Practice Support

Embarking on opening a new dental practice? Our comprehensive checklist and resources are designed to assist dentists in addressing common challenges when establishing new practices. For more detailed information and personalized guidance, please reach out to the NYSDA at 800-251-2100 to speak directly with a knowledgeable NYSDA staff member.

New Practice Checklist

NYSDA and the American Dental Association's Contract Analysis Service provides a free legal analysis of managed care contracts. Learn More >>

NYSDA is committed to aiding our colleagues in addressing substance abuse, addiction, and related mental health disorders. Our Committee on Substance Use Disorder and Well-Being provides a statewide network of dentist-peers who are available to assist members, their families, and the dental office staff in a confidential and caring manner. Learn More >>

The NYS Dental Association is working diligently to find solutions to address the workforce crisis in dentistry. Below, please find resources to assist you as we highlight strategies to improve staff retention, assist in your understanding of the future of dental workforce and education, and share our Workforce Development Action Plan. >>> Learn More

Knowing the top risk factors, providing oral cancer examinations and educating parents on the benefits of the HPV vaccine can be vital in early detection and prevention. Learn More >>

Although the American Dental Association (ADA) has updated its recommendations for radiation shielding, New York State law requires the use of lead radiation shielding for patients. This has not changed and is not subject to ADA recommendations. The New York State law is quoted below.

New York State Education Law:

§ 6611. Special provisions.

7.  Any dentist or dental hygienist, who in the performance of dental services, x-rays the mouth or teeth of a patient shall during the performance of such x-rays shield the torso and thyroid area of such patient including but not limited to the gonads and other reproductive organs with a lead apron thyroid collar, or other similar protective garment or device. Notwithstanding the provisions of this subdivision, if in the dentist's professional judgment the use of a thyroid collar would be inappropriate under the circumstances, because of the nature of the patient, the type of x-ray being taken, or other factors, the dentist or dental hygienist need not shield the thyroid area.

A funding assistance program is available to dentists impacted by the cyberattack on Change Healthcare. The Feb. 21 attack is preventing many dentists from sending electronic claims and attachments to insurance companies to receive payment. Change Healthcare, owned by UnitedHealth Group, is one of the largest health care technology companies in the U.S.
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New York State requires all prescriptions to be issued electronically for both controlled and non-controlled drugs. When prescribing controlled drugs, doctors must first query the NYS Department of Health's Prescription Monitoring Program (PMP). Learn More >>

NYSDA can help to resolve problems you may be having with your patients' dental benefit plans. Please complete the information below and a member of NYSDA's staff will contact you. Include any supporting documentation you may have (i.e., EOBs, correspondence, etc.). Be sure to redact patient identifying information. Learn More >>

Patients present with a variety of dental insurance benefit plans, including self-funded benefits, Medicaid,  Medicare Advantage plans, and No-Fault or Workers' Compensation insurance. NYSDA can help your practice navigate this complex system. Learn More >>

Medicare is a federal health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease. Learn More >>

Submission guidance for claims with third party liability (Medicare or other insurance). Learn more >>

When treating a patient injured on the job (Workers' Compensation) or in a motor vehicle accident (No-Fault), dentists must abide by the rules and regulations of the NYS Workers' Compensation Board or the NYS Department of Financial Services, respectively. Dental claims are billed to the patient's Workers' Compensation or No-Fault insurance carrier. For both of these programs, dentists cannot collect fees in excess of those allowed by the NYS Workers' Compensation Dental Fee Schedule. Both Workers' Compensation and No-Fault share the same fee schedule.

Dentists are not compelled to treat patients injured in these types of accidents; however once they agree to do so, they are required to accept the fees established by the carrier as payment in full. The treating dentist cannot balance bill the patient for any difference between the NYS Workers' Compensation Dental Fee Schedule and the usual office charge for the same treatment procedures. Patients cannot establish “private pay” arrangements with their dentists. If a dentist chooses not to accept the Dental Fee Schedule, the patient's only option is to obtain care from a doctor who will.

As part of an initial examination, dentists should question patients about the source of any apparent injuries and document the source of the injuries in the patient record. Not knowing whether an injury occurred in the workplace or involved a motor vehicle accident does not exempt the doctor from Workers' Compensation or No-Fault program requirements.

Resources:

Workers' Compensation Overview, Fee Schedule, FAQs
Workers' Compensation On Board Claims System
No-Fault FAQs
Workers' Compensation Dental Claim Submissions

The NYSDA Legal Protection Plan is designed to protect your career investment by providing legal coverage in exchange for a payment for potential claims, proceedings and/or investigations. It is not insurance or an insurance plan. It provides The plan safeguards your practice and protects you from the financial and emotional devastation of unexpected encounters with federal and state regulatory agencies, insurance companies, managed care plans, and the Office of Professional Discipline.

Stay Protected

The New York State Dental Association offers a panel of attorneys and law firms to whom NYSDA members can go for legal advice on dental matters including: Office of Professional Discipline (OPD) cases; Managed care plan and dental insurance contract analysis; Medicaid; Dental practice formation and practice sales and employment matters; and Commercial litigation and collections. Learn more.

NYSDA has created model forms for dental offices to use on a variety of critical topics like HIPAA compliance, patient consent, terminating the doctor/patient relationship, and other commonly encountered issues.  The forms can and should be modified where necessary to adapt to the specific needs of your dental office.  They provide a basic framework for handling matters that frequently arise in a dental office in accordance with legal and sound risk management principles.

Sample Forms

Sample Letters

Letter to Terminate a Patient (PDF)
Notice of Jury Duty (PDF)
Letters to Patients: Practice closure, retirement, and patient records. (PDF)

Documents

New York State Dental Association members demonstrate their commitment to quality care through our Peer Review and Quality Assurance Program.

Peer Review provides a confidential, impartial and timely way to resolve complaints about the appropriateness and quality of dental treatment provided by NYSDA-member dentists. Participation in this alternative dispute resolution process is a membership requirement.

Peer Review resolves patient complaints confidentially. Neither the process nor its outcome is reported to any outside agency – or the public. Peer Reviews are resolved by a committee of impartial professional peers. Peer Review resolutions are final. Peer Review findings have been upheld by the court, providing the doctor with immunity from subsequent litigation.

A Guide to Peer Review outlines the process a Peer Review case undergoes on its way to resolution.
The Peer Review Manual: PR Manual 2017 -- is the official rules document for the Peer Review process.

Peer Review provides:

• An alternative to resolve complaints about dental treatment;
• An objective evaluation of treatment by a committee of impartial professional peers;
• Confidentiality;
• A refund of fees to the patient when treatment is not consistent with the standard of care.

To be eligible for Peer Review:

• Treatment must be provided by a NYSDA member dentist; 
• Treatment must have been completed within 2 ½ years prior to submission of the Agreement to Submit to Peer Review;  
• Dispute cannot have been submitted to or resolved by an alternative mechanism; i.e., collection action, legal proceeding, OPD, etc.

Benefits to NYSDA Members 

• Process is confidential. There is no reporting to any outside entity, i.e., OPD, National Practitioner Data Bank, the public, etc;
• Process is definitive and final. Parties cannot sue subsequent to a Peer Review decision. The process has been upheld repeatedly by the courts;
• Treatment is evaluated by your professional peers;
• When treatment is found to be acceptable, the doctor receives the fees owed by the patient.

Peer Review Training Video's

Please click here to watch the peer review training videos. 

The mandated 2023 Sexual Harassment Training is now available. To complete the training:

1. Watch the 2023 Sexual Harassment Prevention Training Video
2. Complete the Sexual Harassment Assessment Form
3. Dentists should keep the form for their employees on file

Sexual Harassment Assessment Form: New York State Sexual Harassment Prevention Training Assessment Form (ny.gov)

Model Sexual Harassment Prevention Policy: Sexual Harassment Prevention Model Policy

Model Sexual Harassment Complaint Form:  Sexual Harassment Model Complaint Form

The term "sexual harassment" refers to unwelcome or unwanted sexual advances, requests for sexual favors, and other conduct of a sexual nature directed at an individual whose submission to, or rejection of this conduct is used explicitly or implicitly as a factor in decisions affecting his/her hiring, evaluation, promotion or other aspects of employment. It also encompasses conduct that substantially interferes with a person's employment or creates a hostile, intimidating or offensive work environment.

According to regulations issued in 1980 by the Equal Employment Opportunity Commission (EEOC), two types of sexual harassment are unlawful under Title VII of the Federal Civil Rights Act (1964):

• Quid pro quo harassment, in which the supervising employee "acts in the behalf" of the employer in holding out the employer's benefits as an inducement to the employee for sexual favors

• Hostile environment harassment, which may occur absent any economic effect, and which translates into a pervasive atmosphere of discriminatorily severe or unwelcome working conditions that interfere with the individual's work performance

Examples of sexual harassment include, but are not limited to:

• Unwanted sexual demands for sexual favors in exchange for favorable treatment or continued employment
• Repeated sexual jokes, flirtations, advances or propositios
• Verbal abuse of a sexual nature
• Graphic verbal commentary about an individual's body, sexual prowess or sexual deficiencies
• Leering, whistling, touching, pinching, assault, obscene or demeaning comments or gestures
• Display in the office of sexually suggestive pictures or objects

 

Your Liability as an Employer

Under the principle of respondent superior, the courts have consistently held that the employer is strictly liable in the case of quid pro quo harassment, whether or not the employer had been aware of the employee's conduct.

In hostile environment harassment, the employer may be held liable if management level employees had been aware of the existence of a sexually hostile environment and neglected to take prompt and adequate remedial action.

 

What You Can Do to Prevent Sexual Harassment

Prevention through education is the key to avoiding liability and to overcoming sexual harassment in the dental workplace. It is incumbent upon every dentist employer to educate his/her entire staff about sexual harassment and to review the specific procedures staff should follow if they feel they are being sexually harassed. These procedures should be designed to encourage victims of harassment to come forward. Every office should have a designated investigator for sexual harassment complaints. If the dental office is large enough, two people should be appointed to investigate the alleged harassment. Included in the office policy concerning sexual harassment should be a protocol for reporting and investigating any sexual harassment complaints. The protocol should be publicized and supported by the employer(s).

 

What to Do if an Employee is Being Harassed

If one of your employees claims to be a target of sexual harassment, it is important that he/she promptly and clearly notify the designated investigators of the alleged incident. The employee should be assured that, as an employer, you take all complaints of sexual harassment seriously, and that the investigators will do their best to explore the matter expeditiously and as confidentially as possible. A separate, confidential file should be created and maintained by the investigators. Through interviews with the complainant, the alleged harasser and any available witnesses, the investigators gather the facts, evaluate the evidence, prepare a written report and, finally, decide upon an appropriate action. (c) 1995

The practice of dentistry was established as a profession with one overriding principle in mind: the benefit of the patient. This is the cornerstone of dental ethics. This philosophy is the foundation of The Principles of Ethics and Code of Professional Conduct of the New York State Dental Association. All members should make the Principles and Code an important part of the very fabric of their practices.

The 5 Promises ADA Dentists Make to Their Patients

The Dental Practice Act guide (PDF), prepared by NYSDA, is provided as a service to members of NYSDA who need a concise source of information regarding the laws and regulations that make up the body of the New York State Dental Practice Act.

It should be noted that sections of law and regulation outside of the Dental Practice Act are not included in this guide and that anyone needing additional information should contact an attorney or NYSDA. Also, it is important to remember that New York's Dental Practice Act is a "living" document which is continually subject to amendment.

New Federal requirement takes effect June 27, 2023

The Medication Access and Training Expansion (MATE) Act, passed by Congress as part of the Omnibus Bill of 2022, mandates most practitioners licensed to prescribe controlled substances, including dentists, complete eight hours of one-time training on safely prescribing controlled substances (Schedules II, III IV, and/or V) in order to receive or renew their registration with the U.S. Drug Enforcement Administration (DEA).

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Effective June 27, 2022, under certain circumstances, doctors in outpatient settings prescribing an opioid for pain management may also be required to simultaneously prescribe an opioid antagonist to the patient. This new LAW applies to the first opioid prescription to a patient each year when any one of the following conditions are known to exist:

(a) a history of substance use disorder; or

(b) high dose or cumulative prescriptions that result in ninety morphine milligram equivalents or higher per day; or

(c) concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics.

Each provider's first opioid prescription of the year to a patient is subject to this law. It does not matter if the patient already had received another opioid prescription from a different provider earlier in the year. If it is your first opioid prescription to the patient that year and one of the noted conditions exist, you must also prescribe an opioid antagonist.

Seven-Day Limit on Initial Opioid Prescriptions for Acute Pain

Since July 2016, New York State has limited the initial supply of opioids that can be prescribed for acute pain to seven days. Acute pain is defined as pain, whether resulting from disease, accidental or intentional trauma, or other cause, that the practitioner reasonably expects to last only a short period of time. This rule does not include prescribing for chronic pain. Chronic pain is defined as pain being treated as a part of cancer care, hospice or other end-of-life care, or pain being treated as part of palliative care practices.

Upon any subsequent consultations for the same pain, the practitioner may issue, in accordance with existing rules and regulations, any appropriate renewal, refill, or new prescription for an opioid.

The New York State Department of Health provides information about the requirements for opioid prescribing, treatment guidelines and education.

Prescriber Information & Requirements
Educational Resources

As of November 2022, the CDC has updated their clinical practice guideline for prescribing opioids for pain.

CDC Opioid Prescribing Guideline

On April 3, 2020, Governor Cuomo signed legislation establishing the right to paid leave for New Yorkers. New York's paid sick leave law requires employers with five or more employees or net income of more than $1 million to provide paid sick leave to employees and for employers with fewer than five employees and a net income of $1 million or less to arovide unpaid sick leave to employees. Learn more >>

New York State Paid Family Leave Law went into effect January 1, 2018. 

The New York State Paid Family Leave Law took effect on January 1, 2018.  This important law applies to all employers in New York State, including all dental practices, regardless of size or type--no exceptions, no exemptions.  It is not a law NYSDA supported, but it was a priority of the governor, which coupled with broad public support, made it a law the Legislature was destined to pass. Learn more >>

HIPAA (Health Insurance Portability and Accountability Act of 1996) mandates data privacy and security provisions for safeguarding medical information. Federal HIPAA regulations include requirements for doctors to safeguard, store and transmit electronically maintained information to protect patients’ privacy. Adherence to these requirements can help dentists avoid potential prosecution and sanctions. In addition to the requirements for the security associated with information technology and electronically maintained patient health records, both HIPAA and New York State laws include provisions for the protection of patient privacy. Learn more >>