Saturday, May 17, 2008

Hawaii's HB 2301 Leaves Dental Mills On The Main Land.

It appears Hawaii is doing all it can to protect their citizens from Medicaid dental mills such as Small Smiles, Kool Smiles, Ocean Dental, and Western Dental.
Hawaii has a law in place that says “a dentist must own, maintain or operate an office for the practice of dentistry.” However the laws as they stand now do leave a “loop hole”, as in other states, that people like Michael DeRose of Small Smiles and Dr. Tran Pham of Kool Smiles seem to find a way to slither through.

Majority Leader Kirk Caldwell's HB 2301 bill to prohibit "interference in the practice of dentistry by an unlicensed person or entity" and prohibit "the practice of dentistry in a commercial or mercantile establishment"

Jeffrey Miyazawa, D.D.S., Chair of the Board of Dental Examiners opposes the bill, no big surprise there, but other dentists of Hawaii fully support it.
Dr. Miyazawa argues that passing this law would not give the board any power to enforce it, and I’m saying to myself, "why the hell not?"
Dr. Miyazawa also says “HRS 448-17(a)(12) provides for sanctioning "any other improper, unprofessional, or dishonorable conduct in the practice of dentistry.”
Provisions like this or something close is on the books in most all states, and it hasn’t done one thing to stop these Medicaid dental mills, slowed them down one bit, or even caused them to pause for a split second despite the hundreds and hundreds of complaints and reports.
Hawaii’s HB 2301 would amend HRS 448-A to include as follows:
(a) No person or entity without a license issued pursuant to this chapter shall direct or interfere with a licensed dentist's judgment and competent practice of dentistry.
(b) No dentist licensed pursuant to this chapter who engages in the practice of dentistry in any form, shall permit a person or entity, other than a dentist licensed pursuant to this chapter, to direct, participate in, or interfere with the licensee's practice of dentistry.
Section B above certainly would limit that quota and bonus system that the dental mills have established in other states now wouldn’t it?
HB 2301 would also add 448-B to read as follows:
No person licensed pursuant to this chapter shall engage in the practice of dentistry in a commercial or mercantile establishment, or advertise, either in person or through any commercial or mercantile establishment, that the person is a licensed practitioner and is practicing or will practice dentistry in a commercial or mercantile establishment.

This section shall not prohibit the rendering of professional services to the officers and employees of any person, firm, or corporation by a dentist, whether or not the compensation for the service is paid by the officers and employees, or by the employer, or jointly by all or any of them. For the purposes of this section, the term "commercial or mercantile establishment" means a business enterprise engaged in the selling of commodities or services unrelated to the practice of dentistry or other healing arts.

I think this is a great beginning to an end of the dental mills and I would suggest everyone who reads this and its language to get with their state law makers and get something like this or close to it passed in their respective states.
One thing that is not addressed in this bill is the use of papoose boards. I understand people think the Dental Board would regulate this since the ADA and the AAPD have "guidelines" however leaving things like this to "Boards" of dentists' own peers simply isn't working.
I’ve already started that quest in my state and I can’t urge my many loyal readers enough to do it in your own.

update 3-2010:
I've written to Rep. Caldwell, who at present is running for Mayor of Honolulu to see what happened to his bill.

I did find this:

HB 2301 HD1, Relating To Dentistry
Majority Leader Kirk Caldwell's bill to prohibit "interference in the practice of dentistry by an unlicensed person or entity" and prohibit "the practice of dentistry in a commercial or mercantile establishment" was characterized on the Floor by Rep. Gene Ward as "the anti-Wal Mart, anti-Big Box bill" who went on to say that it was a premature, misplaced constraint of trade. The bill passed, with Rep. Ward as the only no vote.

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