaid program. An initial analysis of the nearly 500-page publication, “Medicaid and PeachCare for Kids® Design Strategy Report,” is not encouraging. The top three recommendations favor continuation of the managed care model that has failed so many dental patients and dentists. The report does not recommend a carve-out for dentistry from the managed care model, which the GDA supports. Instead, Navigant makes a strong case for including all services, including those for the aged, blind, and disabled populations which were previously not included in a fully managed care system. “Our members who see Medicaid patients have continued to see these patients despite being mired in red tape to authorize needed care, seeing cuts to already below market fees, being told that they cannot provide certain services to patients, and being denied payments for providing needed care,” said GDA President Mike Vernon. “The current CMO system has failed dental patients and dentistry in many ways. The GDA will continue to address the vital concerns of dentistry with the state during its Medicaid redesign.” Your Association is preparing a detailed report to submit to DCH by its February 29 public comment deadline. Some questions dentists may have about the report are answered below. If you have further questions about the report or about Medicaid in general please email layfield@gadental.org.

Was the GDA Involved in Producing the Navigant Report? Not directly. The GDA did provide significant input during two dental Medicaid Focus Groups hosted by DCH and

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Navigant as part of the report preparation process. The groups were held in Macon and Gainesville last October. Medicaid provider dentists and GDA staff members testified on the current state of the Medicaid and PeachCare for Kids (PeachCare) programs and distributed packets of information to the facilitators. The GDA is now reviewing the Navigant report, which, while acknowledging the problems that the managed care system imposes on the delivery of dental care in Georgia, nevertheless recommends continuing that system relatively unchanged into the future. The GDA will continue to advocate for “carving out” dentistry from the current delivery system. The Navigant report notes that dental care is the benefit most commonly carved out of Medicaid managed care contracts—of states that have managed care programs and participated in a recent Kaiser survey, 25 reported carving out dental services and 5 of these states contract with a pre-paid health plan to administer the benefit (Kaiser Commission of Medicaid and the Uninsured. A Profile of Medicaid Managed Care Programs in 2010. A Summary from a 50-State Survey. September 2011.) The GDA is hardly alone in recognizing the value of this option for patients.

Why Did DCH Commission the Navigant Report? When David Cook, former Executive Director of the Medical Association of Georgia, was named by Gov. Nathan Deal as DCH Commissioner in January 2011, he was given broad authority to analyze DCH and make significant changes. Preparatory to making major changes, Cook and DCH commissioned the survey as part of a global review of the state’s Medicaid and PeachCare programs. Georgia, like many other states, has seen enrollment applications for aid pro-

grams rise as the economy shrinks and state coffers empty. Additionally, DCH expanded eligibility for PeachCare in January 2012 to allow enrollment of eligible children who have parents with coverage through the State Employee’s Health Plan. DCH estimates an additional 16,000 individuals are now eligible for PeachCare. With the implementation of federal health care reform looming during the period 2014-2020, DCH must also look ahead to potentially making room for 650,000 new enrollees at an estimated cost of $25 billion. Thus, with the contracts for the three care management organizations (CMOs) Amerigroup, Peach State, and WellCare expiring in 2014, state officials believe now is the optimal time to review the program and pursue three re-design goals: 1. To improve health care outcomes for members. 2. To achieve long-term sustainable savings in services. 3. To enhance the appropriate use of services by members. DCH currently provides services for approximately 1.6 million low-income children, pregnant women and people who are aging, blind and disabled via managed care and Fee-For-Service Medicaid programs. DCH is also responsible for PeachCare, the state’s Children’s Health Insurance Program, begun in 1998 to cover eligible uninsured children. An estimated 202,527 of the approximate 1.6 million covered lives managed by DCH are PeachCare members.

When Did Medicaid Managed Care Start in Georgia? In September 2006, Georgia transitioned many of its Medicaid and all of its PeachCare members from a Fee-ForService delivery system to a full-risk mandatory managed care Medicaid deliv-


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ery system. This full-risk delivery system is now called Georgia Families. While the majority of Medicaid members participate in Georgia Families, the majority of Medicaid dollars are spent on members who are not enrolled in Georgia Families. Georgia’s Fee-For-Service delivery system serves Medicaid’s most highrisk high-cost populations, including children in foster care; individuals who are dually eligible for Medicaid and Medicare; and aged, blind, and disabled persons. The FFS system serves 23.8% of Medicaid members, but represents 54.9% of total costs. The Navigant report noted that the FFS delivery system was a prime area to target for cost savings, and recommended that these groups be moved into the managed care fold.

What Does the Report Say About Dentistry? The report characterizes access to and utilization of dental care among the most chronic challenges for Medicaid programs. The report also notes the three most com-

mon reasons that dentists give for not participating in Medicaid are low reimbursement rates, administrative burdens, and patient behavior. Dentist “stakeholder” concerns noted in the report included: • Lack of consistency in credentialing, formularies, standards of care, and prior authorization processes. • Exceptional difficulty receiving accurate member eligibility information. • Slashed reimbursement rates, varying reimbursement rates for the same procedures, and sometimes slow payments. • A need for closer DCH monitoring of vendors in terms of meeting contract requirements and performance targets.

• Cumbersome, slow, and variable provider credentialing processes. • The impact on access to care from the CMOs closed dental panels. • Tracking of services provided by mobile dental vans and brick and mortar dental offices in order to prevent duplication of services and denials of payment. The report acknowledges that some stakeholders are advocating for particular service carve outs, including dental. To address that angle, the report states, “DCH and the CMOs have refined the initial infrastructure and are working on the next generation of quality initiatives, improvements and innovations … DCH now has a history operating in a managed care environment and staff now have the background and experience

• The need for CMO and FFS administrators to improve communications with providers and patients. MEDICAID Continued on page 16

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MEDICAID Continued from page 15

to seamlessly manage and monitor a managed care program and take it to the next level of value-based purchasing.” Going further, the report states “… our assessment found that some of the concerns and frustrations voiced by stakeholders are not due to the Georgia Families program design, but result from operational issues within the Medicaid program … DCH’s current leadership is working to communicate to stakeholders about efforts that are currently underway” to improve credentialing and eligibility, and revise contract language and reporting requirements. In other words, this could sound like managed care today and managed care tomorrow.

What Recommendations Does the Report Make? The report details four options the state may wish to pursue. Navigant recommend-

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ed that the state look at implementing Options 1, 2, or 3, leaving the most radical Option 4 on the table. Each of these recommended systems incorporates a managed care model. As the report states, “Through implementation and operation of Georgia Families over the past six years, DCH has built an infrastructure for operation of a managed care model.” Since the foundation is laid for this model, Navigant recommends moving along the same tracks with improvement of the basic model as a goal. Option 1: All patients, including those currently in the FFS payment system, would be enrolled in a managed care Georgia Families Plus, so essentially the same basic program as offered today with the additional groups of enrollees and presumably a renewed focus on streamlining and improving the system. Option 2: This option is Option 1 topped with what the report terms “commercial style managed care levers” applied to certain groups of patients. While certain pop-

ulations cannot be charged copayments or deductibles without a federal waiver, other tools such as HRAs and incentive payments or prizes could be brought into play. The goal is to have members stand to gain or lose from their health behavior decisions. Option 3: The only difference between Option 2 and Option 3 is that participating CMOs would be required to include Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs) in their provider networks. The goal of including ACOs and PCMHs would be to create a more patient-centered program that involves teams of providers sharing responsibility for care for individuals. Option 4: DCH would implement Georgia Families Plus for children, including children in foster care, and for individuals who are aged, blind and disabled as well as a “free market” health insurance purchasing program for low-income needy adults and potential expansion popula-


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tions. Insurers would offer the standard Medicaid benefit package as one of their products. DCH would not contract directly with health plans and would not process claims. Medicaid members would be given a credit with which to purchase a standard Medicaid benefit insurance product from a certified insurer. Most members, outside of foster children, would be required to make copayments. This model does not currently exist in the world of Medicaid systems and would require special federal approval to implement. This option was not one of the top three recommended options.

What is Next for the Report and State? The state’s Redesign Initiative is divided into four phases: (I) Assessment; (II) Recommendation; (III) Procurement; and (IV) Implementation. The Assessment Phase is now complete. The Recommendation phase began with the issuing of the Navigant report in January 2012. Report analysis will take place from January to April, with the state announcing a

finalization of the Redesign Model in April 2012. The next steps will involve the state obtaining documents from interested CMO organizations, with an eye toward awarding contracts in January 2013 to successful vendors. Implementation of the “new” program would begin in 2014.

Can I Comment on the Report and Medicaid?

carve-out would eliminate multiple layers of administrative costs and profits. Currently, the average CMO administrative and profit fees for all Medicaid dental claims paid in Georgia are between 17 and 26 percent. The Medicaid Mean is 11.9% and the industry average is 10.5%. A carve-out would also address many of the dentist stakeholder complaints as highlighted above.

The GDA will provide detailed feedback to the state on the report, but individual dentists may share comments about the report at www.dch.georgia.gov/medicaidredesign. Briefer comments may be sent to MyOpinion@dch.ga.gov. Read the full Navigant report at http://dch.georgia.gov (click the Medicaid and CHIP Redesign link at right on the DCH home page). The GDA will include information in its comments from the Association position paper advocating a carve-out for dental Medicaid and PeachCare from the current delivery system. (You may read the full position paper at www.gadental.org.) A

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Gov. Deal Focuses on Education, GDA Pursues Goals as Session Begins President Dr. Mike Vernon Council on Governmental Affairs Chair Dr. Jack Bickford Executive Director Martha Phillips

The 2012 legislative session kicked off on January 9. Thanks to the GDA and Alliance volunteers who spent their morning at the Capitol distributing 900 dental kits to legislators, staff, and support personnel. We were able to get the legislature thinking positively about dentistry from the start. Governor Nathan Deal’s State of the State address on the first day emphasized education and revising the criminal justice system. Gov. Deal indicated that even though Georgia’s revenue collections have stabilized and even grown a bit over the past year, state government coffers are still not overflowing with cash. And speaking of funding, for the first time in several years, there are no dramatic cuts in the governor’s proposed budget, although there are some cuts. Gov. Deal is proposing a $19.22 billion state budget for FY2013, which would be nearly $700 million larger than the amended budget for the current fiscal year. Looking at the Governor’s proposals, it appears that Georgia has hit the bottom of the down cycle and has begun the process of at least stabilizing the state budget. The spending plan Gov. Deal released recommends $28 million to construct a medical education commons building at Georgia Health Sciences University (GHSU) in Augusta. GHSU has aggressively sought funding for this commons building, which would provide additional educational space for the College of Dental Medicine. WRDW-TV in Augusta reported in 2011 that GHSU scaled back the initial $100 million budget for the building in hopes of securing more state funding. The idea was to have the new dental building and commons building eventually support dental classes of 100 students. “We need it,” the station quoted Dental Dean Connie Drisko as

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saying about the commons building. “We can’t expand beyond 80 [students].” Of interest on the Medicaid front is the announcement by the Department of Community Health (DCH) that Peach State and WellCare will provide services state-wide effective January 1, 2012. Amerigroup was denied state-wide coverage due to an inadequate provider network. The GDA is now reviewing an official report released in January 2012 by DCH consultant Navigant on the state’s proposed Medicaid Re-design. The GDA participated in focus groups held by Navigant and provided extensive information to the consultant and DCH about dentistry’s unique issues. The GDA’s legislative agenda includes the following: 1. Advocating for 12-month eligibility for Medicaid recipients, rather than the current six-month limit. The current protocol translates to dentists having to verify monthly thereby creating additional administrative burdens. 2. Partnering with the Medical Association of Georgia to introduce legislation that will prevent physicians or dentists from being mandated to sign on or participate in any public or private insurance plan as a condition of licensure. A dental license should be issued on the basis of competency and education and not on whether an applicant agrees to be a participating provider in an insurance plan. SB 337 was introduced in the Senate by Sen. Greg Goggans. 3. Working with Sen. Goggans, the GDA supports SB 338 to simply amend an existing law that currently allows retired dentists from Georgia and from out-of-state to obtain a license to volunteer in Georgia. To help not-for-profit events like the

Georgia Mission of Mercy, the law will be amended to allow actively licensed dentists from out-of-state to receive a volunteer license. A dentist with a volunteer license will be prohibited from receiving any compensation for his or her dental work. Right before the legislative session, Sen. Frank Ginn informed the GDA of his plan to introduce legislation that would require that patients in Georgia be notified of the materials in their dental prosthetic devices and appliances. The bill requires labs to disclose in writing to a dentist the composition of patient contact materials and point of origin of those materials. Dentists will be required to maintain this information in the patient’s chart as well as ensure that the patient agrees to use of a dental device that has been manufactured in a foreign country should that be the case. The GDA did not initiate this bill.

What We Love: Involved Districts Thanks to our GDA districts for hosting incredible legislative receptions in late 2011. These receptions, which bring dentists and legislators together in low-key settings to talk about local issues, along with our Contact Dentist Program, GDA Political Action Committee funds, LAW Day program, and legislative dental kit distribution on opening day of the session are all ingredients in our successful professional and patient advocacy efforts. The district receptions, 10 in all, took place in November and December. Dr. Vernon and Dr. Bickford alternated attendance at the various receptions while Mrs. Phillips attended all of the receptions. The receptions are well-attended by legislators and dentists alike. Attending legislators have been sent PAC contributions as well as special GDA ties or scarves.


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Western District Legislator Attendees (Nov. 3)

Central District Legislator Attendees (Nov. 29)

Reps. Bill Horne, Debbie Buckner, and Richard H. Smith.

Reps. James Beverly, Robert Dickey, Bubber Epps, Matt Hatchet, Buddy Harden, Susan Holmes, Lynmore James, Rusty Kidd, Larry O’Neal, Allen Peake, Nikki Randall; and Willie Talton; Sens. Miriam Paris and Cecil Stanton.

Eastern District Legislator Attendees (Nov. 8 Athens) Reps. Lee Anderson, Ben Harbin, Barbara Sims, Quincy Murphy, and Wayne Howard; Sens. Bill Jackson and Jesse Stone.

Southwestern District Legislator Attendees (Nov. 10 Albany)

Eastern District Legislative Attendees (Nov. 30 Augusta)

Reps. Gerald Greene, Winfred Dukes, Carol Fullerton, Ed Rynders, and Gene Maddox; Sen. John Bulloch.

Reps. Doug McKillip, Keith Heard, Tommy Benton, Chuck Williams, Bruce Williamson; Sens. Frank Ginn and Bill Cowsert.

Southwestern District Legislator Attendees (Nov. 17 Valdosta)

Northern District Hall County Legislative Attendees (Dec. 6)

Reps. Terry McBrayer, Darlene Taylor, Ellis Black, Amy Carter, Jason Shaw, and Mark Hatfield.

Reps. Doug Collins and Carl Rogers.

Northwestern District Legislative Attendees (Dec. 7)

and Jason Spencer; Sens. Buddy Carter and Lester Jackson.

Reps. Tom Weldon, Roger Williams, John Meadows, Tom Dickson, Barbara Massey Reece, Rick Jasperse, Paul R. Battles, Rick Crawford, Howard Maxwell, Kevin Cooke, Paulette Rakestraw Braddock, Calvin Hill, Sean Jerguson, Mark Hamilton, Mike Dudgeon, Judy Manning, David Wilkerson, Ed Setzler, Terry Johnson, Sam Teasley, Stacey Godfrey Evans, Sharon Cooper, Don Parsons, and Matt Dollar; Sens. Jack Murphy, Bill Heath, Judson Hill, Lindsey Tippins, Steve Gooch, Jeff Mullis and Charlie Bethel.

Northern District Legislative Attendees (Dec. 14 Druid Hills)

Southeastern District Legislative Attendees (Dec. 8)

Reps. Kathy Ashe, Glenn Baker, Roger Bruce, Josh Clark, Valerie Clark, Pam Dickerson, Elly Dobbs, Hugh Floyd, Pat Gardner, Harry Geisinger, Brett Harrell, Joe Heckstall, Michele Henson, Scott Holcomb, Darryl Jordan, Rahn Mayo, Mary Margaret Oliver, Lynne Riley, Sandra Scott, Tom Taylor, Joe Wilkinson, Wendell Willard, and Coach Williams; Sens. John Albers, Gloria Butler, Gail Davenport, Vincent Fort, Steve Henson, Donzella James, and Nan Orrock.

Reps. Mickey Stephens, Ben Watson, Ron Stephens, Al Williams,

Health Care Exchanges: Fed Health Care Reform Law Says Yes, Georgia Says No The Patient Protection and Affordable Care Act (PPACA) of 2010 would require most people in the U.S. to purchase health insurance (the so-called “individual mandate”). The legislation also requires states to set up health care exchanges to allow individuals and businesses employing fewer than 100 employees to “shop” for the best rates and coverages suitable for their needs. Some shoppers could qualify for funding assistance to purchase health coverage. The exchanges would inspect offered policies to make sure they meet certain government standards, and are supposed to make sure the plans are “in the interest” of buyers, according to the health care reform bill. Then the exchange would offer approved policies to interested buyers. The exchanges are supposed to be operational in each state by 2014. If a state declines to open one, the federal government can open an exchange in the state itself. However, despite a recommendation from an advisory committee* appointed by Governor Nathan Deal that Georgia move forward at least with creating an exchange structure for small

businesses to use (if not for individuals), news comes that the state Republican legislative leadership and Gov. Deal will not to push an insurance exchange bill during the 2012 session. “With the Supreme Court set to issue a landmark decision on Obamacare this spring, the governor does not want to move forward until the court has ruled,” said Brian Robinson in a statement reprinted in Georgia Health News. “Plus, the governor was concerned about mandates concerning exchanges from the Obama administration’s Department of Health and Human Services.” The Georgia Health News states that the 2012 General Assembly session could be the last opportunity to create health care exchange legislation for Georgia ahead of the 2014 deadline unless a special session is called. Already, 12 states have set up exchanges. Rep. Richard Smith (R-Columbus), chair of the House of Representatives Insurance Committee, was quoted in Georgia Health News as saying that if the U.S. Supreme Court upholds the law, Georgia could let the federal government

set up an exchange, and the state could take over its operation later. As it stands now, 26 states, including Georgia, and numerous organizations and individuals have filed actions in federal court challenging the constitutionality of PPACA. As of October 2011, the constitutionality of PPACA has been upheld by three out of four federal appellate courts, with the fourth declaring the law’s individual mandate alone as unconstitutional. The U.S. Supreme Court has agreed to review the suits and has scheduled over five hours for oral arguments on the matter in March 2012. Many pundits believe that the health care system is transforming itself and that the outcome of court challenges or even the presidential election will be anticlimactic to what will have already happened in the marketplace. We will see what March brings at the federal and state level. *To read the advisory committee’s reports, and review in general what Georgia’s various agencies are doing to prepare for the advent of health care reforms, visit http://healthcarereform.georgia.gov.

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Do You Administer a 401(k) in Your Practice? Be Aware of New Disclosure Requirements JJ McKinney, Retirement Strategies, Inc.*

Two regulations issued by the Employee Benefits Security Administration (EBSA), part of the U.S. Department of Labor (DOL) seek to give employers and employees a better understanding of the behind-the-scenes workings of 401(k) and other defined contribution plans. The regulations’ aim is to help employers / plan sponsors and employees / participants make better decisions when it comes to selecting and managing investments held in participant-directed retirement plans. Starting July 1, 2012, the DOL is requiring 401(k) plans to provide plan sponsors and persons enrolled in defined contribution plans with quarterly details on administrative expenses and other charges imposed on retirement accounts. In addition to information about fees, the new rules require disclosures about the performance of mutual funds that are offered as investments, along with benchmark numbers, so participants can assess a fund’s performance. The new rules also require that individuals have access to an easily understood glossary of terms to help explain investment options, fees, and other details. The regulations do offer protection to plan sponsors on the accuracy of the information provided by a plan’s service provider, upon which the sponsor in good faith relies. This outline on the fee disclosure rules will provide the basics on what plan sponsors need to know. Plan sponsors will want to discuss with their service providers (third-party administrators, record-keepers, fund managers) the various disclosure requirements and ensure they are meeting all requirements.

What’s New Regarding 401(k)s The 401(k) has successfully transformed employees who were ill-prepared into diligent savers for the future. The 401(k) plan is only approaching its third decade in wide use as a savings plan, so the mechanism is very young and not without issues.

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However, over the last 20 years industry professionals and government officials alike have enacted solutions for consistent problems. Fee disclosure is front and center on the agenda to improve 401(k)s. New fee disclosure regulations take effect in July 2012, but 401(k) plan sponsors have enough information to plan appropriately. Fee disclosure is simply fair play. Restaurants have menus and retailers have price tags because to a consumer, price is an important factor in decision making. Quality, necessity, and name recognition have a hand in the outcome, but price generally plays a central role.

Your Fiduciary Role Financial services, particularly investment products, have a direct connection with 401(k) savings plans and fiduciary prudence. Fiduciary duty is the highest responsibility afforded to a plan sponsor with a notable role of ensuring that fees, associated with or paid by the plan, are reasonable for the services provided. Thirty-seven years after the Employee Retirement Income Security Act (ERISA) was enacted, Congress realizes that fiduciaries may not be able to determine whether fees are reasonable when:


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1) They do not understand the services provided,

• Document collecting the data and determination of reasonability.

2) Do not know what services typically cost, and

• Compare theses costs and expectations across various competitors.

3) Do not have ready and constant access to written representation of either fees or services.

• Communicate to others involved so they can understand.

Free enterprise has not properly engaged the disclosure issue, resulting in more legislation to complicate a fairly simple concept. The list below summarizes a plan sponsor’s role regarding expenses. • Know all of your service providers. • Know what the service providers are doing and how to distinguish one from another. • Know what each service costs. • Know what and how the service providers are paid for each service.

Remember “CDCC.” Bullet points 1 through 4 imply Collecting data while bullet points 5 through 7 are your resulting actions— Document, Compare, and Communicate.

Your Service Providers Costs can vary widely based on the level of service a plan sponsor requires. Low cost service providers may offer a “do-it-yourself” model by giving the sponsor access to a platform to execute the necessary functions while more expensive providers give a boutique approach relieving most of the burden from the sponsor. Other aspects that affect cost include plan design or type, investment platform, and flexibility or bundling tasks together.

Understanding how service providers determine their respective fee structures is important, especially when they bundle multiple services and present cost savings as a result. Determining what a firm charges for each service is also pertinent, but do not leave the table without knowing how much they are paid. For example, a firm may charge $45 per participant to record-keep. However, due to a fee wrapped into the assets the total amount you pay to the service provider is $60 per participant. The extra $15 per participant might be reasonable depending on the level of service, or maybe not. Are you aware of any additional expenses? Were you provided the proper disclosure? Do you understand the fee and its relationship to the service? Is the extra $15 paid from participant assets? If so, do the participants know this fact?

Take Action Plan sponsor fee disclosure regulations take effect July 1, 2012, so many service providers will be amending service contracts based on the new regulations. Review your service contracts and invoices. Determine whether the service contracts relate to the invoices. Know and understand the charges. Familiarize yourself with the services provided. Ask your service provider to explain any item that you do not understand. Once you understand the expenses as they relate to you and the plan, prepare for communication of these expenses to plan participants—your employees. The next set of guidelines take effect in August 2012 for disclosures to plan participants. Stay tuned. GDA Wealth Management partner UBS provides articles to the members of the association on pertinent issues. This timely article was written by J.J. McKinney of Retirement Strategies Incorporated, the administrator for the GDA 401(k). If you have questions related to your retirement plan, or would like more information about the UBS / GDA Wealth Management Program, please contact Harris Gignilliat of UBS at (404) 760-3301 or email him at harris.gignilliat@ubs.com.

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gda alliance What We Love: Alliance Focuses on Worthwhile Projects Helaine Sugarman, President

The Alliance of the Georgia Dental Association assembled 100 care packets containing hats, gloves, socks, and oral care items when we put together legislative dental kits late last year. Alliance volunteers had the opportunity to deliver those care packets in January when we visited The Atlanta Day Shelter for Women and Children and The Covenant House to provide items for their at-risk male youth. Molly Bickford, Janelle Kauffman, Nancy Ferguson, and I were given a tour of The Atlanta Day Shelter when we made the care packet delivery there. We were most impressed with their “Job Readiness” program part of the social work they perform. The Covenant House volunteers claimed our donation to be the most needed on their list. With the cold weather, think of the use those items will get! It was a very special treat to send and hand-deliver our monetary donations to the Hebron Community Dental Clinic and the Ben Massell Dental Clinic! The Alliance raised $1,200 in fundraising events in 2011 that we split between the two charitable organizations. Fran Brown and I had the pleasure of personally seeing the appreciation on the faces of Deborah Fluker, the office manager at Ben Massell, and Barbara Jones, their clinical supervisor as we took a check by the facility in Atlanta. Many thanks to member Pam Pafford for arranging a fabulous and fun Alliance Holiday Party at the Ansley Golf Club! Also, much appreciation to Dr. David and Zoe Zelby for allowing us to use their membership for this wonderful evening! We had a special tribute for Debbie Torbush, our own Alliance of the American Dental Association President. We all agreed it was a night to be remembered!

(L to r): Ben Massell Dental Clinic clinical supervisor Barbara Jones, Alliance Treasurer Fran Brown, clinic office manager Deborah Fluker, and Alliance President Helaine Sugarman as the Alliance presents a donation to the clinic.

I look forward to reporting on our February events. Your Alliance will be participating in Give Kids a Smile Day and Children’s Dental Health Month activities, and holding a Thank You Brunch near Valentine’s Day. We also invite all dental spouses to these amazing events: • The Alliance is hosting a social during the Hinman Dental Meeting. This will be Saturday, March 24, at the Lobby Bar, from 3-4 p.m. For more information on this, contact AADA President Debbie Torbush at debbietorbush@bellsouth.net. • Wednesday, March 28 is our GDA Alliance LAW Day, along with the Northern District Hall County Branch. Please contact Nelda Greene at greene@gadental.org for more information and to RSVP. Nelda needs to know by March 19 if you plan to attend, so the appropriate amount of preparation material can be provided. This is such a rewarding experience! • The AADA Conference will be held at The Evergreen Marriott in Stone Mountain, Georgia, April 10-14. Georgia is so proud to host this meeting, and needs many participants to make it successful! Plan to stay onsite so you can really be a part of this event and truly enjoy all the wonderful activities! There is a registration form in the Alliance Key, or you can visit the Alliance web site at www.AllianceADA.org for more information. In continuation with the AADA Head to Toe Membership project, we would like you to bring hats, socks, gloves, and dental supplies for packaging at the meeting. You might want to purchase these items now while they are still available and on sale!

(L to r): Alliance members Janelle Kauffman and Nancy Ferguson, and Alliance President and Past President Helaine Sugarman and Molly Bickford, deliver hats, gloves, socks, and oral care items to residents at a shelter in Atlanta.

For information on any of these events, please email me, Helaine Sugarman, at hgs0409@aol.com. I look forward to welcoming all dental spouses at an Alliance event. Get involved in this aspect of dentistry! GDA ACTION FEBRUARY 2012

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classified ads Dental Related Services How GDA members can place classified ads AD FORM: Submit all ads on a GDA Classified Advertisement Form. To obtain a form, call Courtney Layfield at (800) 432-4357 or (404) 636-7553, or email layfield@gadental.org. (Note: The GDA may accept or reject any ad for any reason and in its sole discretion.)

AD DEADLINE: Ads and ad check payments are due by the first of the month before the publication month (i.e., Dec. 1 for January).

AD RATES: ADA member dentists pay $75.00 per 60-word ad per month. There is a 25 cents per-word charge for each word over 60. Non-dentist-owned companies (real estate firms, etc.) pay $195 per 60-word ad per month (additional word charges as above). Non-member dentists may not place ads.

LATE FEE: Ads for which full prepayment is not received by the first day of the ad’s publication month (i.e.; Nov. 1 for a November ad) will incur a $25 late fee in addition to the ad rate.

FORMS OF PAYMENT: Submit a check or money order with the ad form. (Make checks payable to GDA.) Credit cards are not accepted as payment.

X-RAY SAFETY CERTIFICATION for assistants is required by Georgia law. This up-to-date take-home course has effectively certified thousands of x-ray machine operators. Send $149.99 per registrant with name(s) to: Dr. Rick Waters, 385 Pinewood Circle, Athens, GA 30606. Visit www.gaxray.com for credit card payment or to use the immediate-access online version. Call (706) 255-4499 for more information.

Dentists Available for Locum Tenens Dentist will fill in for illness, vacation, or continuing education. Licensed, insured, DEA #, call (404) 786-0229 or email breighard@gmail.com. Dentist Available Daily (DAD): Dentist available during vacations, emergencies, and CE courses. Leave your practice in well-trained hands. I am licensed, insured, and have a DEA registration number so I can write prescriptions. Call Dr. Richard Patrick at (770) 993-8838. DENTIST: Need Part Time Fill In? Vacation, Illness, Maternity? GENERAL DENTIST SOLD LONG ESTABLISHED PRACTICE. GA & DEA LICENSED. (Available Expanded Atlanta Area.) Cell: (404) 219-4097. Home: (404) 842-1196. Jesse Hader, DDS. Dentist available during emergencies, vacation, CDE courses. I have a current license, DEA certificate, and insurance. Contact me at (706) 291-2254 or cell (706) 802-7760. I hope I can be of service to you. Patrick A. Parrino, DDS, MAGD.

For sale or assumable loan—2-year-old E4D crown milling machine, excellent condition with three year warranty remaining. Great investment, inquires call (229) 344-5636.

Positions Available Oral Surgeon Needed: American Correctional Healthcare, Inc. is seeking an Oral Surgeon for approximately six fourhour visits / year at the United States Penitentiary, in Atlanta, GA. Pay is $150.00 / hour. Candidate is required to submit an application / credentialing package, and undergo a security background investigation. Service duration: up to five years. If interested, please submit your Qualification Summary to: winston@americancorrectionalhealthcare.com. NORTH GEORGIA #8621: Full time associate needed for well-established practice. Contact dentalinfo@tds.net or fax to 1-866-441-1860. We have an outstanding part time opportunity in our successful, wellrespected, quality oriented private pediatric dental practice for the right candidate. We are seeking a special, motivated, personable individual to join in our success. General dentists would require a minimum of at least 2 years’ experience in pediatric dentistry. We are a booming practice with tremendous growth and earning potential. We offer in office sedation. We offer excellent compensation and benefits. For more information, please contact Amanda Moseley at amanda@kidshappyteeth.com or (678) 352-1090 / (678) 429-9931.

Dental Equipment for Sale WEB SITE PLACEMENT: Prepaid ads will appear on the GDA Web site www.gadental.org for the month the ad appears in print. Non-prepaid ads will NOT be placed online.

For Sale: (2) Pelton & Crane lights, model LF Plus, pole mounted with replacement bulbs. A classic light with natural color. $295.00 / each. Call for details (404) 874-6464.

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CLASSIFIEDS Continued from page 25 Georgia: Cartersville, Hiram, East Point: Opportunity available for general dentist in established family practice. We are a multi-specialty group providing quality patient care. Locations in Atlanta area. State-of-the-art offices. Excellent incentive packages. Requirements: 1+ year of experience and active Georgia license. Email resume to HR@asmile4u.com. Dentist Jobs: Aspen Dental offers tremendous earning potential and a practice support model that empowers dentists to achieve goals. We eliminate obstacles for dentists to own their own practice. To learn more about our compelling proposition and to apply, please call (877) 332-9154 or visit www.AspenDentalJobs.com. EOE Dentist Jobs Columbus / Albany / Macon / Valdosta. FT/PT base salary over $100K per year with tremendous commission and profit share upside. No HMOs. Join our network of affiliated private family practices. Benefits include medical, vacation, 401K. Call Dr. Todd Christie at (321) 432-5922 (confidential) or email tchristie@dental-partners.com or fax (321) 254-6800.

Norcross Dental office for sale or lease. Beautiful 2,800 square foot, single story, brick building. Five operatories, office, lobby / reception, two lab prep areas, three restrooms, breakroom, and storage areas. Not part of an office complex so all fifteen parking spaces are yours. Call Mike at (770) 815-4940. GREAT INVESTMENT OPPORTUNITY in beautiful north Georgia. Ten-year-old 10,000 sq. ft. high image glass building well located for public awareness along with dental practice in this same location for 39 years. State Agency also renting with the building, some vacant space available for rent to dental specialist, physicians, or other professional businesses. Close to hospital. Motivated cross-trained staff. Friendly patients who appreciate what you do for them. Modern equipment. Computers in all operatories. Ideal for solo or group practice. Growing community with excellent school system. Low crime rate. Tons of family /sportsman outdoor recreation. Call soon to arrange a convenient time to meet us and see our facility. (706) 745-6848.

WEST CUMMING: Beautiful rural practice for sale right outside of Cumming, GA. There are 4 operatories loaded with nice equipment and technology. The practice collected over $600K last year and is referring out many procedures. Seller is flexible with his transition plans. For more information call (678) 482-7305, email info@southeasttransitions.com, or visit www.southeasttransitions.com. Available: BUCKHEAD: Beautiful, prime location. GAINESVILLE: Grossing $600,000, 3 operatories. GWINNETT: Grossing $550,000, 4 operatories. SNELLVILLE: Grossing $580,000, 5 operatories. TUCKER: Grossing $350,000, 5 operatories. MERGERS: Buckhead, Duluth, Peachtree City. Contact Richane Swedenburg, New South Dental Transitions: (770) 630-0436, Check new listings, www.newsouthdental.com; info@newsouthdental.com.

CLASSIFIEDS Continued on page 28

Associate Dentist Buford—Sugar Hill, State of the Art digital practice in busy Gwinnett County. Full-time fax resume to (770) 945-1449 or email info@dentistgwinnett.com or call (770) 845-9159.

Practices/Office Space Available A Brand New, Busy Private Marietta Practice is looking to bring in a pediatric dentist & an oral surgeon who are looking to establish and grow with our Practice. Currently have about 500 pediatric patients and 4,000 adult patients. Looking for a competent, proficient, and energetic doctor to add to our team to take care of the large pediatric and adolescent patient pool that we have in our community. Rewarding compensation packages with additional pay as you grow the practice. Feel free to contact Dr. Mansouri if you have any further questions at (267) 4412565, mansouridmd@comcast.net, or visit our web site to see both of our office location at www.NaturalSmile.biz. GDA ACTION FEBRUARY 2012

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West Point: Prime fee-for-service practice. Consistent gross $750K + 3 1/2 day / wk. Attractive building in high traffic area near West Point Lake. Four very nicely equipped ops. Area experiencing excellent growth but still has a charming small town atmosphere. Boating, fishing, golf, Callaway Gardens, Auburn, Columbus, Lagrange nearby. Dr. retiring; will stay as needed for nice transfer of patients. Call p.m. (334) 644-3865.

a highly visible area where NO specialists are located at this time! Be the first in the area for a promising long term career location. Whether you want 1,500 or 5,000 square feet, space will be tailored to each individual’s needs. Perfect location for a new practice startup or a 2nd satellite location! Close to the newly approved satellite location for Northeast Georgia Medical Center. Demographics are off the charts and schools are unbelievable … literally one of the most sought after locations around! Priority will be given on a first come / first serve basis. Please e-mail: SpoutSpringsProfessionalPark@gmail.com for more information or call (678) 612-2277.

FLOWERY BRANCH / HOSCHTON/ BRASELTON, GA: 20,000 square foot dental office building for lease in the #4 most economically developing area in the country! Now Leasing and Interior Build Out Can Begin Immediately! Great lease rates & TI allowance available. Looking for PERIO, ENDO & ORAL SURGEON. In

Available: SNELLVILLE #8807—Dental office only; No patients. Five equipped ops. Ample parking Approx. 1800 sq. ft. ATLANTA #8490—Gross Collections $1.08M; 4 days; 5 operatories; 3850 sq. ft. office space. Savannah Area #8779—Gross Collections $1.05M; 4 days; 5 operatories; 2660 sq. ft. office space. ATLANTA

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PERIO #5241—Gross Collections $1.32M, 3 days, 4 ops; 2400 sq. ft. office space DENTAL EQUIPMENT #8822—5 rooms of equipment, $49,500 or best offer. NORTH ATLANTA PERIO #5241— Associate needed for high tech perio practice. All phases of perio performed. PAULDING COUNTY #8799—Gross Collections $653K, 4.5 days, 6 ops, 3600 sq. ft. office space. NW GA #8816—Gross Collections $1.09M; 4 days; 5 ops; 2450 sq. ft. office space. For information, call Dr. Earl Douglas, (770) 664-1982 or email Earl@adssouth.com.


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Scenes From the First GDA LAW Day The GDA Legislative Awareness (LAW) Day program enables dentists, dental spouses, and dental students to learn more about how the legislative process affects the practice of dentistry. The Georgia Health Sciences University dental student LAW Day—the first one of the session— was a great success! Students discussed key bills with legislators then visited the GDA office in Atlanta with Dean Connie Drisko for lunch and to meet the GDA staff. Thanks to this awesome group for their hard work in supporting their (future) profession: Class of 2013: Wendy Cardenas, Jimmy Cassidy, Meagan Chaffins, Shiven Gandhi, and Kaley Peek.

GDA Staff: Monitoring Issues for You Your GDA executive office staff spends time all during the year monitoring events held by advocacy and legislative groups, as well as taking in part in events with the American Dental Association

and

Georgia

Health

Sciences University, among other dental groups. The intent is to identify issues that may impact dentistry and dental patients, and take action to help dentistry and dental patients as needed. These are the events monitored by your staff in January and February. If you have Entering the Capitol prepared to talk with legislators. (Photo: Michael Winstead.)

any questions regarding these events, please call the GDA at (800) 432-4357 or (404) 636-7553.

Class of 2014: Kristen Bonkowski, Jovas Booker, Chris Clance, Heath Moody, Alex McTier, Orlando Lopez, Beau Upshaw, Blake Upshaw, Bob Wilson, and Michael Winstead. Class of 2015: Bryan Benton, Jonathan Bookout, Brittany Burgess, Chris Haggard, Catharine Moss, David Haithcock, Dylan Hamilton, Lauren Hughes, Alena Reich, Alex Riccardi, Zoanna Scheinfeld, Arielle Scherz, Christina Skarpalezos, Ray Wallace, and Josh White. During LAW Day, the GDA meets near the Capitol for breakfast and an orientation,

then attendees visit the Capitol to speak with legislators. Email Nelda Greene at greene@gadental.org to sign up:

January 2012 10: State Public Health meeting 12: Dept of Community Health meeting

Feb 22: Western / Northern (East; Central Branches) / Leadership GDA.

17: Senate meeting / budget hearings

Feb 29: Northwestern.

23: ADA State Public Affairs conference call

Mar 7: Southeastern / Ga Dental Society / N. Ga Dental Society. Mar 14: Northern (North Branch).

18: State budget hearings 18: Dept of Community Health meeting 25: LAW Day / legislative meetings 26: Dept of Community Health meeting 26: HP Medicaid meeting

Mar 21: Southwestern.

February 2012

March 28: Alliance / Northern (Hall Co Branch).

8: GHSU Clinic Day 8: Healthy Mothers Healthy Babies advocacy event 9: Dept of Community Health meeting 10: Board of Dentistry meeting, Macon 15: Oral Health Coalition meeting 15: LAW Day / legislative meetings 15: Dept of Community Health meeting 22: LAW Day / legislative meetings 22: Voices for Children event 23: Georgia Legislative Black Caucus event 24: Dept of Community Health meeting 29: LAW Day / legislative meetings 29: Children and Youth legislative dinner

Sharing a smile with Sen. Greg Goggans, an orthodontist. (Photo: Michael Winstead.)

29: GHSU risk management seminar

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Inside This Issue • Annual Meeting Tropical Fire Island Event Announced • GDA Launches Key Bills in Legislature DATED MATERIAL PLEASE DELIVER AS SOON AS POSSIBLE

ACTION

Suite 200, Building 17, 7000 Peachtree Dunwoody Road Atlanta, Georgia 30328-1655 www.gadental.org


GDA Action February 2012