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ADA House eyes survey reportage, dental care and benefit issues, policy language

San Antonio—The following are among dental benefits, practice, science and health resolutions the 2008 House of Delegates adopted during the ADA annual session in October.

Resolution 1H-2008 amends language in the ADA policy on Authority for Code Revision by deleting the word "all" in the second resolving clause and adding "In accordance with a process that reflects applicable legal and regulatory requirements (e.g., the Health Insurance Portability and Accountability Act of 1996)." The clause reads as follows:

The Council on Dental Benefit Programs, with the approval of the Board of Trustees, has the authority to effect changes to the Code in consultation with national dental organizations and the dental benefits industry in accordance with a process that reflects applicable legal and regulatory requirements (e.g., the Health Insurance Portability and Accountability Act of 1996).

Res. 3H-2008 amends language in the ADA policy on Standards for Dental Benefit Plans paragraph 11, by deleting the words " 'Attending Dentist's Statement' (claim form)" and adding the words "ADA Dental Claim Form" so that the amended paragraph reads as follows:

Procedures for claims processing should be efficient and reimbursement should be prompt. The third-party payer should use or accept the American Dental Association's "ADA Dental Claim Form and the Code on Dental Procedures and Nomenclature" that the Council on Dental Benefit Programs has approved after appropriate consultation with representatives of nationally recognized dental benefit organizations and the ADA-recognized dental specialty organizations.

In Res. 34H-2008, the House of Delegates resolves that the ADA shall explore the development of a Dental Quality Alliance in the oral health care delivery system. A Dental Quality Alliance is an organized group of stakeholders involved in the dental care system that serves as a forum for discussing ways to improve the quality of dental care that is provided.

The resolution calls for the Board of Trustees, in consultation with the appropriate ADA agencies, to obtain additional and sufficient information to determine if participation should be pursued by the ADA and report to the 2009 House of Delegates.

Res. 55H-2008 directs the ADA Survey Center to make appropriate efforts to incorporate "total salaries, wages, commissions and bonuses of shareholder dentists" as dental practice overhead expenses in reporting expenses as a percent of gross billings for incorporated practices in all Survey Center publications, as appropriate, according to established reporting standards.

The resolution also directs the ADA Survey Center to clearly identify in titles and text when "total salaries, wages, commissions and bonuses of shareholder dentists" are not included in dental practice overhead expenses for unincorporated practices in ADA Survey Center publications in instances where established reporting standards do not permit the inclusion of this category of expense in dental practice overhead.

The changes are called for implementation in ADA Survey Center publications released in 2009.

Res. 61H-2008 calls on the ADA to work with government agencies and dental carriers to enact coordination of benefit laws requiring that when a premium is paid and a claim submitted, that each benefit plan will pay the same amount they would allow if no other coverage was applicable up to 100 percent of the total claim. The House also directs the ADA to encourage states to enact similar laws and the ADA to use its staff and resources to assist states in this process.

Res. 80H-2008 directs all appropriate ADA Survey Center results to be published in the members-only section of the ADA Web site and that there be no cost associated with this information for ADA members.