Content Dam Diq Online Articles 2017 08 Paying A Fine 1

4 ways to prevent dental practice-killing regulatory fines

Aug. 7, 2017
WARNING: Dental practices are at risk like never before to be hit with steep fines imposed by government agencies for failure to follow applicable dental practice regulations.

WARNING: Dental practices are at risk like never before to be hit with steep fines imposed by government agencies for failure to follow applicable dental practice regulations.

This article originally appeared in the Principles of Practice Management e-newsletter. Subscribe to this informative twice monthly practice management ENL here.

Recent studies show that MANY DENTISTS DON’T KNOW THE APPLICABLE REGULATIONS that apply to their practices well enough to survive a visit from a federal or state inspector. For example, surveys show that dentists are not following nitrous oxide safety guidelines,(1) not using proper amalgam management,(2) are not properly prepared for possible cyber attacks on their patients records,(3) and are not controlling exposure to bloodborne pathogens.(4)

What’s the result of not being prepared? Dentists are at risk of being fined thousands of dollars or much more by agencies such as Occupational Safety and Health Administration (OSHA), Office of Civil Rights (OCR, which handles HIPAA), Drug Enforcement Agency (DEA), and the Environmental Protection Agency (EPA). Violations and fines have recently been increasing.(5)

Several states have discovered that OSHA violations can be a source of revenue during this time of tight budgets. Something as simple as failing to have an updated pathogen exposure control plan can trigger a $2,500 fine, while HIPAA violations can cost an office up to $1.5 million. Criminal penalties for a breach in HIPAA protocols can result in 10 years in prison. Any of these violations can produce a years-long and life-disrupting investigation, a practice-killing fine, or a life-changing incarceration in prison.

There is no better time for dental practices to ensure that they are in compliance, regardless of whether they have been recently selected for an audit or not.

Here are three steps offices can take to prevent regulatory fines that could end your practice:

Do it yourself: Learn the state and federal regulations that apply to your practice.

For those dentists with the patience and bandwidth for self-help, a comprehensive list of applicable dental regulations can be compiled from checking these websites:

CDC Guidelines for Infection Control in Dental Healthcare Settings

OSHA Bloodborne Pathogens Standards and Regulations

OSHA PPE Standards

OSHA Hazard Communications Standards

OSHA Non-Ionizing Radiation Standards

Standards from the Federal Controlled Substances Act (Title 21 Code of Federal Regulations)

Health Information Portability and Accountability Act (HIPAA): Patient Privacy Rules

Health Information Portability and Accountability Act (HIPAA): Breach Notification Rules

Health Information Portability and Accountability Act (HIPAA): Security Rules

Purchase and use pre-packaged training modules on regulatory compliance. Many vendors provide off-the-shelf training packages to help practices ensure compliance. For example, dentists can help protect their practices from HIPAA violations by purchasing and implementing the concepts in the American Dental Association’s Complete HIPAA Compliance Kit, available at Other training courses can be found by accessing the Commission for Continuing Education Provider Recognition Course Listing. The database at provides information about courses offered by ADA CERP-recognized providers.

Hire a compliance coach.

For those without the time and patience to compile and learn all of the applicable regulations, experts in regulatory compliance are available to guide you through the potential minefield. The benefit is that your practice receives a professional audit that ensures you avoid future litigation, fines, and disciplinary actions. A search using the term “dental compliance specialist” plus the name of your state (e.g., “dental compliance specialist Texas”) will reveal the names of several consulting firms that can provide the knowledge and training to ensure you’re in line with the law.

Get accredited.

Submitting your practice to an accreditation process not only ensures it meets all applicable regulatory guidelines and standards, it also allows you to market your achievements in practice excellence to your patients. The only accreditation service available for general dentistry is the Accreditation Association for Dental Offices (AAFDO). AAFDO has compiled all of the applicable federal and state regulations into a single-source document with over 400 criteria covering 13 domains of practice excellence. The accreditation survey process by AAFDO allows a dental practice to:

• Gain peace of mind that it has met the most comprehensive and stringent assessments of standards of care and best practice and is thus ready for a visit from a federal or state auditor.
• Achieve one of the key benchmarks measuring the quality of dental practice.
• Certify, because it meets all regulations, that it is a provider of choice.
• Publicize that its patients are receiving the best care that is in compliance with all regulations and best practice guidelines.

With the proliferation in state and federal regulatory agencies that govern dental practices, it’s nearly impossible to comply with the rules and regulations set forth by the agencies without taking specific action to ensure compliance. Ignoring the threat and hoping you won’t be audited is not an option. Any of these four steps will help ensure that your practice won’t die from a practice-killing fine for non-compliance. Take action now to protect your profession and navigate the complicated regulatory waters.

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John B. Roberson, DMD, obtained his dental doctorate at the University of Mississippi School of Dentistry. During dental school, he was president of the American Student Dental Association, which consisted of 15,000 members. He received numerous awards in dental school, including the American Association of Oral & Maxillofacial Surgeons (AAOMS) Award for outstanding performance in undergraduate oral surgery. Dr. Roberson is a board certified oral and maxillofacial surgeon, and is a member of the AAOMS, American College of Oral & Maxillofacial Surgeons, American Dental Association, Mississippi Dental Association, and the South Mississippi Dental Association. He was awarded a Presidential Citation from the AAOMS for his ongoing community service project, MOST (Mississippian's Opposed to Spit Tobacco). He has published articles in several professional journals.