Thursday, November 03, 2011

The Morning Drill: November 3, 2011

A collection of dentistry and health related links/comments for your day.

Audit: UNMC dental practice overpaid dentists
A private dental practice affiliated with the University of Nebraska Medical Center College of Dentistry on East Campus overpaid dentists and failed to ensure proper billing and collection practices, state Auditor Mike Foley's office has found.

Foley's office examined University Dental Associates' financial records and practices from July 1, 2008, through June 30. The nonprofit corporation opened in 2006 and offers dental services as an affiliate of UNMC.

It is run by 25 general dentists and dental specialists who also are full-time faculty for the College of Dentistry. The money they earn supplements their university incomes.

Foley's review found the earnings of those dentists and dental specialists ranged from $294 to $123,665 over the past fiscal year. Combined, they earned $775,788 above their university salaries.

Dr. James Jenkins, president of University Dental Associates, said the private practice is similar to other practices affiliated with similar universities. As for the pay the College of Dentistry professors earn, it is lower than pay earned by most other faculty at private practices run by the college's peer institutions.

Jenkins said the private practice allows the College of Dentistry to more effectively recruit and retain dentistry professors, who typically can earn significantly more in private practice. It also allows those professors to stay abreast of dental innovations, he said.

"It's very nice to offer faculty the chance to practice here at the college," Jenkins said.

Foley's review found University Dental Associates overpaid dentists and mishandled $102,407 between fall 2009 and June, largely as a result of problems with a software package it implemented in January 2009. Foley's office found University Dental Associates had accounted for all but $56,885 of that figure based on its own projections.

Dr. Randy Haack, chief financial officer for University Dental Associates, said the accounting problems arose from coding errors in using the new software system. He said the private practice, in a few incidents, paid the wrong doctors but never overcharged patients for services.

Jenkins said Foley's office never found evidence of fraud.

"The problem was in the software," he said.
Campbell council considering clinic to be run by convicted dentist
City council advanced an ordinance that would allow it to give 3.6 acres of city-owned land to a company that wants to build a dental clinic.

Council passed to a second of three required readings the ordinance, which would allow the transfer of land at Woodland Avenue and McCartney Road to United Dental Group LLC.

Robert Maruschak, a retired dentist from Poland, and Alvin G. Sullivan, who owns a financial consulting business in Girard, gave council a letter last month that indicates a plan to develop a nine- to 12-chair dental clinic that would offer all phases of dentistry in a 4,000-square-foot, $1.2 million building.

Maruschak, who pleaded guilty to felony drug charges in 2006, said he is not an owner of the company but is the “project manager” and will be the clinic director.

The Ohio State Dental Board notified him he was under review after his drug conviction, and he voluntarily surrendered his license in 2007. He is not allowed to practice in Ohio.
Medicare to Slightly Reduce Big Physician Pay Cut in 2012
In the category of not exactly good news, the Centers for Medicare and Medicaid Services (CMS) yesterday announced that it would cut Medicare reimbursement for physicians by 27.4% on January 1, 2012, instead of 29.5% as previously planned.

To physicians, this resembles telling a condemned man that his firing squad will consist of 5 riflemen instead of 6.

The slightly lower reduction in reimbursement appears in the final regulations that CMS released yesterday regarding the 2012 Medicare Physician Fee Schedule. Medicare sets these fees using the so-called sustainable growth rate (SGR) formula, which organized medicine wants to abolish. The SGR formula establishes an annual target for Medicare spending on physician services based in part on annual growth of the gross domestic product. If actual spending exceeds the target, the difference is taken out of next year's outlays for physician services.

In March 2011, CMS estimated that physicians would be subject to a 29.5% reduction in reimbursement. The change to 27.4% reflects the fact that Medicare costs this year have grown more slowly than expected, according to the agency's announcement.

The SGR has triggered annual pay cuts for physicians since 2002, but starting in 2003, each one has been postponed by an act of Congress. The postponed cuts then accumulate, leading to the deep one scheduled for January 1. Organized medicine has warned that such a steep drop in revenue would cause droves of physicians to stop seeing new Medicare patients or drop out of the program altogether.

The slightly lower reduction announced yesterday is not changing anybody's tune. Robert Doherty, senior vice president of governmental affairs and public policy for the American College of Physicians, told Medscape Medical News that "27.4% isn't going to make doctors any happier than nearly 30%."
Over Time, Even Low Alcohol Use Ups Breast Cancer Risk
The regular consumption of a modest amount of alcohol — 3 to 6 glasses of wine per week — over a long period of time increases a woman's risk for invasive breast cancer by a small but statistically significant amount, according to researchers.

Their prospective observational study of 105,986 women comes from the large Nurses' Health Study and examines "cumulative average consumption" over the 28-year study period. Participants were followed from 1980 to 2008, and completed 8 updated alcohol-assessment questionnaires during that time.

The study appears in the November 2 issue of JAMA, The Journal of the American Medical Association.

It adds to the literature on the effects of alcohol consumption on breast cancer risk, particularly that of "low levels of drinking," which "has not been well quantified," say the authors, led by Wendy Y. Chen, MD, MPH, from Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts.

Not surprisingly, larger amounts of alcohol consumption were associated with increased breast cancer risk over the study period, the authors report.
Enjoy your morning!

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