The Business of Dentistry – Successful Practice Transitions and Financial Well-Being

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Learn from leading experts in the dental industry as they provide some of the most cutting-edge information on dental practice transitions and financial well-being. Speakers and topics covered at The Business of Dentistry seminar include:

Stuart J. Oberman, Esq.
Oberman Law Firm
• What buyers and sellers need to know
• From due dilligence to closing
• How to handle selling to corporate or a DMSO
• How to avoid landmines in the sale process

Bill Morris, CPA
Rozar Morris, LLC
• How to structure a partnership
• Tax perspective
• What you need to know for a successful buy-in
• How to avoid the tax consequence of a partnership buy-in
• Updates 2017 – New tax law (what every dentist needs to know)

Tiffany Stewart, Founder
Bridgeway Transitions
The Value of a Dental Practice:
• Is it still a seller’s market?
• How do you determine the fair market value of a practice?
• Are DSO’s paying more for practices than individual dentists?
• What are some actual statistics on practices sold within the last 12 months?

Ben Cotton, Vice President
Dental Team Performance
Key Things to think about before and when you decide to Transition your practice:
• The current seller/buyer market
• Sellers have choices to make
• Planning to Optimize the Value of your practice

Harris M. Gignilliat, Senior Vice President
Wealth Management, UBS Institutional Consulting
• What is the impact of the recent tax reform, regulatory
changes, and the robust stock market to dental practice owners?

The event will be held from 6:00 pm to 9:00 pm (and dinner will be served) on September 20, 2018 at the Polo Golf and Country Club in Cumming, Georgia. Dentists are welcome to attend free of cost, and CE credit will be provided to those who attend. See the event flyer.

Register below!

Pregnancy and Employment in the Dental Practice

Due to the vast number of female employees in the dental field, the issue of employee pregnancy arises frequently. Many dentists fail to abide by federal law in their dealings with pregnant employees because they simply aren’t familiar with the legislation protecting the pregnant employee: the Family and Medical Leave Act (FMLA) and the Pregnancy Discrimination Act (PDA). However, the lack of knowledge surrounding these laws can be costly and can lead dental employers straight into disputes with labor boards.

The Family and Medical Leave Act applies to employers with fifty (50) or more employees. Covered employers must provide up to 12 weeks of unpaid leave to eligible employees. In addition, the Pregnancy Discrimination Act (PDA), which applies to employers with fifteen (15) or more employees, also prohibits discrimination against pregnant women.

These federal laws provide that women affected by pregnancy, childbirth or related medical conditions shall be treated the same for all employment-related purposes as other persons not so affected but similar in their ability or inability to work. Further, most states have enacted their own pregnancy discrimination laws. Many states have also lowered the covered employer threshold to those employers with fewer than fifteen (15) employees, with some states requiring that employers with four (4) or more employees comply with such laws.

When federal or state pregnancy laws apply to your dental office, it is important to be aware of and to adhere to certain guidelines. First, if the pregnant employee refuses or is unable to perform certain tasks, then the dental employer must determine what accommodations may be needed. However, if the accommodation would cause an undue hardship and require significant difficulty or expense for the employer, then the employer may deny any accommodation.   In addition, when federal or state laws apply to a dental practice, the dentist must remember that it is illegal to deny employment, promotions, or to fire a woman because she is pregnant. Finally, employees returning from a pregnancy leave are entitled to return to their former or a similar position at the same work schedule and pay, unless there is a legitimate business reason as to why that job is no longer available.

Women are a protected class, and if an employee’s pregnancy is handled inappropriately, the employer could end up in court, incurring costly fees and time away from the practice. Therefore, it is extremely important that dental employers familiarize themselves with the laws that apply to their practice.

Stuart J. Oberman, Esq handles a wide range of legal issues for the dental profession including cyber security breaches, employment law, practice sales, OSHA, and HIPAA compliance, real estate transactions, lease agreements, noncompete agreements, dental board complaints, and professional corporations.

 

For questions or comments regarding this article

please call (770) 554-1400 or visit   www.obermanlaw.com

 

If you would like Stuart J. Oberman, Esq. to speak at an event to your organization, please contact Katharine Drum, Marketing Coordinator (kath@obermanlaw.com)

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Labor Law Update for Dentists

As of April 30, 2012, most private sector employers will be required to post a notice advising employees of their rights under the National Labor Relations Act. This requirement applies to a variety of entities with a gross annual volume of at least $250,000.00. The poster is available for free at https://www.nlrb.gov/poster or by calling (202) 273-0064.

In addition to the NLRA poster, the U.S. government requires the posting of these workplace posters: 1) Employee Polygraph Protection, 2) Equal Employment Opportunity, 3) Fair Labor Standards Act, 4) Job Safety and Health Protection, 5) Rights Under the Family and Medical Leave Act (for employers of 50 or more individuals), and 6) Uniformed Services Employment and Reemployment Rights Act. You can obtain them for free from the U.S. Department of Labor Web site www.dol.gov/compliance/topics/oster.htm.

Social Media and the Dental Practice

The online world is growing. Facebook now boasts a “population” larger than the United States. Thousands of dentists are currently taking advantage of all types of social media. It is important to take a brief look at some important issues and areas of concern for dental professionals using or considering the use of social media to build and promote their public, patient, and employee relationships.

Public Relations

The advantages of a strong social media presence are clear. Information may be shared with colleagues to sustain camaraderie, with patients to strengthen dentist-patient relationships, and with the public to bolster your reputation. It is vitally important to consult with your legal advisers early and often when bringing your professional presence to an online forum.

Patient Relations

If content on your social media page is also medical in nature, depending on the forum, the Health Information Portability and Accounting Act (HIPAA) may be implicated.

Members of the dental profession should adhere to the following guidelines:

(a) Dentists should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online.

(b) When using the Internet for social networking, dentists should use privacy settings to safeguard personal information and content to the extent possible.

(c) If dentists interact with patients on the Internet, dentists must maintain appropriate boundaries of the patient-dentist relationship.

(d)  To maintain appropriate professional boundaries dentists should consider separating personal and professional content online.

(e)  Dentists must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, and may have consequences for their professional careers (particularly for dentists-in-training and dental students), and can undermine public trust in the dental profession.

When dental professionals provide a social media forum for patient feedback, they risk running afoul of HIPAA rules and regulations. Prior to building a social media presence, it is important to develop policies and procedures designed to guide appropriate use of the relevant forum.  A few key points follow:

Under the Health Information Technology for Economic and Clinic Health Act (HITECH Act), there are substantial penalties and fines that may be assessed for HIPAA violations that occur during social media exchanges. Under the HITECH Act, fines range from $100.00 to $100,000.00.

Be clear with a disclaimer that patient information is personal and should never be shared via the Internet. Inform participants that any posting that appears to be a violation of this policy will be removed.

Employee Relations

It is important to keep your employees from becoming lax about privacy rules when it comes to social media.

Education is always the first line of defense when it comes to privacy and security safeguards. Make sure all employees are trained and up to date about the privacy and security rules and be sure to disseminate a written company policy outlining permissible and impermissible actions. Make social media training a part of your HIPAA compliance program.

Social media is a powerful tool for expanding a dental practice, but be aware of the potential complications. Always consult your legal adviser before branching out into online forums.

Five Potential Legal Risks Associated with Groupon

With the explosion of social media and online marketing, members of the dental community “must” be aware of the risks associated with the new marketing. While dental practices have successfully utilized the services of Groupon to attract new patients, there are growing concerns regarding this type of marketing. The American Dental Association has recently published its opinion on the Groupon issue. Before a dentist participates in a Groupon marketing campaign, they must be aware of potential ramifications.

1: Fee-Splitting
A dentist utilizing Groupon to offer discounts to new and current patients will split a portion of the revenue generated from the promotion with Groupon. Many states have regulations that prohibit fee splitting between a dentist and a third party. A violation of the state regulations could result in the dentist facing censure and reprimand, fines, suspension, and even license revocation.

2: Federal Anti-Kickback Statute
The federal anti-kickback statute, 42 U.S.C. § 1320a-7b(b) generally prohibits a dentist from offering or paying remuneration to induce a person to refer a patient that may be eligible for services under a federal health care program, including Medicare or Medicaid. A dentist violating federal law could be charged with a felony and subject to fines, imprisonment, and exclusion from federal health care programs.

3: Most Favored Nations Clause
The terms of a dentist’s contract with third party payors [insurance carriers] may pose problems with the offer and award of Groupon’s discounts to patients. Many insurance contracts provide that the dentist must provide the insurer with the best price that the dentist charges for a particular service (a “most favored nations” clause). Providing a discounted rate to Groupon customers may breach the most favored nation provision in an insurance contract. As a result, the dentist may be required to offer the same discount to the insurer’s patients.

4: ADA Ethical Rules
According to the American Dental Association Principles of Ethics and Code of Professional Conduct Section 4.E. Rebates and Split Fees, dentists “shall not accept or tender ‘rebates’ or ‘split fees’”.

5: Dental Boards
Most dental boards provide that a dentist “shall not give rebates or split fees with a referral source”.

Before a dentist enters in to or starts any type of marketing campaign (or social media campaign), they should seek legal advice as to the application of state and federal laws, the most favored nations clause, ADA Ethical rules and Dental Board rules. While the marketing of any dental practice is important, an ill-advised marketing campaign could result in a dentist being censured, reprimanded, fined, suspended, and lose their license.

Oral Cancer: Risk Management Considerations

Due to the increasing public concern regarding oral cancer, it is important for dentists to be aware of proper patient assessment and documentation procedures so that they may provide timely and proper treatment to their patients.

The U.S. Department of Health and Human Services states that oral pharyngeal cancers affect around 30,000 people per year in the United States, with around 8,000 of those cases resulting in death. A good deal of malpractice claims against dentists in the United States involve oral cancer cases.

For every dental practice, correct patient assessment is the first step in minimizing any risk to future legal entanglements. When assessing a patient and planning a treatment strategy, dentists should first carefully review the patient’s medical history to note any predisposing oral cancer factors. Next, a comprehensive oral evaluation should be completed.

This full examination should be followed with a review of oral radiographic images in order to note any potential abnormalities in the bones and dentition of the patient.

Properly documenting the patient assessment is just as important as accurately assessing the patient. In order to satisfy the basic standard of care, all dentists are required to perform these evaluations and note all the results from the examination in the patient’s permanent record.

In cancer cases, it is crucial that a treating dentist contact the patient’s oncologist to determine if any special precautions should be taken for the patient before and after undergoing medical treatment, such as chemotherapy. It is also essential that the medical history dictated in the patient’s record include information regarding whether or not the patient has undergone such medical treatment.

Dentists must carefully follow all procedures in the practice in order to help them avoid legal pitfalls. Properly assessing and examining the patient and documenting the patient’s record will not only keep the dentist out of legal trouble, but it will also provide the patient with positive dental care service.