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April 2019

Marijuana Use: Legal in Michigan, Not in the Workplace

Now that Michigan voters have legalized marijuana for both medical and recreational use in Michigan, does this require your dental office policy to change? The short answer — it does not!

The legalization of marijuana does not exclude it from your zero-tolerance/substance abuse policy. Prohibiting employees from being under the influence of substances while at work, denying use of substances while at work, and testing for substances are all still expected as an employer.

Think about marijuana use in the workplace like you would alcohol use in the workplace. Although you can legally drink at the age of 21, as a private employer you do not allow employees to consume alcohol while on the job. As with alcohol, as an employer you can still enforce a drug- and alcohol-free workplace.

The Michigan Regulation and Taxation of Marihuana Act clearly states, “This act does not require an employer to permit or accommodate conduct otherwise allowed by this act in any workplace or on the employer’s property. This act does not prohibit an employer from disciplining an employee for a violation of a workplace drug policy or for working while under the influence of marijuana. This act does not prevent an employer from refusing to hire, discharging, disciplining, or otherwise taking an adverse employment action against a person with respect to hire, tenure, terms, conditions, or privileges of employment because of that person’s violation of a workplace drug policy or because that person was working while under the influence of marijuana.”

With that language in mind, your employee handbook policy should reflect your office’s policy on marijuana use, as well as other substances, and notify employees of testing procedures and consequences of noncompliance. Although Michigan does not have any specific statute governing drug testing in the workplace, employers should ensure that their drug testing policy is implemented in a fair, consistent, and non-discriminatory manner to avoid potential claims of discrimination.

The Michigan Dental Association is available to help if you need assistance in drafting a substance abuse policy. For assistance, email Brandy Ryan, director of human resources.

Discounts and Rebates: Not the Best Ideas for Marketing a Dental Practice

It’s not uncommon for dental offices to think discounts, rebates, or rewards are great ideas for promoting the practice and increasing their patient bases. While the staff and dentist may be excited and ready to rock this new marketing plan, a dental office needs to tread carefully.

According to MDA Legal Counsel Dan Schulte, JD, in general, dentists are free to determine the amount of fees that they will charge for their services and to determine what discounts they will offer to their patients. But — there are some important constraints of which a dental practice should be aware.

Participation agreements. The first set of constraints would be contained in any participation agreement or other agreement between the dentist and a managed care plan or other insurer. For example, say an office wants to offer a 10% discount for paying in cash. However, that may not be allowed. Generally speaking, participation agreements often restrict a dentist’s ability to charge the full amount of their fee, discount their fee, waive co-payment and deductible obligations, and to bill the patient for the difference between the dentist’s normal fee and the maximum fee the plan or insurer offers as reimbursement. Be sure to carefully review all such agreements prior to offering any discounts or waivers.

Rebates prohibited. Offering a rebate on treatment for providing referrals to another office may seem harmless in nature and may be suggested as a great marketing tool, but nothing could be further from the truth.

According to Schulte, Michigan’s Health Care False Claim Act makes it illegal for a person to submit a claim for payment to a health care corporation. In addition, it also prohibits the “rebate” of a dentist’s fee if the rebate is given by the dentist to the patient in consideration of that patient providing a referral(s) to the dentist of other patients.

“A violation of the False Claim Act is a felony punishable by imprisonment for not more than four years or by a fine of not more than $50,000, or both,” Schulte says. “There are also ethical considerations that can be found in Section 4.E and 5.B.1 of the ADA/MDA Code of Ethics.”

Medicare and Medicaid Waivers. In a 1991 fraud alert, the U.S. Department of Health and Human Services took the position that the routine waiver of Medicare co-payments and deductibles by health care providers could be a violation of the Federal False Claims Act and the Federal Anti-Kickback statute. HHS’ theory was that violations of these federal statutes occur if the waiver of the patient’s co-payment and/or deductible was based upon something other than the patient’s financial hardship.

“An example of such a violation would be a referral of a patient by another patient whose deductible or co-payment had been waived,’ Schulte says.

Don’t Be Discouraged

While discounts, rebates, and waivers may not be in the promotional cards, there are still fun ways to encourage referrals and grow the practice.

For example, your office could offer gift cards for new patients. Another idea is implementing a stuffed animal of the month club for younger patients, or a no cavity club. All these promotional ideas are within the acceptable guidelines and will get your patients talking about how great your office is.

The Bottom Line

Attracting new patients is a goal of every practice and a necessity to keep the practice growing. Just be sure that patients are being charged appropriately and be aware of the legal and ethical considerations of any of your promotional actions and act accordingly.

New ‘Sugary Truth’ Brochures Available

Attention office managers! The Michigan Dental Association has just produced an all-new brochure, The Sugary Truth, providing patients with easy-to-understand facts on what sugary drinks are bad for their teeth.

As we all know, when it comes to teeth, sugar isn’t all that sweet. With that in mind, the MDA’s new brochure includes an eye-opening list of just how much sugar content is contained in popular sweetened beverages. The brochure also contains easy-to-follow tips on how to properly enjoy a sugar snack or beverage for those times when patients want to indulge.

The brochure was developed as part of the MDA statewide public education campaign. More patient information on sugar consumption and its effect on dental health is available on the MDA consumer site at

The Sugary Truth brochures can be ordered from the MDA Web Store in packs of 100 at $18 per pack and are also available in Spanish. For a sample brochure, email the MDA’s Jason Heinrich.

Look for additional “Sugary Truth” stickers, T-shirts, and coloring books coming soon!

MDA Job Board: Ads Seeking Dental Staff Members are Free!

Job seekers and employee seekers! The Michigan Dental Association Job Board — MI Dental Jobs — is continuing its promotion offering free ad placement for dental office staff, assistants, and hygienists. The free offer runs through May 2019.

If you haven’t checked out the Michigan Dental Association’s job board, you should! Find it at

The MDA’s interactive job board was created specifically as the go-to site for posting dentist, dental assistant, dental hygienist, and all dental staff positions.

MI Dental Jobs serves as Michigan’s No. 1 resource for dental employ¬ment. Job-seekers can create user profiles, receive job alerts when new ads are posted, receive job alerts based on specific criteria, search geo¬graphically or by specialty, or other customization. Employers posting jobs will have the ability to include complete job descriptions and other details.