Tuesday, November 13, 2018

The Federal Employees Dental and Vision Insurance Program Will Replace the Tricare Retiree Dental Program Later this Year - Eligible Members MUST Sign Up

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According to the ADA News, the Tricare program will be transitioning to the Federal Employees Dental and Vision Insurance Program.  The plan will begin coverage on January 1, 2019.  Information regarding enrollment and webinars that explain the enrollment process can be found via this link.  
The important thing for those affected is that you must enroll during open season if you'd like FEDVIP dental and/or vision coverage in 2019.
Here is all the info courtesy of the American Dental Association:

Participants may begin enrolling in the federal program Nov. 12 through Dec. 10 for coverage that starts Jan. 1, 2019.

Delta Dental previously administered the program. The move from Delta Dental to a federal plan resulted from  the 2017 National Defense Authorization Act, which mandated giving military retirees access to a vision plan that was not previously available to them in Tricare.

Under the new plan, retired uniformed service members and their families who are eligible for the Tricare Retiree Dental Program will be eligible to enroll in dental coverage under the Federal Employees Dental and Vision Insurance Program. 

The federal plan will give enrollees the option of choosing from six national plans: Aetna Dental, Delta Dental, FEP BlueDental, GEHA, MetLife and United Concordia Dental, and four regional plans: Dominion Dental, EmblemHealth, Humana and Triple-S Salud. 

For dentists who receive questions from patients, Delta Dental is urging them to have patients select a FEDVIP dental plan in order to continue their dental benefits. The switch is not automatic: Patients must sign up during the open enrollment period.

Tricare is also encouraging patients to use its online comparison tool for figuring out which plan works best for them. The comparison tool can be found here. By entering specific ZIP codes, patients will receive estimates on what to expect from coverage costs.

"Many dental offices may be treating patients who are retired from the military and using the Tricare dental plan," said Dr. Steven Snyder, chair, ADA Council on Dental Benefit Programs. "Following enrollment in the Federal Employee Dental and Vision Insurance Plan, their benefits may be significantly different. Offices should have a conversation about the patients' needs and their new benefits along with explaining the office's financial policies. Experiences that offices have with the national carriers already participating in the federal plan may give them a sense of what to expect in terms of processing policies and documentation requirements for claims for these patients."

For more information, including enrollment tips and scheduled webinars on enrollment, visit the Tricare page here.


Monday, November 12, 2018

FDA alerts patients and health care professionals that some EpiPen auto-injectors may not readily slide out of carrier tube

For those of you with EpiPens in your office medical emergency kit and also for those of you with loved ones that have severe allergies, here is a recent release by the FDA.
FDA is alerting patients, caregivers and health care professionals that the labels attached to some EpiPen 0.3mg and EpiPen Jr 0.15mg auto-injectors, and the authorized generic versions, may block access to the auto-injector and prevent the ability to easily access the product.
In a letter to health care professionals from Pfizer, the manufacturer of the Mylan EpiPen, the label sticker on the auto-injector unit may have been improperly applied, causing resistance when removing it from the carrier tube. The carrier tube is the immediate package in which the auto-injector is contained. In some cases, the patient or caregiver may not be able to quickly remove the epinephrine auto-injector from the carrier tube.
The auto-injector device and the epinephrine it delivers are not affected by this issue and can be used as prescribed. It is vital for lifesaving products to work as designed in an emergency situation, and patients and caregivers should inspect their epinephrine auto-injector prior to needing it to ensure they can quickly access the product.
The letter also describes how to inspect potentially affected products and explains that patients should contact Mylan Customer Relations at 800-796-9526 if an auto-injector does not slide out easily from the carrier tube ORthe label is not fully adhered to the auto-injector. Pharmacists should inspect the products before dispensing them to patients to ensure quick access to the auto-injector and should not dispense any product which does not easily slide out of its carrier tube.   
FDA is not aware of any adverse event reports associated with improperly applied EpiPen or EpiPen Jr auto-injectors, or their authorized generics label. As stated on the product label, consumers should always seek emergency medical help right away after using their epinephrine auto-injector.

Thursday, November 8, 2018

Learn About Orthodontics and Obstructive Sleep Apnea in Las Vegas March 2019

We are at an exciting time in dentistry.  The problems related to OSA (Obstructive Sleep Apnea) are becoming more well known and better understood.  
I find it fascinating that as knowledge of any subject increases, we often find out that treatments that were considered “scientific breakthroughs” and “state of the art” can sometimes be realized to create new problems or actually make some situations worse.  During the late 1800s morphine addiction was a serious problem and some well respected scientific minds favored treated those addicted to morphine with cocaine.  Obviously this didn’t work out too well, but it was a popular idea for a few years.  Medical history is full of examples like this.
There have also been some similar situations in orthodontics over the years.  Even into the early 80s, it was very common to do what is referred to as “4 bicuspid extraction”.  This was a treatment where, to decrease crowding, 4 permanent teeth (usually first bicuspids) were extracted to create room and then the anterior teeth were moved backward to fill the space.  This made straightening the teeth pretty easy, but at the time no one seemed to consider the option of keeping all the teeth moving the anterior teeth forward to increase arch length.
The other option was to use “headgear” which is an extra oral appliance that attached to the molars and had an elastic strap that went behind the patient’s neck.  This moved the molars in a posterior direction, creating space in front of them.
What we have learned since then, is that all of this “distalization” actually caused the airway to become more constricted.  When you think about it logically, it makes sense.  You have a finite space in the patient and as you move things backward, the tube that is the airway becomes pushed back and compresses against the spine.  This causes the airway to become more narrow which decreases the volume of air that can pass through it.  Think of this in terms of breathing through a drinking straw.  A straw with a large diameter is easy to breath through, but a very narrow straw makes it very difficult.
To the rescue comes Dr. William Hang.  Here is his bio:

A traditionally trained orthodontist, early in his career Dr Hang saw serious limitations in esthetics and function with the orthodontics he had been taught. Having rejected retraction - in all of its obvious and not so obvious forms - he learned and developed innovative techniques to protect and enhance the airway while enhancing esthetics and function.

Patients from more than 25 states and several foreign countries have come to Dr. Hang for non-retractive orthodontics &/or resolution of their E.R.R.S.™ (Extraction Retraction Regret Syndrome™). In his presentation Dr. Hang will outline these nonretractive techniques as well as give a step-by-step protocol to reopen extraction spaces which often eliminates symptoms such as TMJ pain, facial pain, sunken lips, and SDB/OSA.


Dr. Hang has spoken on orthodontics, facial esthetics and airway locally, nationally, and internationally. He was awarded the AAPMD Lifetime Achievement Award in 2016 for his contribution to the field of airway orthodontics.

Dr. Hang is presenting a seminar on methods and treatment that can provide great aesthetic results while also protecting or opening the airway.  

The seminar is being held at the Aria Hotel in Las Vegas on march 22-23, 2019.

If you are interested in attending, here is a link to the website.  





Wednesday, November 7, 2018

What NFL Retirees Need to Know About Sleep Apnea and the Concussion Settlement

As a board member of the Foundation for Airway Health, helping patients sleep better and not suffer with sleep apnea has become a passion of mine.  Recently I was approached by the Advocacy for Fairness in Sports.  This is a group that provides lots of information to former players regarding the NFL concussion lawsuit and settlement.  The NFL is a multi-billion dollar business run by multi-billionaire owners who are fighting with everything they have to prevent having to pay for the poor health suffered by former players to do the physical trauma they endured while playing.
The latest tactic NFL lawyers are using is to claim that players who suffer from sleep apnea are experiencing mental problems not due to all the head trauma they endured while playing, but because they are not wearing their CPAP devices.  The science behind this is dicey at best, but that doesn’t mean a lawyer cannot argue it.
So… the group asked if I could write an explanation to help players be able to verify their proper CPAP usage.  Here’s what they published:
Word has it that current NFL strategies to disqualify players from the concussion settlement can involve blaming the symptoms and effects of Obstructive Sleep Apnea (OSA). The NFL seems to be approaching this from the perspective of saying that OSA can mimic the same symptoms and problems of repeated concussive head trauma.

The best way for this to be dealt with is to use a CPAP that tracks usage and then sends it to a secure website that is run by the manufacturer.

While manufacturers and devices vary in the amount of data they can create, at a minimum tracking the amount of time the CPAP is used is crucial.  Some machines will track pressure, mask fit, AHI, and time worn, among other statistics.

Some CPAPs will store usage data in the machine itself, while others can connect to the user’s phone via Bluetooth.  While both of these options are better than no tracking data at all, I feel that using an impartial storage system from the manufacturer will help head off potential arguments that data could have been altered.

CPAP units such as the Philips Respironics Dreamstation connect to the manufacturer via a built in cellular transmitter and send the data directly to the Philips servers.  This data can be accessed by your doctor and, if authorized, your insurer.

This uploaded data allows your doctor to review your nightly statistics to better understand your condition.  Reviewing the data can allow the doctor to make changes to the CPAP to better treat your condition and help you get more restful sleep.

Your health insurance company may request access to this data to prove that you are using the machine as instructed and therefore help you pay for your CPAP supplies.

Obviously with doctors and insurers relying on this data, this aids in verification that you are using your device as prescribed which should proved that OSA is not the cause of your problems.

As an aside to this if, despite CPAP usage your numbers show you are still being deprived of oxygen while you sleep, you should consult a dentist who treats sleep apnea.  Often mouthpieces can be created and worn while you sleep to correct airway problems.  Some patients wear only these specialized mouthpieces without a CPAP while more difficult cases require a mouthpiece and a CPAP.

If you have questions about your CPAP and recording data, ask your doctor or check the company’s website.  It’s important for these records to be kept to help protect you.

Editor’s Note: Special thanks to Dr. Flucke for providing this valuable information to instruct players with sleep apnea as how to best preserved their rights in the NFL Concussion Settlement, as the NFL has been questioning dementia diagnoses of players with this condition and blaming impaired memory and function on the sleep apnea as opposed to concussive hits in football play. Some players have been required to provide proof of using a CPAP and Dr. Flucke has provided great instruction in this regard.  You can follow him on Twitter @jflucke .

Tuesday, November 6, 2018

Don’t Be A Statistic - Courtesy of Delta Dental

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After my Delta post last week, I thought I’d post this in the interest of fair play, I thought I’d post a nice guest column that appeared on the Delta Dental of Missouri website that discusses basic cybersecurity.
The author is Tom Terronez, who is the CEO of Medix Dental.  Here is his guest column:

Every day, my company helps practices overcome IT nightmares they never before anticipated. Dental professionals are extremely busy, and often can’t find the time to prioritize and implement preventive measures that keep their business and patients safe. Hackers are having a hay-day right now, and your office’s network filled with sensitive information is a goldmine. This keeps a dental technology company like ours quite busy, as we assist with everything from standard tech issues to the prevention of critical problems. This includes protecting networks from breaches, proactively fighting malicious malware, and mitigating devastating data loss.

If you don’t currently work with a trustworthy dental IT partner, a cybersecurity assessment is a great place to start. A good assessment helps you identify needed protections for your practice and serves as a helpful road map to security. If you do have an IT partner, a trusted third-party assessment is a great way to see if you are being protected as strongly as you assume. In either case, it’s important to know where exactly where your practice’s security stands.

Delta Dental of Missouri has agreed to allow us to introduce a special value-add offering to preferred providers like you. You may request your complimentary cybersecurity assessment at medixdental.com/DDMO1. Your assessment results are 100% confidential, and will not be shared with Delta Dental. Your practice will receive a comprehensive report detailing vulnerabilities found in your practice, prioritized by importance. You may resolve the issues with your current IT provider, otherwise we will be happy to provide guidance. The assessment takes about one hour and does not interfere with practice operations.

Medix Dental is a Midwest-based dental technology integration and support provider. Since founding in 2003, we’ve partnered with dental practices all over the nation to manage their IT as well as advise strategically on practice technology decisions and security. By becoming an extension of their clients’ practices, Medix Dental is able to minimize technology issues, increase practice profitability, and improve practice contentment. We look forward to helping your practice become more secure and efficient than ever before.

If you’d like to see the article as it originally appeared.  Here is the link.  

Monday, November 5, 2018

Help in Avoiding Phishing Scams

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We live in a time where security needs to be at the forefront of everything we do before we click or tap a screen.  You could easily be giving away access to your phone, your tablet, your computer, or God forbid your corporate network.  It’s a very easy mistake to make and happens all the time.  All of the recent data break-ins that I’ve researched recently have started with a phishing attack like the one shown above.
The concept behind phishing is pretty simple.  Send someone an email and convince them to click on a link that downloads malicious code to the device.  Usually the email comes from what appears to be a “trusted source” such as a friend, co-worker, or as in the case above a credit card company.  These emails also frequently utilize some psychology that is referred to as “impending doom” to get you to act.  This impending doom in the example above is “avoid temporary block of your card”.  Many folks see this and panic thinking they are about to have their card shut off.  In that temporary moment of fear, they panic and, not thinking rationally, click the link… and that is all that it takes.  The link unleashes nefarious software that then takes control.  Of course the user is never aware of this.  The device/computer continues to function perfectly in a normal fashion.  However, in the background, the device begins to leak information like the proverbial sieve.
If this is a personal device, everything you do, type, every website you visit, EVERYTHING is sent to a bad guy somewhere who can then begin draining bank accounts, sending SPAM with your device, access and attempt to phish your contacts.  They can also control your camera and your microphone to use your device as a way to spy on you personally.
The only thing worse may be having this happen at work and the only reason that’s worse is that it may get you reprimanded and best and terminated at worst.  That’s because all of the above and more can be stolen from your employer’s network.  Hackers will soon gain administrative logins and then begin to steal or delete data.  They may also trigger a Ransomware attack that encrypts essential hard drives and then demands a payment to send you the unlock code… if they ever send it.
Ransomeware is becoming a much bigger threat every day.  I personally know of several people who have fallen victims to it.
So how do you avoid these types of scams?
The number thing to do is t be vigilant!!!  Cyber criminals count on either frightening us into action or lulling us into a false sense of security, either of which can then get us to act against our own self interests.  The above screen shot is a great example.  It appears come from a trusted source that you depend on and also uses the fear of having your account inactivated.
Some good advice for these situations is, first of all, stay calm.  No matter how great the impending doom, the delay of a few minutes won’t really make it any worse.  So stop, take a couple of deep breaths, and then re-read the notice.
By looking at the notice calmly and with a clear head, you may notice things out of the ordinary such as misspellings, mistakes in grammar, or incorrect use of a word which is a homonym for another.  There and their are classic examples.
Also check the *actual* email address my hovering over it.  In the example listed above, the sender was “American Express” but the actual address was some gibberish account.  The one you see when you hover, is the real address that your email will be sent to.
Also check with the company itself.  AmEx has a huge section on their website related to security.  I have even forwarded copies of emails to the fraud protection department of companies to find our if they are legit or not.  Amazingly, every one of them I have sent has been a fake.  If it is from a friend, text or call them and make darn sure they sent you the questionable email.  A few minutes of checking can save you inordinate amounts of time and grief trying to “undo” a security breach.
Also do some research on phishing scams.  There are many good websites out there with great advice and info.
Remember, preparing for an emergency is the best way to prevent one!

Thursday, November 1, 2018

Delta Dental of California Announces Departure of Chief Executive Officer Tony Barth - Due to "Consensual Relationship"

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Well, well, well it seems that those of us practicing dentistry are not the only ones being *ahem* taken advantage of by Delta Dental (BTW you have no idea how difficult it was not to be more blunt there).
Delta Dental of California appointed Tony Barth as CEO not quite 2 years ago (January 2016 if memory serves) and they have now announced he is being terminated… or “departing” in dental insurance speak.  The reason?  It seems, according to Delta, that Mr. Barth was "engaging in and failing to report a consensual relationship with a subordinate employee”.  
While his career has ended in shame, he won’t be living out of a cardboard box.  According to the company’s Form 990 for the fiscal year of 2016,  Barth managed to eke out a subsistence living on a mere $8.2 million that year.  That’s a pretty good draw FOR A NON-PROFIT CORPORATION.  Sorry for the all caps, but Delta is notorious for being stingy with doctors, while they seem to have no problem paying Mr. Barth the equivalent of a good MLB middle reliever.
Here is the official press release from Delta Dental California announcing the termination:

Delta Dental of California and affiliates announced today that the Board of Directors has terminated the employment of Chief Executive Officer Tony Barth, effective immediately, for reasons relating to his engaging in and failing to report a consensual relationship with a subordinate employee.

Lynn Franzoi, Chair of the Board of Directors of Delta Dental of California, said, “Delta Dental’s culture is based on a strong set of ethics and values, including trust, service, excellence and innovation. As one of the nation’s largest dental benefits providers, these values are vital to our culture, guide how we operate and treat one another, and are essential to our future success.”

The Board of Directors is taking several steps to ensure strong leadership and continuity during this transition. The Board has formed an Office of the CEO and appointed Chief Financial Officer Mike Castro as acting CEO to lead the Company. Mr. Castro will be supported by Steven McCann, a member of the Board of Directors, who will serve as Special Advisor to the CEO, and Chief Human Resources Officer Sarah Chavarria. The Office of the CEO will report to the Board and have oversight over all operations of the company throughout the transition.

The Board intends to launch a formal search process to identify a permanent CEO. It has also appointed Senior Vice President of Finance Alicia Weber as acting CFO while Mr. Castro serves as acting CEO.

Mr. McCann said, “Mike has been a widely respected leader at this company for almost two decades and he has the full confidence and support of Delta Dental’s Board. With a strong acting CEO and talented senior leadership team, we expect a seamless transition.”

Mr. Castro said, “I thank the members of our board for placing their trust in me and look forward to leading the company during this transition, with the support of Steven and Sarah and the rest of our outstanding senior management team. In the meantime, it will be business as usual, and our day-to-day operations will not change. We are more committed than ever to serving the customers and enrollees who rely on us.”