Insurance Commons^™

The Back Page Commentary: Care For Special Needs Patients: We Must Do Better, Craig C. Spangler Dds, Fscda

The Journal of the Michigan Dental Association

Despite strides in providing resources for neurodivergent and geriatric patients, access to suitable dental care remains a challenge. A survey revealed finding capable dentists as the primary barrier to care for special needs individuals. Transitioning from pediatric to adult care lacks continuity, highlighting gaps in predoctoral dental education. Challenges include inadequate training, limited opportunities for continuing education, and reimbursement issues. Collaboration between medical and dental leaders is crucial for addressing these pressing issues and ensuring equitable access to care.

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Staff Matters: How Can We Be More Creative With Our Benefits?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

As open enrollment for health benefits approaches, this column discusses creative and cost-effective benefit offerings to attract and retain employees. The focus is on innovative benefits beyond traditional health, life insurance, and retirement plans. Suggestions include pet insurance, paid volunteer time, lunch and learn sessions, and flexible scheduling to accommodate employees' needs, particularly working parents and those with caregiving responsibilities. The importance of seeking employee input in benefit planning is emphasized for discovering practical, employee-desired options.

Doj Withdraws Healthcare Antitrust Protections, Lance Plunkett Jd, Llm

The New York State Dental Journal

DOJ has withdrawn longstanding antitrust guidance that provided safe harbors for specific conduct in the healthcare marketplace.

J Mich Dent Assoc March 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members across the state. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on canceling provider agreements with dental plans.
• A clinical update on when and how to use Silver Diamine Fluoride to manage carious lesions
• News from Delta Dental on efforts to address access to care for disabled individuals through enhanced commercial dental benefits.
• The value of focused counsel from a …

Improving Access For Children And Adults With Disabilities Through Enhanced Commercial Benefits, Holli Seabury Edd, Jeff Johnston Dds, Ms

The Journal of the Michigan Dental Association

This article explores the critical issue of accessibility to oral healthcare for people with disabilities in the United States. Delta Dental of Michigan, Ohio, and Indiana has taken a step by providing enhanced commercial benefits to children and adults with disabilities. The article delves into the challenges faced by this vulnerable population, including cost barriers and transition issues, and discusses how expanded benefits and coding, along with special dental care provisions, aim to improve access. It emphasizes the importance of proper benefits verification and presents a case study illustrating the utilization of these benefits. The article highlights the need for …

Dentistry And The Law: Can Dental Plan Ratings Be Defamatory?, Dan Schulte Jd

The Journal of the Michigan Dental Association

This article discusses the legal implications of dental plan ratings for dentists. If a dental plan assigns a rating to dentists and publishes it to patients without providing specific information about the rating's basis or an opportunity for dentists to contest it, legal recourse may be limited. Currently, no statutory law regulates such ratings, leaving dentists potentially vulnerable to defamatory ratings. Under Michigan law, dentists could sue for defamation, but proving the rating's falseness and the resulting loss of patients may be challenging. Federal regulation is suggested to ensure fairness, transparency, and protection for dentists subjected to involuntary ratings.

Negotiating Reimbursement Rates With A Ppo Plan, Dana Moss

The Journal of the Michigan Dental Association

Dentists often struggle to negotiate reimbursement rates with dental insurance companies. This article discusses the importance of managing reimbursement from benefit plans and highlights the advantages and disadvantages of participating in insurance networks. It provides a step-by-step guide to negotiating insurance allowances effectively, emphasizing the need for preparation, data analysis, and communication skills. The article suggests ways to maintain profitability in practices with a significant PPO patient base. It includes recommendations for keeping fees balanced, choosing negotiation plans, and building relationships with insurance representatives. The emotional aspects of negotiation are also addressed, promoting a respectful and collaborative approach.

News You Need: Reminder: What You Must Know About Antitrust Law, Dan Schulte Jd

The Journal of the Michigan Dental Association

This reminder emphasizes the critical importance for dentists, particularly members of organizations like the Michigan Dental Association, to understand antitrust laws and their implications. The U.S. Justice Department and Federal Trade Commission actively pursue antitrust violations among physicians and dentists. The article outlines key aspects of the Sherman Antitrust Act, emphasizing that joint activities among independent dentists that restrain competition may lead to violations. The concept of joint action and the restraint on competition are explored, with a focus on potential pitfalls, such as price-fixing and group boycotts. Dentists are urged to stay informed to avoid legal consequences.

Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd

The Journal of the Michigan Dental Association

This Dentistry and the Law column addresses a dentist's concern about being reported to the National Practitioner Data Bank (NPDB) during a billing dispute. The dentist questions the validity of such a report, considering no issues with treatment quality are raised. The response emphasizes that adverse actions based solely on billing practices may not be reportable to the NPDB. Additionally, it clarifies that a dental plan administrator may not be eligible to make a Data Bank report, offering guidance on informing the plan about rights and potential contestation.

Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd

The Journal of the Michigan Dental Association

The ADA Lobbyist Conference highlighted crucial issues in dentistry, including Medicare reform, teledentistry, workforce concerns, and insurance challenges. State dental associations collaborated on building advocacy partnerships and shared successful grassroots engagement strategies. Medicare reform discussions focused on the ADA's opposition to Plan B inclusion and the impact of constituent outreach. State associations addressed Medicaid reform, emphasizing personal stories to convey the need for change. Teledentistry legislation and insurance company relationships were also key topics. The insights gained will shape the MDA's advocacy strategy for 2022.

J Mich Dent Assoc October 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story, “Welcoming Colleagues from Different Practice Models”.
• A feature article from the Journal’s DEI series, “Diversity, Equity, and Inclusion: Perspectives from an LGBTQ Dentist”.
• A feature article, “Congratulations, 2021 MDA Life Members!”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news. …

J Mich Dent Assoc September 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story with “Reports from the Dental School Deans”, Dr. Mert Aksu and Dr. Laurie McCauley.
• A feature article from the Journal’s DEI series, “Building a Culturally Competent Practice”.
• A feature article, “Disability Insurance: 10 Things You Need to Know”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and …

The Rescue Of American International Group Module F: The Aig Credit Facility Trust, Alec Buchholtz, Aidan Lawson

Journal of Financial Crises

In September 2008, American International Group, Inc. (AIG) experienced a liquidity crisis. To avoid the insurance giant’s bankruptcy, the Federal Reserve Bank of New York (FRBNY) extended an $85 billion emergency secured credit facility to AIG. In connection with the credit facility, AIG issued 100,000 shares of preferred stock, with voting rights equal to and convertible into 79.9% of the outstanding shares of AIG common stock, to an independent trust (the Trust) set up by the FRBNY. Three trustees held the stock for the sole benefit of the US Treasury, exercised the rights, powers, authorities, discretions, and duties of the …

The Rescue Of American International Group Module A: The Revolving Credit Facility, Alec Buchholtz, Aidan Lawson

Journal of Financial Crises

On September 15, 2008, the big three rating agencies downgraded AIG’s credit ratings multiple levels, exacerbating liquidity strains that the company was experiencing due to increasing cash demands by securities borrowers and collateral calls by credit default swap (CDS) customers. To prevent AIG from filing for bankruptcy, the Federal Reserve (the Fed) announced on the following day that, pursuant to its emergency powers, it would provide the company with an $85 billion Revolving Credit Facility (RCF). The RCF was secured by AIG assets and interests in its subsidiaries and required AIG to grant the US Department of the Treasury a …

J Mich Dent Assoc April 2021

The Journal of the Michigan Dental Association

In the April 2021 issue of the Journal of the Michigan Dental Association, we offer a comprehensive range of original feature content showcasing the latest developments in dental practice and knowledge, including:

1. AI in Dental Care Delivery: Explore the groundbreaking role of Artificial Intelligence (AI) and Machine Learning in dental care, revolutionizing efficiency, safety, care outcomes, and treatment planning consistency.
2. AI in Dental Claims Processing: Discover how AI is employed by third-party payers to streamline dental claims processing, resulting in cost containment and the proactive identification of potential fraud, waste, and abuse.
3. Evidence-Based Dentistry: As part of …

J Mich Dent Assoc December 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Related Breathing Disorders: A Two-Part Series”.
• The “2020 Author/Title Index to the Journal of the Michigan Dental Association”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes three articles reprinted …

J Mich Dent Assoc November 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Feature articles on how “Routine Blood Lead Testing During Pregnancy Empowers Future Dental Caries and Neurotoxicity Research”, how to “Recoup Your Dues and More with MDA-Endorsed Programs”, and your “2021 MDA Membership Benefits Guide”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, 10-Minute EBD, Headquarters …

J Mich Dent Assoc May 2020

The Journal of the Michigan Dental Association

Every month,The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on Michigan Dentistry in the COVID-19 Pandemic
• A message from the MDA President
• “Severe Acute Respiratory Syndrome Coronavirus-2: What Dental Professionals Need to Know” a feature on protecting the health of your patients and your dental team.
• “Keep the Lights On: Protecting the Health of Your Practice During the Economic Downturn” a …

J Mich Dent Assoc February 2020

The Journal of the Michigan Dental Association

Every month,The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on the 2020 MDA Annual Session
• A feature covering student perspectives on the Opioid Crisis
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, Headquarters Report, and component news

This issue also includes articles reprinted with permission:

• “Muscle Deprogramming: A Source of Confusion”, …

Ethical Imperatives Critical To Effective Disease Control In The Coronavirus Pandemic: Recognition Of Global Health Interdependence As A Driver Of Health And Social Equity, George A. Gellert Md, Mph, Mpa

Journal of Health Ethics

Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity

George A. Gellert MD, MPH, MPA

ABSTRACT

Decades into the era of emerging infectious diseases, the 2019-2020 coronavirus pandemic has caught the world, and the United States in particular, poorly prepared to engage effective public health disease prevention and control measures. In part, this reflects poor public health planning, response, logistical preparation and pandemic readiness, and complacency by governments and disease control agencies. In terms of future responses to emerging infection pandemics, these deficiencies can be …

The Fatal Failure Of The Regulatory State, W. Kip Viscusi

William & Mary Law Review

Although regulatory agencies place high values on the benefits associated with the reduction in mortality risks due to regulations, these same agencies substantially undervalue lives in their enforcement efforts. The disparity between the valuation of prospective risks and fatalities that have occurred is often by several orders of magnitude, diminishing whatever safety incentives the regulations might have generated. A review of the practices by the major federal agencies with responsibility for product safety and occupational safety finds that the value placed on fatalities in agencies’ regulatory analyses can be a factor of 1000 times greater than the magnitude of the …

Transforming The Insurance Sector In Nigeriain Using The Fss 2020 Platform, Chris O. Muo

Bullion

The National lnsurance Commission (NAICOM) is the statutory Regulatory body of insurance business created to ensure the effective administration, supervision and regulation of insurance business and regulate transactions between insurers and reinsurers within and outside Nigeria. FSS 2020 Insurance Sector, in collaboration with NAICOM aims to deepen the insurance market; ensure lnsurance credibility and protect policy holders; Embed governance and risk management framework for the lnsurance Companies; Enhance access to finance (financial inclusion) with business development support and new products; and risk-based capitalization of lnsurance Companies.

The Changing Nature Of Long-Term Care In Maine, Paul Saucier, Julie Fralich

Maine Policy Review

The increase in the proportion of older adults, many with one or more chronic medical conditions, will increase the demand for long-term care. Paul Saucier and Julie Fralich discuss the socio-demographic factors affecting long-term care policy, and describe various state and federal options for providing and financing long-term care. They note that Maine’s long-term care system has so far been able to absorb considerable growth in people by serving increasing numbers in lower-cost settings. Cost sharing has been introduced, and tax policy has been changed to provide incentives for long-term care insurance. Policymakers must now consider whether the current balance …

Review Of: Making Decisions About Liability And Insurance (Colin Camerer & Howard Kunreuther Eds.), Joseph M. Carreiro Jr.

RISK: Health, Safety & Environment (1990-2002)

Review of: Making Decisions about Liability and Insurance (Colin Camerer & Howard Kunreuther eds., Kluwer Academic Publishers 1993). Figures, index, notes, tables. ISBN 0-7923-9393-7 [139 pp. Cloth $89.95. 101 Phillip Drive, Assinippi Park, Norwell MA 02061.1

Book Review, Thomas G. Field Jr.

RISK: Health, Safety & Environment (1990-2002)

Review of the following: lAIN HAY, MONEY, MEDICINE AND MALPRACTICE IN AMERICAN SOCIETY. (Praeger 1992) [244 pp.] Abbreviations, annotated list of personal communications, figures, glossary, index, full legal citations, notes, preface, references, tables. LC 91-38477, ISBN 0-674-13645-4. [Cloth $49.95. P.O. Box 5007, Westwood CT 06881-9990.]

A Crisis In Insurance, Benjamin Lipson

New England Journal of Public Policy

As the life and health insurance industry evaluates its long-term financial goals, the cloud of Black Monday — October 19, 1987, the day the stock market collapsed — blurs its cherished investment income projections. With investment portfolios under siege, mutual life insurance companies and stock companies alike are wary of making policy-pricing miscalculations that could prove to be disastrous. As if that weren't enough, one single disease — acquired immunodeficiency syndrome — looms as the most serious threat to life and health insurers for the remainder of this century. The spread of the new disease has caused insurers to adjust …

The New Ohio Motor Vehicle Safety Responsibility Act, A Preliminary View, Nelson G. Karl

Cleveland State Law Review

The purpose of the Ohio Motor Vehicle Safety Responsibility Act is to reduce the number of unsatisfied judgments entered against those found liable in motor vehicle accidents. The new Act provides that an operator of a motor vehicle must either carry liability insurance or be in a position to deposit security if and when he is involved in an accident. Under the present Financial Responsibility Act, the registrar revokes an operator's license where there is a failure to satisfy a final judgment. The new Act enables the registrar to revoke this license before a judicial body has made a determination …