Legal Ledger

The expansion of telemedicine is changing the landscape of providing Dental Sleep Medicine and oral appliances. This article will address key issues and regulations dentists and dental practices should consider and navigate in order to avoid potential pitfalls and liability.

by Jayme R. Matchinski, Esq.  In 2017, the ADA House of Delegates passed Resolution 17H-2017 which included language stating that: “Dentists are the only health care provider with the knowledge and expertise to provide oral appliance therapy”. The Council on Dental Practice developed the ADA Policy Statement on the Role of Dentistry in the Treatment of Sleep-Related Breathing Disorders. The Council on Scientific Affairs formed the Oral Appliance Evidence Workgroup and produced an evidence brief, Oral Appliances for Sleep-Related Breathing …

ADA Policy Statement and the Role of Dentistry in the Treatment of Sleep Related Breathing Disorders Read More »

by Jayme R. Matchinski, Esq. As the provision of Dental Sleep Medicine continues to evolve and expand, dentists are faced with the challenge of how to incorporate home sleep apnea testing (HSAT) into the care and treatment of their patients who may have obstructive sleep apnea (OSA) and require Oral Appliance Therapy (OAT). HSAT has changed the provision of Polysomnography from the traditional setting of providing an in-lab attended sleep study at a sleep disorder center to the utilization of …

Home Sleep Apnea Testing and Dental Sleep Medicine Read More »

by Jayme R. Matchinski, Esq. In recent years, there have been an increasing number of government and commercial insurance company audits and investigations related to durable medical equipment (DME) companies, dentists, and physicians providing Oral Appliances to patients who have been diagnosed with Obstructive Sleep Apnea (OSA). Most sleep disorder centers and DME companies have historically billed the Medicare and Medicaid programs and other third-party payors, including commercial insurance companies, for the provision of patient care, Oral Appliances, and related …

Provision of Oral Appliances and Regulatory Compliance: Why Your Practice Should Have a Compliance Plan Read More »

by Ken Berley, DDS, JD, DABDSM, and Jan Palmer In writing this article, I have partnered with my dear friend, Jan Palmer. Hopefully, together we can shed some light on the complex subject of Medicare “same or similar” regulations, which have recently resulted in the routine denial of Medicare OAT claims. Federal regulations on the Reasonable and Useful Lifetime (RUL) of a piece of Durable Medical Equipment is a complex matter and readers are, hereby, forewarned that this is the …

MEDICARE: Reasonable and Useful Lifetime (RUL) What is THAT? Read More »

by Ken Berley, DDS, JD, DABDSM The turf war continues and sadly, nothing has been decided. Almost daily I’m asked by a dental client why a dentist cannot diagnose OSA or Snoring. Many of my clients want to be able treat their patients who complain of chronic snoring without referring that patient to a sleep physician. Many dentists believe that an in-lab sleep study is unnecessarily costly and may result in some patients being placed on CPAP who could easily …

HSAT Usage: Are We There Yet? Read More »