Reporting From The ADA House of Delegates 2022

The 4 ADA Delegates from Utah and the UDA officers traveled to Houston in October for the annual ADA House of Delegate’s (HOD) meeting and 14th Trustee District Caucuses. Actions of the ADA House included the following:

Strategic Forecasting Committee

A landmark and historic change to the ADA Bylaws established a Strategic Forecasting Committee (SFC) to provide ongoing ADA strategic plan review and give guidance to the Association leaders and professional staff. This 13-member committee meets 4 times per year and is composed of 8 dentist members of the ADA HOD (2 from each of 4 geographic areas), 4 ADA Trustees and a new member dentist.

This change in ADA governance is intended to facilitate a timelier response to changes in the profession – in member benefits and advocacy policy. The SFC will establish subcommittees whose focus is directed to four areas 1) Dentists, 2) The ADA Tripartite (ADA, UDA, State Dental Districts), 3) Enterprise (ADA non-dues revenue), and the 4) Professional/ Public (state and national advocacy). The subcommittees will have 4 Action Groups in each geographic region. The West Action Groups are where the UDA and individual members can now influence ADA member benefits and advocacy policy, in real time. In the past, changes to ADA member benefits, advocacy, governance and tasking ADA Councils with projects could only be done as a Resolution to the ADA House - which meets only once a year in conjunction with the ADA’s Annual Meeting (SmileCon). A change proposed by a Resolution had to be reviewed by all ADA Delegates, debated in ADA Reference Committees then voted on at the next ADA HOD resulting in either bein adopted, not adopted, or sometimes referred to an ADA Council for study and reporting back at the next year’s HOD – starting the prolonged review and voting process over again. The ADA HOD continues to maintain its governing body status, however going forward in many instances I believe it will be more as “ratifying” action rather than “proposing ” action to be taken in the future. As ADA Delegates and UDA Officers we will be making sure to move your concerns and suggestions to the West Action Groups.

Dental Plans – Third Party Payers

A Resolution passed creating “a model Explanation of Benefits (EOB) statement” which would include: “Any difference between the fee charged and the benefit paid is due to the limitations in your dental benefits contract. Please refer to your summary plan description for and explanation of the specific policy provisions which limit or exclude coverage for the claim submitted. The treatment reported on the claim by CDT codes as submitted by the dentist and the procedures have been adjudicated by …(statement of how an individual plan processes claims.” Provider rating systems by 3rd party payers: “Resolved that the Appropriate ADA agency prioritizes legislative efforts to prevent the used of flawed and misleading provider rating systems and that any third party who publishes rating systems clearly convey to the public that provider ratings are not based on quality of care, but on provider conformity to the dental plans’ design and cost containment. Additionally, that those third parties who publish provider rating systems should be transparent in the methodology, provide quarterly reports to providers, provide a mechanism for appeal and improvement of provider scores and an opt-out option from being publically rated.” 3rd Party network leasing: “Resolved, that the ADA urge that any amendments to existing third party payer contracts between a dentist and a third party payer, dental benefits administrator or a dental network leasing company require signature by the dentist, and that such amendments with any and all changes to the contract terms, policy manual and fee schedule be communicated to the dentist via certified mail with at least 90 days’

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notice prior to the date of implementation and to require the dentist’s signature to opt in. And further resolved, that when third party payers choose to establish a new network using the name, image and likeness of dentists participating in the carrier’s existing network, then dentists should be provided the opportunity to opt-in to such new networks.”

Adopted 14th Trustee District Resolutions

Each year dentist and state associations in our 14th Trustee District (AZ, CO, HI, NM, NV, UT, WY), move Resolution to the ADA HOD for consideration, some important policy and actions to be taken by the ADA. At this year’s HOD, the 14th District Resolutions which were adopted included: Paid Extended Leave: “Resolved that the appropriate ADA agency explore options to help employer dentists offer paid extended/family leave that could be purchased as a member benefit.” This resolution recognizes that some employed associate dentists need to have the flexibility to take a paid leave-ofabsence for their own health, or care giving for a family member including such conditions as cancer, dementia, maternity, chronic disease, etc. Providing this benefit is a considerable expense to owner dentists so it is rarely available in employment contracts. The hope is the ADA can find an insurance product which will have a reasonable employer cost.

Tobacco and Vaping Cessation and Referral to QuitLines:

“Resolved that the appropriate ADA Agency establish relationships with each state’s QuitLine to gather accurate data on QuitLine referrals by dentists and other dental team members, facilitate a survey by state associations to understand QuitLine referrals by their members, and increase tobacco and vaping cessation counseling and referral to QuitLines.”

Social Media Reviews and Reputation Management:

“Resolved, that the appropriate ADA agencies curate existing social media reputation management content to develop a Reputation Defense Toolkit to help dentists with the appropriate reaction to social media postings and reviews that are misleading or defamatory, to make the Reputation Defense Toolkit available as a member benefit and to initiate a plan to update the Toolkit as needed, and be it further resolved, that the ADA enter into discussions with social media platforms to assess the feasibility of revising user agreements to prohibit misleading or unverifiable posts and reviews, which cannot be responded to due to HIPAA limitations, and creating a fair and reasonable process for victims to remove misleading or defamatory posts.”

ADA Budget: The ADA HOD approved the proposed ADA Budget and set the ADA 2023 dues at $600 (UDA dues are still $310, and your districts’ dues vary). You can renew your membership for 2023 at UDA.org > Member Center > My Membership > Join/Renew or at ADA.org > Renew.

Federal Student Loan Forgiveness: “The position of the ADA is that dentists should not be excluded from government relief of public and commercial student loan debt without obligation or condition. The ADA makes efforts to shape specific student loan forgiveness proposals by stating that education debt associated with graduate and professional programs should be eligible, any means testing should account for regional differences in cost of living and purchasing power, and consideration for eligibility and amount of forgiveness should account for the cost, length and rigor of dental education programs.”

ADA Dental Team Member Membership: A resolution to create a “Team Member” classification in the ADA failed. This was disappointing to the UDA delegation as along with many other state associations, we have “Affiliate Hygienist” members of the UDA, which helps create value for all members of Utah dental teams.

Amended ADA Policy on Evidence-Based Dentistry: “Prin ciples of Evidence-Based Dentistry: The Association supports the concept of evidence-based dentistry developed through systematic examination of the best available scientific data. Evidence-based dentistry provides a framework to help dentists use, appraise and apply research evidence in clinical practice. A primary goal of evidence-based dentistry is to improve the quality of dental treatment and oral health care through the objective appraisal of the best available evidence, improve clinicians’ skills in diagnosing oral and dental diseases and providing treatment interventions that help achieve optimal outcomes for patients. The ADA works to support clinicians in making decisions about the provision of patient-centered, evidence-based treatment and care to allow such decisions to be based on current best evidence, individual clinical expertise and the individual patient’s preferences and values. The ADA also recognizes that treatment recommendations should be determined for each patient by his or her dentist, and that patient preferences should be considered in all decisions. Additionally, dentist experience, diagnostic findings and other patient circumstances should be considered in treatment planning and determining treatment needs. EBD does not provide a “cookbook” that dentists must follow, nor does it establish a standard of care. The EBD process must not be used to interfere in the dentist/patient relationship. The ADA, consistent with its commitment to evidence-based dentistry and the improvement of oral health, supports including complementary and alternative medicine therapies as an adjunct to traditional diagnostic and treatment approaches, as long as they are based on sound scientific principles and demonstrated clinical safety and effectiveness.”

ADA Policy on Amalgam: “Resolved, that the ADA recommends that clinicians review the risks and benefits of all restorative options with their patients, and that dental amalgam restorations continue to be used when appropriate for patient care. The ADA supports the globally recognized need to reduce environmental mercury as set forth in the Minamata Convention on Mercury (September 2019) as a common good, and recognizes the responsibility of dentists to care for their patients’ well-being, in keeping with the ADA Principles of Ethics and Code of Professional Conduct.