This page updates when new information becomes available.
Update on Michigan Emergency Orders, New Directives
In response to the Michigan Supreme Court striking down the governor’s executive orders, the state of Michigan is now issuing directives through state departments. The Department of Health and Human Services issued an emergency order on Oct. 9 under the Public Health Code in order to mitigate the spread of COVID-19. The MDA has created a helpful infographic to highlight key requirements for dentistry.
In addition, on Oct. 14, the Department of Labor and Economic Opportunity, Occupational Safety and Health Administration, issued MIOSHA Emergency Rules pertaining to workplace safety. The MDA’s recommendations regarding the MIOSHA Emergency Rules can be found here.
Governor Executive Orders
Due to the Michigan Supreme Court ruling of Oct. 2, 2020, all Executive Orders issued during the COVID-19 pandemic, are no longer valid. The MDA will post new information as it becomes available. The Executive Directives listed below are still valid. For further information, please refer to the Oct. 6 Journal eNews Special Alert.
State of Michigan Directives
Below is the list of Executive Directives currently in effect that impact dental offices. Executive Directives are directives aimed at state departments within the executive branch. The Executive Directives below do not have expiration dates.
As of 8/7/2020
Implicit Bias Training | 2020-07
Directs the Michigan Department of Licensing and Regulatory Affairs to promulgate rules establishing implicit bias training standards as part of the knowledge and skills necessary for licensure, registration, and renewal of licenses and registrations of health professionals in Michigan. This means rules will be promulgated that will require dentists to complete implicit bias training prior to licensing or relicensing. The enactment date and training requirements are still to be determined.
Executive Order Enforcement | 2020-08
Requires state departments to consider violations of law, including any violation of relevant COVID-19 executive orders or epidemic orders, when determining eligibility for licensing. This includes, but is not limited to, suspension of a license.
MDA Switchboard Open, but Most Staff Working from Home
The MDA headquarters switchbaord is open and being answered by the MDA phone receptionist. Calls to MDA Insurance at 800-860-2272 or 800-906-9924 (health insurance line) will also be answered live and forwarded to staff extensions.
Most MDA and MDA Insurance staff members are continuing to work at home as they have since March, but a limited staff is working on-site at MDA headquarters. Staff phone extensions remain forwarded to cell phones of those working remotely.
You may also email individual staff members by using the staff phone/email directory found on Page 5 of the MDA Journal. Or you may send questions to the general MDA email address at firstname.lastname@example.org.
Hazard Assessment and Checklist Available
The Hazard Assessment and Checklist will help you implement COVID-19 assessments in your office as you return to practice. The new document is a companion to the ADA Return to Work Interim Guidance Toolkit — both are available on the ADA Coronavirus (COVID-19) Center.
Additional COVID-19 Resources
The ADA website contains extensive information helpful to you during the COVID-19 outbreak. Information is constantly updated and includes practice information, a letter to patients, COVID-19 coding and billing guidance, COVID-19 and ethics, contract information, webinars, and more.
Can You Charge for PPE Expenses?
Many members have questions about charging for the added costs of PPE. Here’s what you need to know:
- If your office is fee-for-service and does not take insurance, you can charge all your patients a fee for PPE if you wish.
- You may also charge for PPE for any patient who has no insurance and is fee-for-service.
- You may charge for PPE for patients who have insurance through a plan with which you do not contract.
- If you are a Delta, Healthy Kids, or Medicaid provider, you cannot charge Delta, Healthy Kids, or Medicaid patients a fee for PPE.
- For all other patients with insurance, check with the dental plan provider to determine if a PPE fee is allowed.
In response to the extraordinary circumstances dentists and their patients face due to the COVID-19 pandemic, and the skyrocketing cost of infection control procedures, the American Dental Association has issued a COVID-19 Coding and Billing Interim Guidance: PPE, available for download from the ADA website.
If your situation allows you to charge for PPE, the ADA recommends using code D1999. If you do decide to charge your patients a PPE fee, be sure to explain to them the reasoning for your charge. If you have additional questions regarding charging for PPE, contact the MDA’s Josh Kluzak.
N95 Decontamination Service Available
The federal government has set up an N95 decontamination unit (Battelle Critical Care Decontamination System) at the TCF Center, formerly Cobo Hall, to serve Michigan health care providers, including dentists. Upon entering into an agreement with Battelle, health care facilities can ship their contaminated N95 masks to the facility and the Battelle system will decontaminate the masks and return them. There is no cost to use this service. To utilize the service, dental offices will need to enroll and sign a contract with Battelle. According to Battelle, most N95 masks can be decontaminated up to 20 times.
Dental PPE Shortage Affecting Everyone
The Michigan Dental Association understands the concern for getting the necessary PPE. The shortage of PPE, specifically N-95 masks and CDC-accepted alternatives to that product, is being experienced everywhere and is expected to be in limited supply for some time to come. New domestic manufacturing is being dedicated nearly exclusively to hospitals, first responders, and nursing homes. Very little — if any — FDA/CDC authorized product is allocated for dental.
The Dentists Supply Company, the MDA’s recommended source of dental supplies for members, has been vetting every N-95 offer it receives and has not yet found one that is providing an approved product. It would be irresponsible to sell a product that has not undergone the appropriate testing and gained approval by authorities to serve the purpose for which it is intended. Industry sources have confirmed that the major dental suppliers also are out of N-95 with little prospect of obtaining them soon, and that Level 3 masks are also becoming unavailable.
There is no short-term solution to this problem. The MDA advises you to be very cautious of ads for N-95s that may hit your inbox. More than one member has reported purchasing such products and found they are “junk.”
Optimization of Personal Protective Equipment
The Michigan Department of Health and Human Services guidance on how to optimize personal protective equipment during crisis capacity. These are strategies that can be utilized by health care workers to optimize use of PPE during periods of known shortages. They should only be used when there is limited supply that has exceeded the ability to provide conventional standards.
Financial Relief Resources for Dental Offices
The MDA and ADA are working with government officials and other interest groups to help provide financial relief to dental practice owners impacted by the COVID-19 pandemic. Below is a list of current and potential financial relief programs. This list will be updated as things develop.
- Small Business Administration Paycheck Protection Program
- Detailed Information on Available Small Business Administration Loans
- Michigan Small Business Restart Program Grants (application period open until Aug. 5, 2020, at 11:59 p.m.
Dental Office Closures for Non‐Essential Services (PPE/Exposure)
The MDA has prepared a frequently asked questions document highlighting the top questions staff has received regarding dental practice closure for non-essential services, personal protective equipment, and exposure.
Families First Coronavirus Response Act
Human resources expert Jodi Schafer, SPHR, SHRM-SCP, has compiled an informative frequently asked questions document detailing the Families First Coronavirus Response Act and how it impacts your dental practice.
NOTE: Employers need to post the requirements of the FFCRA Act model notice. The model notice must be posted “in a conspicuous place on the employer’s premises.” For eligible (covered) employees who are unable to come in to work, employers can email or direct mail the notice to them or post the notice on an employee information internal or external website.
MDA Releases Employee Recall Q&A, Sample Letter
The MDA has released two documents to help dental practice owners reopen their offices. The first is an Employee Recall Q&A, which covers a wide-range of questions you may receive from your staff. The second is a sample Employee Recall Letter, which you can download and customize for your specific needs.
The MDA believes a consent form is not necessary. The main purpose of a consent form is to provide notice to the patient about a certain situation. However, by following the guidance provided by the ADA and MDA, which recommends a prescreening process prior to an office visit, a screening process at the time of the office visit and appropriate signage at the office, the patient will receive the same notice of the inherent risks in the COVID-19 era as having them sign a consent form.
A covered health care provider may use audio or video communication to provide telehealth to patients during the COVID-19 nationwide public health emergency, according to the ADA and the federal Office for Civil Rights, which enforces HIPAA, and is exercising enforcement discretion. If you choose to use teledentistry refer to the guidance resources below:
- Get Full Guidance Here
- MDA Teledentistry FAQs
- Video-teleconferencing and Cybersecurity during COVID-19
- ADA Interim Guidance for COVID 19 Billing and Coding
- Blue Cross Blue Shield Teledentistry Statement
- Delta Dental Teledentistry Statement
- MDA Journal: “Implementing Teledentistry: The Why and the How”
Other Dental Benefit Policies
These are policies of dental benefits companies not related to teledentistry.
COVID-19 and the Dental Team
Recorded June 4, 2020 | Vince Benivegna, DDS; Marie Fluent, DDS; Chris Smiley, DDS
This webinar covers the facts about COVID-19 as it relates to PPE, infection control, and CDC/OSHA guidance. NOTE: CE was granted only for live viewing of the webinar.
Calling Employees Back to Work: Setting the Stage for Success and Responding to Resistance
Recorded May 21, 2020 | Jodi Schafer, SPHR-SHRM-SCP; Dan Schulte, JD
This webinar provides practical guidance for calling team members back to work, including advice on how to handle employees who are unable or unwilling to return, employee safety, and more. NOTE: CE was granted only for live viewing of the webinar.
Download Webinar Slides
(Includes all templates mentioned in the webinar.)
COVID-19 and HIPAA
Recorded April 29, 2020 | Jennifer Cosey, of Eagle Associates
This webinar outlines several aspects of HIPAA compliance impacted by the COVID-19 pandemic, including an understanding of the temporary, limited waivers. NOTE: CE was granted only for live viewing of the webinar.
Coping with the Stress of COVID-19
Recorded April 23,2020 | Kit Welchlin
This webinar helps you recognize and respond effectively to the emotional and psychological impacts this pandemic has had on you, your staff, your patients, and the community. NOTE: CE was granted only for live viewing of the webinar.
Webinar: The Practice Management Impact of COVID-19
Recorded March 18, 2020 | Speaker Panel
This webinar addresses insurance, human resources, and insurance questions dentists have about managing the business aspects of their practice during the pandemic. NOTE: CE was granted only for live viewing of the webinar.
Questions from the Webinar:
Pandemics and Insurance Ramifications
In general, it is possible property and casualty insurance policies may not treat pandemics such as the coronavirus as covered perils, while life, health and disability policies may provide some coverage depending on policy provisions and normal claims procedures. MDA Insurance offers current updates and resources regarding insurance and services during the COVID-19 pandemic.
- Bank of America Paycheck Protection Program
- MDA Health Plan Subscribers
- Employe-provided Insurance
- Blue Cross Blue Shield/Blue Care Network Group Insurance
- Other Types of Insurance
- MDA Insurance and MDA Services Website
Get the facts about the COVID-19 pandemic from reliable resources.
- “Coronavirus: What Is It?” Video | World Health Organization
- COVID-19 Information Page | Centers for Disease Control and Prevention
- COVID-19 Situation Summary | Centers for Disease Control and Prevention
- Respiratory Hygiene/Cough Etiquette/Infection Control Measures | Centers for Disease Control and Prevention
- Michigan COVID-19 Information Page | Michigan Department of Health and Human Services