Agd house of Delegates (hod) Policy Manual



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AGD House of Delegates (HOD) Policy Manual

HOD 2014

Table of Contents


Diagnostic tests, dentists’ right to prescribe and perform 18

Environmental “best management” practices 18

Expanded Function Dental Assistant (EFDA) 18

Evidence-based dentistry 19

Definition of 19

Use of 19

Fees, adjustment of 19

Fees; i.e., usual, reasonable, customary: definition of 19

Flexible Spending 20

Fluoride in water supplies and toothpaste, position statement 20

Freedom of choice provider 20

Health care reform 21

Health care reform criteria 21

Licensing 22

Criteria for eligibility 22

Uniform standards for 22

Voluntary/Temporary Licensing 22

Medically compromised dental patients 23

Disclosure of relevant information 23

Policy statement on treatment of 23

Medicare, amendment to reimburse dentists for rendering same service as a physician 24

Nutrition and oral health 24

Oral Conscious Sedation, position statement 25

Parameters of care, ADA 26

Parameters of care, criteria for 26

Preferred Provider Organizations 27

Prepayment plans 28

Bill payer system 28

Exclude certain contract language 28

Include all phases of preventive dental services 28

Structuring of dental prepayment programs 29

Public information available to public of dental office safety 29

Resource Based Relative Value Scale 29

Rights of employers to provide health care benefits 29

School curricula – oral health education 29

Soft drink consumption/pouring rights contracts 30

Surgeon General's Report on Oral Health 30

Implementation plan 30

Third party mechanisms 31

ADA's role in problems with 31

Claim contested by dental consultant of 31

Considerations in deliberating dental health insurance programs 31

Consultant of, should make no representation to patient regarding dentist's service or fee 31

Diagnostic imaging 32

Differentials in levels of reimbursement in 32

Fee Determination 32

Fee schedules based on utilization reviews considered arbitrary 32

Guidelines for handling members’ problems with 32

Not to interfere with dentist's diagnosis and treatment 33

Overpayment recovery practices 33

Participation should not be contingent upon participation in government regulated programs 33

Reduction/denial of dental benefits must be signed by licensed dentist 34

Regulated by law or state governmental agency 34

Tissue biopsy 34

TMD policy statement 34

TMJ 35


Tooth numbering system 35

Untoward responses to products, materials, and medications 35

Vaccinations 36

Workforce, adequacy of present dental workforce 36

Workforce Policy Statement 36

Insurance, Malpractice 45

Diagnostic Imaging 58

Separation of Governance and Scientific Session 80

No member e-mail or fax information will be provided to corporate sponsors 96

Proposed projects of, sponsors to provide estimates 96

2014 Budget 99

2015 Budget 99

Member Programs 103

Constituent Services 104

Board 112

Publication credits 126

Requirements for application submission 127

Organizational Marketing 141

Advocacy Guidelines 144

Educational Objectives for the Provision of Dental Implant Therapy by Dentists 150

OPTIMAL DELIVERY OF ORAL HEALTH SERVICES THROUGH PRIMARY CARE: 176

Barriers and Solutions to Accessing Care 216

Determining the Makeup of the House of Delegates 241

AGD ELECTION GUIDELINES 242

THE ACADEMY OF GENERAL DENTISTRY 248

Rules of Procedure for Conducting The Reference Committee Hearings and Business of the Academy of General Dentistry’s House of Delegates 274

II Continuing Dental Education 291

IV Communication 292

Lifelong Learning & Service Recognition Program Guidelines 298

Mastership Award Guidelines 302


CURRENT POLICIES

Public Affairs Policies

Advocacy Policies


Accreditation and Recognition of Non-Specialty Areas


2005:5-H-7

“Resolved, that the AGD adopt the following position regarding the accreditation and recognition of non-specialty areas of general dentistry:
AGD Position on

the Accreditation and Recognition of Non-Specialty Areas


The AGD supports excellence in general dentistry and the pursuit of professional development through lifelong learning.  Advanced education should meet independent standards so that the education is valid and provides the framework for excellent patient care. General dentistry is not just treating patients – it is being the educated gatekeeper of oral health so that the patient is provided with all the available options for treatment. The knowledge of when to treat and when to refer, and to whom, is the responsibility of the general dentist. The general dentist’s emphasis is on primary care.  They guide patients to efficient, cost effective treatment while maintaining continuity of care.
AGD supports the responsibility of the Commission on Dental Accreditation (CDA) to develop accreditation standards for all formal education programs in dentistry, whether they are in an ADA-recognized specialty, in general dentistry or in a non-specialty area of general dentistry. This is not changing the scope of practice for general dentists and dental specialists, nor is it adding new specialties.   If non-specialty areas that provide formal advanced education can seek accreditation then the public will benefit.
The general dentist is the coordinator of care and as such should be able to inform the patient of all available treatment options. The general dentist should have access to education in all areas of dentistry, including advanced education programs and continuing dental education.
The specialist is a partner in dental treatment that is dependent upon patient referral from a general dentist. If general dentists have had additional education and training they are able to provide better patient care, treatment planning and know better when to refer to a specialist or another general dentist. This will strengthen the profession.
It is not as important an issue that the public understand the scope of practice between practitioners as it is that they understand how oral health affects their overall health. Clear messages about why it is important to see the general dentist twice a year would be powerful messages to the majority of the public who are interested in their health. Whether the public sees a specialist or a general dentist should be on the recommendation of their general dentist
The ADA is uniquely poised to promote the image of modern dentistry to the public. It is not the role of the ADA to make patients aware of how to select a specialist – that is the role of the referring general dentist. The ADA should focus on getting the public to the dentist and in working within the legislative arena to see that access to care is improved.
As CDA accredits advanced education programs in general dentistry, the ADA should consider mechanisms for recognizing board certification in general dentistry areas, including the American Board of General Dentistry.”



Advertising of Credentials
Advertising of Credentials


2008:314R-H-7

“Resolved, that the AGD adopt Announcement of Credentials to the Public: A Position Paper as its policy on the announcement of its FAGD and MAGD credentials.”


Advocacy Fund


2009:315R-H-7

“Resolved, that the AGD create an Advocacy Fund.”


American Dental Association
Advertising campaign, no AGD position on

98:19-H-7


“Resolved, that the AGD take no formal position on the ADA’s institutional advertising campaign and accompanying assessment.”




Requirement by AGD for membership in

79:15 H 6

REVISED

HOD 7/99



“Resolved, that it shall continue to be AGD policy to encourage membership in the American Dental Association, the Canadian Dental Association, or the National Dental Association.”


Anesthesiology
Cost of providing benefit


2002:29-H-7

“Resolved, that the Academy of General Dentistry believes patients with physical, developmental, emotional, or medically compromising conditions may require sedation/general anesthesia in private office, hospital, or surgical center settings for the safe and effective treatment of dental disease and/or injury, and be it further


Resolved, that sedation and/or general anesthesia and related facility costs for the treatment of dental disease and/or injury in these patients should be a covered benefit in all group medical benefit policies and Medicaid.”
Training availability

90:54 H 7


"Resolved, that the Academy of General Dentistry work with the American Dental Association and the American Dental Education Association to recommend that dental schools and hospital affiliated teaching institutions establish anesthesiology programs so that dentists seeking in depth education in anesthesiology will have such training available."





94:14.2 H 7


"Resolved, that educational opportunities be available so that general dentists will have adequate opportunity for training in dental anesthesiology in order to provide optimum pain and anxiety control for the public."




Annual Meeting
ADEA, report to House by Legislative and Governmental Affairs Council

94:22.2 H 7


"Resolved, that the Legislative and Governmental Affairs Council annually report to the Academy of General Dentistry's House of Delegates on the activities of dental schools and other organizations as they relate to the political concerns of general dentistry."





Contracts

Contract analysis service


2008:110-H-7

“Resolved, that Policy 88:47-H-7 be amended so that it reads:
“Resolved, that the Academy of General Dentistry offer to its members a contract analysis service, and be it further
Resolved, that members be encouraged to seek the advice of their own attorney before deciding to sign a contract, and be it further
Resolved, that the Dental Practice Council develop means to educate Academy of General Dentistry members about the ramifications of provider contracts.”


Dental Auxiliaries
Advanced Dental hygiene Practitioner Position Statement


2008:322-H-7 (RE-AFFIRMED 2010:307-H-7)

“Resolved, that the AGD adopt the Position Statement on the Advanced Dental Hygiene Practitioner (ADHP) Concept.”


Training, education, and utilization of

2010:305-H-7


“Resolved, that HOD policy 74:13-H-11 be amended”

"Resolved, that in the training, education and utilization of dental auxiliaries for the purpose of assisting the dentist in providing high quality dental care through performance of expanded functions, it shall be the recommendation of the Academy of General Dentistry that such auxiliaries be permitted to perform under the direct supervision of the dentist those functions which do not require the professional skill and judgment of the dentist and are in compliance with laws of states which have provisions for expanded functions, and be it further

Resolved, that the dentists, and only the dentist, is responsible for the examination, making the diagnosis and formulating the plan of treatment, performing surgical or cutting procedures on hard or soft tissue, fitting and adjusting corrective and prosthodontic appliances, prescribing therapeutic agents and making impressions for other than study casts, and be it further


Resolved, that final decisions related to dental practice and utilization of dental auxiliaries rest with the state board of dentistry, and be it further
Resolved, that the AGD recognize the necessity of effectively utilizing dental auxiliaries to maximize the efficient use of the dentist's time and skills."
Dental Consultant
Coalition to restore deduction for student loan interest

93:29 H 7


"Resolved, that the Academy of General Dentistry support the efforts of the Student Loan Interest Deduction Restoration Coalition to restore the deduction of interest paid on student loans."




Must be a licensed dentist

75:27 H 10


"Resolved, that the AGD recognizes that a dental consultant must be a duly licensed dentist within said state."




Dental Education
Deduction of interest paid on student loans


2008:301S-H-7

“Resolved, that the Academy of General Dentistry support efforts to restore the full deduction of interest paid on student loans regardless of income.”



Dental schools, support state funding for


80:22 H 7

"Resolved, that AGD recognizes the need for adequate funding to enable dental schools to provide a proper dental education, but at the same time, AGD encourages dental schools to seek state and/or private support in lieu of federal capitation funding."




81:37 H 7

"Resolved, that AGD support the concept of using state funds to assist in maintaining and operating the physical facilities of existing dental schools."


Formal academic process leading to a degree or certificate


81:41 H 7

"Resolved, that AGD endorse the concept of a formal academic process of structured, sequential continued or post doctoral education, earned through universities or academically accredited teaching institutions over an extended amount of time, which lead to a degree or a certificate."


Four year curriculum, support of

78:27 H 6


"Resolved, that the AGD expresses its concern with the dilution and shortening of dental school programs for purpose such as the receiving of federal capitation grants, and be it further



Resolved, that the AGD supports a minimum of a four year approved curriculum to achieve a dental degree, and be it further


Resolved, that the AGD send a letter to all of the existing dental schools expressing our support of those dental schools which have relinquished their three year programs in favor of pursuing quality four year dental education programs."
Licensure


82:34 H 7

"Resolved, that in states where laws are already in effect which mandate involvement in continuing education as a condition of dental licensure and/or dental license renewal, AGD's constituent AGD in that state's jurisdiction work with the state board of dental examiners and other appropriate dental agencies to protect the interests of AGD members in that state as mechanisms for enforcement and administration of that requirement are developed and implemented.




2014:204A-H-6

“Resolved, that HOD Policy 96:46-H-7 be amended so that it reads:

"Resolved, that the Academy of General Dentistry encourage its constituent academies to work with state or provincial boards of dental examiners, state legislatures, or regulatory bodies in implementing the following provisions for mandatory continuing dental education when legislation or regulations are under consideration in their states or provinces:


1. acceptance of program providers approved by the AGD’s Program Approval for Continuing Education (PACE) Program and the ADA Continuing Dental Education Recognition Program


2. the acceptability of self-instruction programming;
3. acceptance of the AGD member printout as one form of documentation of the requirement;
4. acceptance of courses relative to the access and delivery of dental care."
Dental Laboratory Techniques

76:40 H 11


"Resolved, that the Academy of General Dentistry urge the American Dental Association to, in turn, influence the schools of dentistry to provide significant instruction in dental laboratory technology for dental students so that dental school graduates will have the ability to adequately supervise the laboratory technicians, and be it further


Resolved, that the Academy of General Dentistry urge the American Dental Association to, in turn, influence the schools of dentistry to institute programs of instruction to train dental laboratory technicians at the college and vocational school level”


Dental Materials

79:30 H 6


"Resolved, that the AGD recognizes the need to give the American Dental Association's Council on Dental Materials and Devices appropriate input from general dentists, and be it further


Resolved, that the AGD recognizes the opportunity given to its president in the Bylaws to appoint an appropriate representative when it is appropriate for him to do so, and be it further


Resolved, that the AGD's representative to the American National Standards Committee MD156 for Dental Materials and Devices be named as a consultant to the AGD's Dental Practice Council, if he is not already a member, and be it further
Resolved, that all problems concerning dental materials and devices be considered under the purview of the AGD Dental Practice Council."

79:31 H 6


"Resolved, that attendance at MD 156 Committee meetings by a representative of the Academy of General Dentistry be included in the Dental Practice Council’s budget, on an annual basis."




Purchasing decisions

82:31 H 7


"Resolved, that the Academy of General Dentistry recognizes the problem of providing the general practitioner with meaningful information upon which to base purchasing decisions, and be it further



Resolved, that the following strategies be implemented in order to accomplish this purpose:


1. Maintain an AGD representative on ANSI MD 156.
2. Recommend through the Dental Practice Council chairman members to participate on ANSI Subcommittees.
3. Relay to the ADA AGD's concerns with regard to having the practicing dentist more informed in order to make proper purchasing decisions.
4. Identify which products should be evaluated.
5. Relay ANSI information to the AGD Foundation Product Comparison Advisory Board.
6. Start Product Comparison Program through AGD Foundation.
7. Publish results of product comparison program in our Journal.
8. Obtain feedback from our membership on which products should be evaluated.
9. Appoint subcommittee of Dental Practice Council to facilitate dental material and device deliberations for the Council."
Dental Practice
Amalgam, position statement supporting


2002:24-H-7


“Resolved, that based on current scientific evidence, including the Food and Drug Administration’s February 2002 Consumer Update on Dental Amalgam, the Academy of General Dentistry maintains that amalgam is safe and effective as a dental restorative material.”


Analyzed health care data
Methodology and source of funding must be disclosed if used for Benefit determination

2000:24-H-7



“Resolved, that if information gathered from analyzed healthcare data is used for either benefit determination or dentist preferential selection, then the methodology and source of funding involved in the analysis must be publicly disclosed and verified by a process that ensures the quality, integrity, and validity of the analysis methodology.”




Uses for, procedures must be publicly disclosed

2000:23-H-7


“Resolved, that the Academy of General Dentistry supports the concept that if health care data is analyzed, it should only be used to advance scientific knowledge or improve the oral health of the patient, while still allowing for professional judgments by practitioners, and be it further


Resolved, that the procedures involved in the analysis must be publicly disclosed and reviewed by the affected communities of interest in order to ensure the quality, integrity, and validity of the analysis methodology.”


ANSI MD 156, AGD representative on

97:25-H-8


“Resolved, that the Academy of General Dentistry recognizes the problem of providing the general practitioner with meaningful information upon which to base purchasing decisions, and be it further



Resolved, that the following strategies be implemented in order to accomplish this purpose:


1. Maintain an AGD representative on ANSI MD 156.
2. Recommend members to participate on ANSI subcommittees through the Dental Practice Council Chairperson.
3. Relay to the ADA AGD's concerns with regard to having the practicing dentist more informed in order to make proper purchasing decisions.
4. Obtain feedback from our members on materials with which theyve experienced problems.”
Appropriate charges made for administrative work

75:28 H 10


"Resolved, that the AGD recognize that it is ethical and proper for appropriate charges to be made when a dentist completes a claim form, a narrative report or other paperwork requiring secretarial, clerical, and professional time as long as the fee is identified."




Benefit coverage for dental surgery performed in office

79:35 H 6


"Resolved, that AGD support the inclusion of clauses in hospitalization and surgical benefits contracts that provide for coverage for dental surgery in the office setting if such surgery would normally be covered were the patient hospitalized for the procedure."




Biophosphonate therapy


2007:27R-H-8

“Resolved, that the AGD communicate the potential serious oral sequelae of bisphosphonate therapy, including osteonecrosis, to the medical and dental communities, and to inform patients of such risk and encourage patients to seek dental care prior to initiating bisphosphonate therapy."


Bleaching trays, license should be required for fabrication of


2001:27-H-8

“Resolved, that the Academy of General Dentistry believes that supervising or providing materials or methodology for consumers to make intraoral impressions constitutes the practice of dentistry, which requires an appropriate license in the state or province where the individual is being treated, and be it further

Resolved, that directing a dental laboratory to fabricate intraoral appliances and devices (including bleaching trays) constitutes the practice of dentistry, which requires an appropriate license in the state or province where the individual is being treated, and be it further


Resolved, that in order to protect the health of the public, the Academy of General Dentistry believes that the fabrication of intraoral appliances and devices (including bleaching trays) by dental laboratories requires a proper prescription by a dentist licensed in the state or province where the individual is being treated.”
Botox and other facial injectables

2010:308R-H-7


“Resolved, that the AGD supports general dentists receiving education on, and the performance of botulinum toxin and cosmetic dermal filler procedures.


2013:303-H-6 “Resolved, that the Academy of General Dentistry encourage its constituents to lobby their state/provincial dental licensing authorities to expand the scope of practice for general dentists to include the administration of facial injectables for therapeutic and cosmetic purposes.”


Childs first visit to dentist, position on

98:24-H-7


“Resolved, that the Academy of General Dentistry officially endorse the position that a childs first visit to the dentist should occur within six months of the eruption of the first tooth.”




Claims, prompt payment of


93:22 H 7

"Resolved, that the Academy of General Dentistry ascribes to the American Dental Association's policy on the prompt payment of dental claims, which reads:

'Resolved, that the appropriate agencies of the American Dental Association, and its constituent dental societies, be urged to seek legislation which would require all public and private third party payers to reimburse dental claims within (15) business days from receipt of the claim by the third party payer or be penalized for failure to do so.'"


Code of procedures, endorsed by AGD

74:12 H 11


"Resolved, that the AGD endorse the principle of one code of procedures for dentistry, and be it further


Resolved, that whenever the ADA Council on Dental Benefit Programs or one of its sub committees considers revisions in the ADA code the Academy of General Dentistry be permitted direct input into such revisions by having representation at those meetings, and be it further


Resolved, that the AGD urge the American Dental Association to take steps to assure that the approved code is used throughout the purview of the Academy of General Dentistry."
Consultant, ground rules for claims denial

93:27 H 7


"Resolved, that when a third party dental consultant applies an alternative benefit provision to the treatment plan submitted by the provider dentist, or when a third party dental consultant denies benefits for reasons other than contract exclusions, the dental consultant must sign the report and provide his/her telephone number, and be it further


Resolved, that the AGD promote this concept to the American Dental Association, the Canadian Dental Association and third party payment groups."


Co payment and overbilling, waiver of

93:23 H 7


"Resolved, that the Academy of General Dentistry adopt the American Dental Association's policies regarding waiver of copayment and overbilling, which read:


'Resolved, that constituent dental societies be urged to pursue enactment of legislation that:


1) prohibits systematic non disclosure of waiver of patient co payment/overbilling by a dentist and

2) prohibits bad faith insurance practices by third party payers, consistent with Association policy, and be it further


Resolved, that third party payers be urged to support this legislative objective.'"
Corporate Guidelines and Mandates


2009:319S-H-7

“Resolved, that the AGD is opposed, as unduly burdensome to general dentistry and the patients it serves, to all corporate mandates that require specified quantities of utilization of the corporation’s products in patient’s dental treatment, without any qualitative assessment of each dentist’s proficiency with the products and without substantial clinical evidence of patient harm as a result of utilization in less than the specified quantities, as prerequisites for continued access to the use of the corporation’s product.



Date of manufacture of dental equipment and devices

81:26 H 7


"Resolved, that AGD encourage that ADA specifications for dental materials and devices include an expiration date where applicable, and when not applicable a date of manufacture or packaging, and be it further



Resolved, that the type of date utilized be clearly indicated and separate from a lot or serial number."


Dental health education for the public

81:33 H 7


"Resolved, that AGD support the concept of having public funds used to support dental health education for the public."






2006:23R-H-7

“Resolved, that AGD seeks to educate the public about the potential financial & health risks, due to lack of legal and contractual insurance recourse when medical & dental care is sought outside of the United States and Canada.”


Dental hygienists, authority of State Boards of Dental Examiners

2014:306A-H-6


“Resolved, that policy 92:34-H-7 be revised as follows:

"Resolved, that because of the nature of dentistry and the manner in which it is delivered to the public, it is the policy of the Academy of General Dentistry that dental hygiene should remain under the authority of the various state boards of dental examiners and that dental hygiene education should remain under the purview of and be accredited by the Commission on Dental Accreditation."



Dental Implants


2008:317-H-7

“Resolved, that the AGD policy shall be that dental implants are an accepted modality of treatment.”




2009:301S-H-7

“Resolved, that the AGD support legislation requiring insurance carriers to cover reimbursement for surgical implant placement and restoration.”




2009:306-H-7

“Resolved, that, when one or more dentists are involved in dental implant therapy, there should be mutual agreement of the restorative objectives by all parties, including the patient, before any invasive therapy is undertaken.”




2009:307-H-7

"Resolved, that the AGD adopt the Educational Objectives for the Provision of Dental Implant Therapy.”


Dental insurance plan to include all facets of dentistry

82:32 H 7


"Resolved, that the AGD recognize that an optimum dental benefits plan includes all facets of dentistry."




Dental products, materials, and medications, opposed to bans on the use of

2010:306RS1-H-7


“Resolved, that the AGD take appropriate action when necessary to ensure that safe and effective dental materials, products, and/or medications remain approved for use in oral healthcare.”




Dental research, public funding for

81:35 H 7


"Resolved, that the AGD support the concept of using public funds if available for dental research."




Dentistry's position on a National Health Program

80:25 H 7


"Resolved, that AGD's Guidelines for Dentistry's Position on a National Health Program and other relevant AGD and ADA policy be reviewed in relation to any future legislation mandating dental benefits."




Dentist's right to collect a larger fee from patient

77:14 H 6


"Resolved, that the AGD is opposed to any administrative procedure by a third party payment mechanism which interferes with the dentist's right to collect from a patient a fee greater than that allowed by the carrier's benefit structure except when a dentist has agreed to become a participant in a benefits program that utilizes a usual, customary, and reasonable method of reimbursement as payment in full.”





Diagnosis and supervision needed for dental treatment


2003:16-H-7

“Resolved, that dental treatment, including the placement of dental sealants and fluoride varnishes, is most effectively and successfully accomplished following a proper diagnosis by, and under the supervision of a licensed dentist in compliance with the regulations of the state or province, and in a dental office setting that ensures optimal treatment outcomes.”


Diagnosis and treatment of substance abuse
2013:316-H-6 “Resolved, that in their capacity as primary care providers, general dentists be encouraged to attain education in the diagnosis and treatment of substance abuse disorders insofar as they relate to oral health issues, and be it further,
Resolved, that the AGD encourages state and district licensing authorities, state and district legislatures, and the federal government to make provisions within the scope of dental practice acts so that general dentists may diagnose and treat substance abuse disorders insofar as they relate to oral health issues.”

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