ADA President and Broken Promises

The Future President

By Darrell K. Puritt; DDS

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The election for a future ADA president occurs the first week in October in Hawaii at the 2009 annual meeting. A couple of days ago, the ADA News Online posted the ADA President-elect candidates’ statements.

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3133

All three sound like they support meaningful dialogue with membership: Candidate Dr. Raymond Gist says one of his goals is: “To protect and preserve ownership of the intellectual property of the ADA while demonstrating transparency and fostering an understanding of how our system works.” Candidate Dr. William Glecos says “My first goal will be to coordinate and improve our communication efforts within the ADA. To make sure we are engaging all our members and imparting a sense of connection and transparency.” Candidate Dr. Marie Schweinebraten says “… communication, internal and external, must be improved to respond in today’s world … barriers must be eliminated to allow member input and volunteer involvement when solving specific issues.” I’ve seen candidates use these same buzzwords before, but not mean them. Dentistry is being severely threatened right now, and I’m too young to retire. So I want to see a future leader confident enough to walk through fire with me on behalf of my patients.

Promises from ADA President-elect candidates have been very disappointing so far. Past President Dr. Mark Feldman, President Dr. John Findley and President-elect Dr. Ron Tankersley each promised “transparency.” Feldman and Findley broke their promises very early, and so far, Tankersley has done no better. Nine months ago I invited Dr. Tankersley to a conversation about the future of electronic dental records and he chose to insult me with silence rather than respond. I took it personally, Ron, and I’ll never forget it. Because all three of these presidents are simply rude people, it wouldn’t bother me to never ask any of them for friendship. 

So do you think our fresh leaders are any more sincere about transparency with membership? Or are they also hoping to be safely elected. This could be an opportunity for one or more of the three to break loose and be counted as a brave leader… or not. Let me show you what Feldman, Findley and Tankersley have gotten us into. Below is a list of duties expected of dentists with NPI numbers that came out today on ANCO Online. If any of you three candidates have the courage to respond to my challenging comments about what I consider to be a perfect example of a renegade department, jump right in. Concerned members need to be warned about the courage we can count on. If you cannot defend the Department of Dental Informatics, just say so. We’ll all be better off. And on truth, we can build. What an opportunity for you! I bet one could easily gain the delegates’ attention by doing the right thing, even if it is unpopular at first to those who may have helped you to power.

Responding to this article in a respectful, professional way could be just what it takes to get a person elected to the highest position in the American Dental Association. That’s what you intensely want, isn’t it? You just have to recognize what I am spelling out for you, Raymond, William and Marie. Just look at the growing discontent with the ADA on the Internet. Whoever is the first to show sincerity and courage, will become a hero to those of us who feel betrayed by those we once trusted. Victory will never be easier. I’ve had a look around. Believe me when I tell you that things are soo bad that even I could be a contender. Don’t make me run for the job.

Here is the first issue for discussion if you are interested: For dentists who were persuaded by the ADA Department of Dental Informatics to quickly volunteer for the 10 digit identifying number, let me ask you this: If you had been told what ADA employees are paid to tell you, which you can read below, would you have applied for an NPI number? And if you were forced to apply for a number by a managed care contract with BCBSTX, Delta Dental or other discount dentistry broker, would that be considered an unfair business practice?

Let’s look at fairness: Who does the NPI number help? Dental patients or BCBSTX? Or perhaps the ADA? We were told again and again in ADA News Online articles written by Arlene Furlong that the best reason for the NPI number was convenience. She said office managers would love it because it would replace numerous identification numbers. When one reads the list of NPI obligations a dentist volunteers their office manager for, all those other numbers don’t seem so bad after all. Why was HIPAA so important that the ADA Department of Dental Informatics forced employees under its supervision to intentionally mislead membership? Does the ADA work for dentists and their patients or for CMS? There you go, Dr. Raymond Gist, Dr. William Glecos and Dr. Marie Schweinebraten. It’s your turn now. If you have the guts to step up to a challenge, it could pay off big. Besides, even if you get elected without first responding to my concerns doesn’t mean you’ll get rid of me. Oh heaven’s no.

D. Kellus Pruitt; DDS

http://anco- .blogspot.com/2009/08/asco-coa-cms-palmettoj1mac-news.html

**** CMS NEWS ****

This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners: · Secure and maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes. Health care providers should maintain the confidentiality of their User ID, password, and Secret Question/Answer in order to protect their NPPES information from unauthorized access. Reset their NPPES passwords at least once a year.

See the NPPES Application Help page at https://nppes.cms.hhs.gov/NPPES/Help.do and select the ‘Reset Password Page’ for applicable rules. Those rules indicate the length, format, content and requirements of NPPES passwords. Review their NPPES records in order to ensure that the information reflects current and correct information. Covered health care providers are required to update their NPPES information within 30 days of the effective date of the change.

Viewing NPPES Information Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways: (1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID. OR (2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.

The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion. Information regarding NPPES data that are FOIA-disclosable can be found at http://www.cms.hhs.gov/NationalProvIdentStand/ by selecting ‘Data Dissemination’. Please note: Business Mailing Address and Business Practice location information (full address and corresponding telephone numbers) are key data elements that are FOIA-disclosable.

Health care providers should not report their residential address unless it is their Business Mailing Address or Business Practice location. The NPPES data appearing on the NPI Registry cannot be deleted; however, it can be updated or changed. Updating NPPES Information Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Deactivating the NPI Health care providers, including physicians and non-physician practitioners, can deactivate their NPIs if the NPIs are no longer required or needed. Reasons for deactivation include retirement, business dissolved, or death of the health care provider. A request for deactivation must be submitted via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Health care providers should review the instructions located on the application regarding deactivations in order to properly complete the deactivation request. The Power of Attorney or Executor of the Will may complete the application for deactivation due to death of the health care provider.

Need More Information?

Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Visit CMS’ dedicated NPI web page at www.cms.hhs.gov/NationalProvIdentStand for additional NPI information.

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On Ingenix and Delta Dental

Or, Birds of a Feather; etc. etc

By Darrell K. Pruitt; DDS

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Introduction

Just a quick note while I’m working on other material. As anyone can see from reading Rabia Mughal’s DrBicuspid article, “Dentists or patients: Who should get the insurance check?” Delta Dental is simply a sleazy company that dentists should shun to protect their patients’ welfare.

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301436&wf=34

It is unethical to sign a contract with Delta Dental, and I will help Delta show you why. Here is a sample of Delta sleaze I intend to present:

Arlene Furlong on Delta Dental

On September 17, 2008, Arlene Furlong posted an article about Delta Dental on ADA News Online titled “Delta caps rates nationally for two networks.”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3218

Furlong writes:

“A contract provision that holds dentists to Delta’s maximum allowed fee for non-covered services will affect all of Delta’s Premier and Preferred Provider Organization participating dentists throughout the country by January 2011.″.

The Upshot 

This means that if a Delta preferred provider wishes to make up for the profit lost from providing Delta customers 25% discounts on dentistry, which works out to over half the dentist’s pay after expenses are deducted, doing more cosmetic dentistry will no longer help keep the doors open.  Delta, like a sleazy dentistry broker, is telling its providers that it will demand discounts on everything for its customers. Think about it. It is beyond unfair business practice. It is tyranny.

Invading the Dental Homes 

And now, Mughal tells us that Delta Dental intends to break up dental homes – where patients enjoy the benefits of continuity of care from dentists they prefer.  Why does Delta harm their clients like that? 

Ari Adler, the communications administrator at Delta Dental of Indiana says it is a matter of dentists stealing something from the network:

“Direct reimbursement to out-of-network dentists is a problem because it allows them to enjoy the benefits provided by the network without following cost guidelines and quality control measures of the network”, [Adler] added.

Quality control; you mean like UnitedHealthcare’s Ingenix? 

When one thinks about it, since dentists will only be paid half of what they are paid today, no matter what they do for dental patients, quality control could indeed become a new issue, just like the appearance of black-market dentistry. 

My Beat 

I will be covering quality control by dental consultants soon. Did you know that they have their own national organization? It is called the American Association of Dental Consultants (AADC). I bet you didn’t know this: Less than a year ago, Dr. Gordon Christiansen as well as Dr. John Luther, Senior Vice-President of the ADA, spoke at their annual convention in Scottsdale, Arizona. Delta Dental was Dr. John Luther’s employer before he came to work for the ADA. Hmm, I wonder?

Wait, there’s more:  the AADC’s largest sustaining sponsor is UnitedHealthcare Dental. http://aadc.org/site/sponsors.php

The Ingenix Scandal

Have you heard of UnitedHealthcare’s company called Ingenix?  New York Attorney General Andrew Cuomo caught Ingenix being creative with physicians’ FOIA-disclosable data for cost-control purposes (profit), and calling it quality control.  Ingenix was marketing its professional number-cooking scheme to insurers across the nation before Cuomo saw through their deceit and recently demanded Ingenix to be dissolved. 

Transparent Feudal Mechanisms 

One can see that incest probably worked well for royalty in Europe until literacy and the free-market brought transparency to their self-perpetuating feudal machinations. I will be watching for a name and email address of an appropriate Delta Dental official to contact about Delta’s sleazy business practices.  At some point in this thread (which I can keep active for years), I intend to make someone from Delta Internet-famous among dentists, just like Trajan King, CEO of Intelligent Dental Marketing. Suggestions from readers and subscribers are always appreciated.  Please, no in-laws.

Assessment 

It is time to come out and defend yourself in front of a hostile audience, you good ol’ boys from Delta Dental … or not.  Your old command-and-control tricks don’t stand a chance in a transparent marketplace, and I will show you that silence is lame defense as well. Someone on your team is trapped. Please, let’s talk sooner than later.

Conclusion

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