Regulatory Compliance: Required Patient Notifications and Disclosures

CDA Practice Support

Adental practice is required to provide certain notifications and disclosures to patients as well as to the public. Other health professions have similar requirements.

Business License

Many cities and counties require posting a business license in a conspicuous location.

Notice of Licensure

Post the notice accessible to public view in all facilities where dental services are provided. The notice must state in 48-point type:

NOTICE Dentists are licensed and regulated by the Dental Board of California 877.729.7789 www.dbc.ca.gov

Name, License Type and Academic Degree

Comply with the requirement to notify patients of clinical staff names, licenses and academic degrees by doing each of the following:

• Clinical staff wear name tag or have license or certificate posted.

• Prominently post the name, license type and highest level of academic degree of each licensed individual or provide the information in writing in 24-point type to the patient at the initial visit.

• Prominently display the name, license type and highest level of academic degree of each licensed individual on the practice website.

Advertising Discounts

The advertisement of a discount must:

• Include the dollar amount of the nondiscounted fee for the service.

• Include either the dollar amount of the discounted fee or the percentage of the discount for the specific service.

• Inform the public of the length of time the discount will be honored.

• Include verifiable fees.

• Identify specific groups who qualify for the discount or any other terms, conditions or restrictions for qualifying for the discount.

Fees

Any fee advertised must be exact and must not use certain limiting words or phrases, for example, “as low as,” “and up” and “lowest prices.” Any advertisement that refers to services or costs for services and that uses words of comparison shall be based on verifiable data substantiating the comparison. Fee advertising should not be fraudulent, deceitful or misleading. The fee for each product or service must be clearly identifiable. The fee advertised for products must include charges for any related professional services, including dispensing and fitting services, unless the advertisement specifically and clearly indicates otherwise.

Fee advertising for a dental service must fully disclose all services customarily included by the dental profession as part of the advertised service, including but not limited to necessary diagnosis, radiographs, restorative treatment, drugs, local anesthesia or analgesia, materials, laboratory fees and postoperative care. The advertisement must also disclose any additional services that are not part of the procedure but for which the patient will be charged, together with the fees for such services. For example, an advertisement for “free teeth whitening” for new patients must mention the requirement for a dental exam and X-rays along with the cost of those services.

Refer to “Dental Practice Marketing and Advertising 101” on cda.org/practicesupport for additional information on other marketing rules and restrictions.

Informed Consent

Obtaining informed consent is required for general anesthesia and conscious sedation procedures. Obtaining informed consent for other dental procedures is not required but is standard risk management protocol. It should be documented in the patient record. Informed consent is a process and the use of a written form can be helpful to the patient’s understanding of the procedure. Forms are available on cda.org/practicesupport.

Opioid Prescription to a Minor

A dentist must discuss risks with a minor and the minor’s parent or guardian before issuing the first opioid prescription in a single course of treatment. “Consent to Prescribe Opioid to a Minor” is on cda.org/practicesupport.

Telehealth

Prior to delivery of health care via telehealth, a health care provider at the originating site must inform the patient that telehealth may be used and obtain verbal or written consent from the patient for this use. The verbal consent shall be documented in the patient’s medical record. See “Teledentistry Consent and Notice” on cda.org/ practicesupport.

Medication Dispensing

When dispensing a drug, provide the patient with a written disclosure that the patient has a choice between obtaining the prescribed drug from the dispensing prescriber or from the pharmacy of the patient’s choice.

Commercial Credit

A patient must be presented with a written treatment plan prior to the dental practice offering them a commercial credit financing product such as a credit card, line of credit or loan. The treatment plan must indicate whether a patient’s dental benefit plan or Medi-Cal coverage includes the proposed treatment, whether the dental practice takes assignment of benefits and an estimate of the patient’s share of cost. The dental practice must obtain a patient signature on a disclosure notice. For additional information, refer to “Offering Commercial Credit to Patients” on cda.org/practicesupport.

Dental Materials Fact Sheet

Provide this dental board-required fact sheet to a patient at least once prior to performing a restorative procedure and obtain an acknowledgment of receipt. The fact sheet is available on the dental board website.

Notice of Privacy Practices

A HIPAA-covered entity must provide patients with a notice that explains the entity’s responsibilities and patient rights regarding the use or disclosure of patient information and obtain patient acknowledgment of receipt of the notice. The notice also must be posted at the entity’s facility and on the entity’s website. When updating the notice, it is not required to obtain a new acknowledgment of receipt from current patients. A sample notice is on cda.org/ practicesupport.

Notice of Nondiscrimination

Dental practices that receive payments from certain types of government programs, such as Medi-Cal, Healthy Families, Medicare or electronic health records incentive (“meaningful use”), must comply with the nondiscrimination rules of the Affordable Care Act Section 1557. This notice must be posted in a facility where patients may easily see it. This notice also must be prominently posted on the dental practice website. See “Nondiscrimination Requirements Under the Affordable Care Act (Section 1557)” on cda.org/ practicesupport.

Referrals to Other Organizations

When a dentist refers a patient to an organization in which the dentist or their immediate family has a significant beneficial interest, this interest must be disclosed in writing to the patient. The dentist must advise that the patient may choose any organization for the purpose of obtaining the service ordered or requested. Such disclosure and advice also must be provided when a dentist charges, bills or otherwise solicits payment from a patient on behalf of an organization in which the dentist or their immediate family has a significant beneficial interest. The disclosure requirement can be met by posting a conspicuous sign or by providing the patient with a written statement.

Radiation

In areas where X-ray machines are operated, post a sign or signs that state:

CAUTION X-RAY

Proposition 65

Businesses with nine or more employees must provide “clear and reasonable warning” prior to exposing any person to a chemical on the Proposition 65 list. Several chemicals used in dentistry, for example mercury, nitrous oxide and chloroform, are on the list. Refer to “Proposition 65 FAQ” on cda.org/ practicesupport for more information and to download the required warning notices.

Regulatory Compliance appears monthly and features resources about laws that impact dental practices. Visit cda.org/ practicesupport for more than 600 practice support resources, including practice management, employment practices, dental benefit plans and regulatory compliance.