Is ARRA Stimulus Money for Dentists?

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Now is the Time to Say “No Thank You” to the ADA

[By D. Kellus Pruitt DDS]

A few days ago on Twitter, @techguy said: “@Dentrix, Are you guys helping dentists get access to the ARRA EHR Stimulus money?” This morning I “retweeted” his question to the electronic dental record giant: “That’s a great question, @Dentrix. What are you doing to help dentists receive stimulus money?

Of Faded Promises  

Dentrix officials no longer shop faded promises of free stimulus money to help dentists purchase their software. The truth is, without taxpayer help, Dentrix’s product offers dentists no return on investment, and it’s unlikely that the profession will ever see a cent of stimulus money. In fact, if American Dental Association President Raymond Gist wants to be a national hero, now would be the time to purchase a press release to tell the nation, “American dentists graciously decline your offer of stimulus money, taxpayers. We say, let our grandchildren keep it for themselves.” The deficit-weary public is very interested in that kind of good news these days. But, the ADA’s PR opportunity has a shelf life. The sooner they jump on this minor deception the more generous American dentists will appear. A year from now, the chunk of faux-generosity won’t work.

Too Late for Cash Give-Aways 

For one thing, it’s simply too late for dentists to take part in the cash giveaway. And even if there was time for a significant number of dentists to convert from paper to digital before September 2011, to receive promised stimulus money, a dentist’s practice has to be 30% Medicaid. That qualification rules out almost all dental practices right off, and here in Texas last week, Governor Perry threatened to opt my state out of Medicaid (and stimulus money) completely. A year ago, Perry threatened secession from the Union. It sounds to me like you are softening him up, Washington.

Meaningful Use Requirements 

That’s not all. Before a dentist can qualify to be reimbursed up to $44,000 dollars, the practice must show “meaningful use” of certified electronic dental records. However, meaningful use of digital records in dentistry has not yet been determined and perhaps does not actually exist. Nevertheless, the best minds in the ADA and HHS are searching for the next best thing – humorous rationalizations. For example, imagine the convenience of the speed-dial on the telephone compared to logging on to a highly secure, password-protected, HIPAA-compliant, encrypted computer just to tell the lab you have a pick up – just to show the Department of Health and Human Services that you are making “meaningful use” of your Dentrix product and spending taxpayer money wisely.


Do you know what is scary about the leadership in my profession? I’m apparently the only dentist in the nation who dares admit that as far as ARRA stimulus money goes, American dentists are out of luck and clueless. Even @techguy is in the dark for crying out loud!


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7 Responses

  1. Under-the-radar trends in dentistry

    To follow-up on the above post, there are far more unanswered basic questions about electronic dental records than electronic medical records, and nobody is talking about them.

    For those who take an interest in what I claim are subtle signs of tomorrow’s trends in dentistry, you may recall that a couple of weeks ago, I pointed out that my long-forgotten March 16th article on this Medical Executive-Post, “Electronic Medical Records and Dentistry,” had mysteriously risen to the top dozen most popular articles on the site, which has over 250,000 readers.

    It remained there a couple of days before again disappearing. I speculated that the interest blip was caused by dentalcare HIT stakeholders in HHS and the ADA who are trying to define meaningful use of electronic health records in dentistry without sounding silly.

    Late last week, the article popped into the dozen most popular for the second time in 3 weeks and stayed popular until the weekend before again disappearing.

    Here is what we know: Something somewhere has caused a continuing increase of interest in electronic dental records. Where do you suppose the interest is coming from? Is it dentists? Or is it maybe HHS or even the FTC?

    D. Kellus Pruitt DDS


  2. Hospital Association Asks OCR to Amend or Clarify HITECH Rule on “Agents”

    The July 14th notice of proposed rulemaking issued by HHS to implement parts of the HITECH Act threw covered entities [CEs] and business associates [BAs] for a loop when it introduced the concept of subcontractors, as well as the notion of agency.

    In the proposed rule, the Office for Civil Rights (OCR) held that if a business associate or subcontractor were acting as an “agent” of the other, then the covered entity [CE] or business associate (BA) would be liable, or at least share the liability if enforcement action were ever forthcoming.

    The question of agency has emerged as a major flash point among CEs and BAs since it was introduced. Commenters on the proposed rule, including the American Hospital Association [AHA], have registered strong opposition to the concept. AHA, in fact, implored OCR to scrap or significantly amend the agency provision, or at least clarify just who is an agent and how a CE would know.

    Source: Report on Patient Privacy [11/15/10]


  3. What about Podiatrists?

    Q: Are podiatrists eligible for EHR incentives? They are trained extensively and hold qualifications for surgery, independent diagnosis and prescription privileges, including all DEA schedules.

    A: The answer probably comes down to how much each “specialized” practice can incorporate the 25 core Meaningful Use requirements into their process. Hopwever, one observer claims the HHS has essentially cut specialists out of the HITECH incentive program.

    While not quite as stark, recently released comments from the American Academy of Orthopaedic Surgeons sound similar concerns.

    As for specialists in mental health, there is currently legislation before Congress that would expand HITECH to include those providers. Current status is unknown.



  4. ARRA/HITECH – billions wasted

    Do the billions in ARRA/HITECH stimulus dollars seem wasteful to you yet? Give it time.

    In the next three years, the US government intends to spend perhaps $20 billion dollars more in subsidies to help physicians’ purchase electronic medical records that many don’t want (but will accept the stimulus money anyway). Years ago, in order to pass the ARRA healthcare legislation as a jobs bill separate from Obamacare (?), healthcare IT stakeholders promised lawmakers that EHRs will save 100,000 lives and 100 billion dollars a year. The truth is, there have been few if any saved lives and millions of Americans’ identities fumbled in data breaches. What’s more, much to everyone’s surprise, the EHRs actually increased payments to physicians. It turns out that EHR software is very good at capturing and filing claims for procedures that were previously not worth the effort to bill for. In other words, physicians are now being paid for unrecognized work they used to do for free. It’s called clicking for cash.

    A month ago, Representatives Dave Camp (R-Mich.), Fred Upton (R-Mich.), Wally Herger (R-Calif.) and Joe Pitts (R-Pa.), expressed growing disappointment to HHS Secretary Kathleen Sebelius for her lack of progress towards interoperable EHRs, and threatened to withdraw taxpayers’ investment in physicians’ software. In the weeks since, it seems as if the Republican Congressmen simply uncorked the bottle of bad news for EHRs.

    Diana Manos, Senior Editor of Healthcare IT News, recently featured patient privacy advocate Twila Brase and the Council for Health Freedom (CCHF) in an article titled, “More voices raised against EHR incentives.”

    Manos writes: “CCHR, a non-profit organization based in St. Paul, Minn., does not want electronic health records pushed forward by a federal program at all. Rather, it supports the market leading the way.” Consumerism in a competitive free-market rather than tax-supported mandates favoring vendors and insurers… What a radical idea!

    Twila Brase, the group’s president, tells Healthcare IT News, “HITECH could go away, as far as we’re concerned.”

    Manos: “Brase said CCHF applauds the lawmakers’ position, but urges them to reconsider their support for EHRs, enhanced interoperability and online access. She said private-market solutions, coupled with consent requirements and individual responsibility for private health records, would be the best approach. In addition, CCHF calls for states to implement ‘true patient privacy laws,’ as allowed under the HIPAA privacy rule.”

    Brase suggests a laissez-faire approach which respects patient privacy: “Left to its own devices, the market would fix interoperability issues on its own, while creating better protections for sensitive health data, or else patients would solve the problem themselves by carrying their private data on portable media such as DVDs or thumb drives…. The problems that the government continues to ignore are privacy and patient consent; no EHR program should move forward until every American has a guaranteed right of consent over the use and sharing of their private medical records.”

    Change is in the air.

    D. Kellus Pruitt DDS


  5. ARRA stimulus fails

    “Lawmakers look to exempt Medicare labs from e-health records.” By Ferdous Al-Faruque for The HILL, July 14, 2014, 03:35 PM EDT

    D. Kellus Pruitt DDS


  6. The Stimulus Act stimulates crime?

    “The Stimulus Act Started a Cyber Crime Wave of Medical Data Theft.” By Christopher Moraff for The Daily Beast, December 21, 2015.

    Moraff: “Thanks to the Recovery Act’s push to digitize health records, your most precious and valuable information is within the reach of most thieves. Cyber criminals are coming after your medical data and you can blame Congress for that.”

    I publicly warned Secretary of HHS Michael Leavitt about political recklessness almost a decade ago, but he obviously did not listen:

    “Careful with that electronic health record, Mr. Leavitt.” By Darrell Pruitt for WTN News, October 18, 2006.

    Pruitt: “Patient privacy is not a priority in the Bush Administration’s push for healthcare IT because its engineers are confident that the efficiency of technology will magically smooth over all the rough spots in security.” I add: “[Dentists] do not know where to turn for information about what is expected of them concerning HIPAA and EHRs, even while the technology rumbles recklessly forward, gaining ever increasing momentum.”

    Once the secret gets out about the true cost and danger of electronic dental records, it will be the patients who will demand a return to paper…

    Is it still too soon to consider de-identification of primary electronic dental records, Doc? Give it a couple of months of new, more enthusiastic HIPAA audits. That just might change your mind.

    D. Kellus Pruitt DDS


  7. Dentists,

    These dentists gave kids unnecessary root canals. Then they billed Medicaid for it, prosecutors say

    Read more here:



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