Florida Senate - 2023 SB 356 By Senator Boyd 20-00350A-23 2023356__ 1 A bill to be entitled 2 An act relating to the practice of dentistry; amending 3 s. 466.003, F.S.; defining the term digital 4 scanning; amending s. 466.016, F.S.; requiring 5 dentists to provide each patient with specified 6 information; requiring individuals and entities that 7 provide dental services through telehealth to provide 8 each patient with specified information regarding the 9 dentists treating such patient; amending s. 466.018, 10 F.S.; requiring that there be a dentist of record for 11 each patient treated through telehealth; subjecting 12 such dentists to certain requirements; requiring 13 individuals and entities that provide dental services 14 through telehealth to make specified information 15 available to each patient before rendering such 16 services and at any time upon patient request; 17 providing construction; amending s. 466.019, F.S.; 18 defining the term advertisement; requiring that 19 advertisements of specified dental services provided 20 through telehealth contain a specified disclaimer; 21 amending s. 466.024, F.S.; specifying that only 22 certain dental practitioners may perform specified 23 functions of dentistry; amending s. 466.028, F.S.; 24 providing additional grounds for disciplinary action 25 against dental practitioners; amending s. 409.906, 26 F.S.; conforming a cross-reference; providing an 27 effective date. 28 29 Be It Enacted by the Legislature of the State of Florida: 30 31 Section 1.Present subsections (8) through (15) of section 32 466.003, Florida Statutes, are redesignated as subsections (9) 33 through (16), respectively, a new subsection (8) is added to 34 that section, and present subsection (15) of that section is 35 amended, to read: 36 466.003Definitions.As used in this chapter: 37 (8)Digital scanning means the use of digital technology 38 that creates a computer-generated replica of the hard and soft 39 tissue of the oral cavity using enhanced digital photography, 40 lasers, or other optical scanning devices. 41 (16)(15)School-based prevention program means preventive 42 oral health services offered at a school by one of the entities 43 defined in subsection (15) (14) or by a nonprofit organization 44 that is exempt from federal income taxation under s. 501(a) of 45 the Internal Revenue Code, and described in s. 501(c)(3) of the 46 Internal Revenue Code. 47 Section 2.Section 466.016, Florida Statutes, is amended to 48 read: 49 466.016License to be displayed. 50 (1)Every practitioner of dentistry or dental hygiene 51 within the meaning of this chapter shall post and keep 52 conspicuously displayed her or his license in the office wherein 53 she or he practices, in plain sight of the practitioners 54 patients. Any dentist or dental hygienist who practices at more 55 than one location must shall be required to display a copy of 56 her or his license in each office where she or he practices. 57 (2)Every dentist shall provide each of her or his patients 58 with the dentists name, contact telephone number, after-hours 59 contact information for emergencies, and, upon the patients 60 request, license information. 61 (3)Any individual, partnership, corporation, or other 62 entity that provides dental services through telehealth as 63 defined in s. 456.47 shall provide each patient with the name, 64 contact telephone number, after-hours contact information for 65 emergencies, and, upon the patients request, license 66 information of each dentist who provides dental services to the 67 patient through telehealth. 68 Section 3.Subsection (6) is added to section 466.018, 69 Florida Statutes, to read: 70 466.018Dentist of record; patient records. 71 (6)For any patient treated through telehealth as defined 72 in s. 456.47, there must be a dentist of record who remains 73 primarily responsible for all dental treatment on the patient 74 regardless of whether the treatment is rendered by the dentist 75 of record or by another dentist, dental hygienist, or dental 76 assistant rendering such treatment in conjunction with, at the 77 direction or request of, or under the supervision of such 78 dentist of record. A dentist of record for a patient treated 79 through telehealth is subject to all of the requirements of this 80 section applicable to dentists of record. 81 (a)Any individual, partnership, corporation, or other 82 entity that provides dental services through telehealth shall 83 make available the name, telephone number, practice address, and 84 state license number for the dentist of record and any other 85 dentist who will be involved in the provision of services to a 86 patient before the rendering of such services and at any time 87 requested by a patient. 88 (b)This subsection may not be construed to assign any 89 responsibility to a dentist of record for treatment rendered 90 pursuant to a proper referral to another dentist who is not in 91 the same practice with the dentist of record or to prohibit a 92 patient from voluntarily selecting a new dentist without 93 permission of the dentist of record. 94 Section 4.Section 466.019, Florida Statutes, is amended to 95 read: 96 466.019Advertising by dentists. 97 (1)As used in this section, the term advertisement means 98 a representation disseminated in any manner or by any means to 99 solicit patients and includes, but is not limited to, business 100 cards, circulars, pamphlets, newspapers, websites, and social 101 media. 102 (2)The purpose of this section is to ensure that the 103 public has access to information which provides a sufficient 104 basis upon which to make an informed selection of dentists while 105 also ensuring that the public is protected from false or 106 misleading advertisements which would detract from a fair and 107 rational selection process. The board shall adopt rules to carry 108 out the intent of this section, the purpose of which shall be to 109 regulate the manner of such advertising in keeping with the 110 provisions hereof. 111 (3)(2)An No advertisement by a licensed dentist may not 112 shall contain any false, fraudulent, misleading, or deceptive 113 statement or claim or any statement or claim which: 114 (a)Contains misrepresentations of fact; 115 (b)Is likely to mislead or deceive because in context it 116 makes only a partial disclosure of relevant facts; 117 (c)Contains laudatory statements about the dentist or 118 group of dentists; 119 (d)Is intended or is likely to create false, unjustified 120 expectations of favorable results; 121 (e)Relates to the quality of dental services provided as 122 compared to other available dental services; 123 (f)Is intended or is likely to appeal primarily to a 124 laypersons fears; 125 (g)Contains fee information without a disclaimer that such 126 is a minimum fee only; or 127 (h)Contains other representations or implications that in 128 reasonable probability will cause an ordinary, prudent person to 129 misunderstand or to be deceived. 130 (4)An advertisement of dental services provided through 131 telehealth as defined in s. 456.47 must include a disclaimer 132 that reads, in a clearly legible font and size, An in-person 133 examination with a dentist licensed under chapter 466, Florida 134 Statutes, is recommended before beginning telehealth treatment 135 in order to prevent injury or harm for each of the following 136 services, if advertised: 137 (a)The taking of an impression or the digital scanning of 138 the human tooth, teeth, or jaws by any means or method, directly 139 or indirectly. 140 (b)Furnishing, supplying, constructing, reproducing, or 141 repairing any prosthetic denture, bridge, or appliance or any 142 other structure designed to be worn in the human mouth. 143 (c)Placing an appliance or a structure in the human mouth 144 or adjusting or attempting to adjust the appliance or structure. 145 (d)Correcting or attempting to correct malformations of 146 teeth or jaws. 147 (5)(3)For purposes of this section, D.D.S. or D.M.D. are 148 synonymous and may be used interchangeably by licensed dentists 149 who have graduated from an accredited American dental school 150 with a D.D.S. or D.M.D. degree, when advertising dental 151 services. 152 Section 5.Present subsections (2) through (10) of section 153 466.024, Florida Statutes, are redesignated as subsections (3) 154 through (11), respectively, a new subsection (2) is added to 155 that section, and present subsections (3), (5), (6), and (8) are 156 amended, to read: 157 466.024Delegation of duties; expanded functions. 158 (2)Only a licensed dentist, a dental hygienist under 159 general supervision, or a dental assistant under direct 160 supervision may take an impression or perform digital scanning 161 of the human tooth, teeth, or jaws, directly or indirectly and 162 by any means or method, for the purpose of the practice of 163 dentistry. 164 (4)(3)For all remediable tasks listed in subsection (3) 165 (2), the following disclaimer must be provided to the patient in 166 writing before any procedure is performed: 167 (a)The services being offered are not a substitute for a 168 comprehensive dental exam by a dentist. 169 (b)The diagnosis of caries, soft tissue disease, oral 170 cancer, temporomandibular joint disease (TMJ), and dentofacial 171 malocclusions will be completed only by a dentist in the context 172 of delivering a comprehensive dental exam. 173 (6)(5)A dental hygienist who performs, without 174 supervision, the remediable tasks listed in subsection (3) (2) 175 shall: 176 (a)Provide a dental referral in strict compliance with 177 federal and state patient referral, anti-kickback, and patient 178 brokering laws. 179 (b)Encourage the establishment of a dental home. 180 (c)Maintain professional malpractice insurance coverage 181 that has minimum limits of $100,000 per occurrence and $300,000 182 in the aggregate through the employing health access setting or 183 individual policy. 184 (7)(6)Notwithstanding subsection (1) or subsection (3) 185 (2), a dentist may delegate the tasks of gingival curettage and 186 root planing to a dental hygienist but not to a dental 187 assistant. 188 (9)(8)Notwithstanding subsection (1) or subsection (3) 189 (2), a dentist may not delegate to anyone other than another 190 licensed dentist: 191 (a)Any prescription of drugs or medications requiring the 192 written order or prescription of a licensed dentist or 193 physician. 194 (b)Any diagnosis for treatment or treatment planning. 195 Section 6.Present paragraph (mm) of subsection (1) of 196 section 466.028, Florida Statutes, is redesignated as paragraph 197 (pp), and a new paragraph (mm) and paragraphs (nn) and (oo) are 198 added to that subsection, to read: 199 466.028Grounds for disciplinary action; action by the 200 board. 201 (1)The following acts constitute grounds for denial of a 202 license or disciplinary action, as specified in s. 456.072(2): 203 (mm)Failure by the dentist of record, before the initial 204 diagnosis and correction of a malposition of human teeth or 205 initial use of an orthodontic appliance, to perform an in-person 206 examination of the patient or obtain records from an in-person 207 examination within the last 6 months and to perform a review of 208 the patients most recent diagnostic digital or conventional 209 radiographs or other equivalent bone imaging suitable for 210 orthodontia. 211 (nn)For dental services provided in-person or through 212 telehealth by an individual, a partnership, a corporation, or 213 any other entity, failing to provide each patient with the name, 214 contact telephone number, after-hours contact information for 215 emergencies, and, upon the patients request, the license 216 information of each dentist who is providing dental services to 217 the patient. 218 (oo)For dental services provided through telehealth by an 219 individual, a partnership, a corporation, or any other entity, 220 failing to designate a dentist of record and make available, 221 before the rendering of such services and upon the patients 222 request, the name, telephone number, practice address, and state 223 license number for the dentist of record and any other dentist 224 who will be involved in the provision of dental services to the 225 patient through telehealth. 226 Section 7.Subsection (6) of section 409.906, Florida 227 Statutes, is amended to read: 228 409.906Optional Medicaid services.Subject to specific 229 appropriations, the agency may make payments for services which 230 are optional to the state under Title XIX of the Social Security 231 Act and are furnished by Medicaid providers to recipients who 232 are determined to be eligible on the dates on which the services 233 were provided. Any optional service that is provided shall be 234 provided only when medically necessary and in accordance with 235 state and federal law. Optional services rendered by providers 236 in mobile units to Medicaid recipients may be restricted or 237 prohibited by the agency. Nothing in this section shall be 238 construed to prevent or limit the agency from adjusting fees, 239 reimbursement rates, lengths of stay, number of visits, or 240 number of services, or making any other adjustments necessary to 241 comply with the availability of moneys and any limitations or 242 directions provided for in the General Appropriations Act or 243 chapter 216. If necessary to safeguard the states systems of 244 providing services to elderly and disabled persons and subject 245 to the notice and review provisions of s. 216.177, the Governor 246 may direct the Agency for Health Care Administration to amend 247 the Medicaid state plan to delete the optional Medicaid service 248 known as Intermediate Care Facilities for the Developmentally 249 Disabled. Optional services may include: 250 (6)CHILDRENS DENTAL SERVICES.The agency may pay for 251 diagnostic, preventive, or corrective procedures, including 252 orthodontia in severe cases, provided to a recipient under age 253 21, by or under the supervision of a licensed dentist. The 254 agency may also reimburse a health access setting as defined in 255 s. 466.003 for the remediable tasks that a licensed dental 256 hygienist is authorized to perform under s. 466.024(3) s. 257 466.024(2). Services provided under this program include 258 treatment of the teeth and associated structures of the oral 259 cavity, as well as treatment of disease, injury, or impairment 260 that may affect the oral or general health of the individual. 261 However, Medicaid will not provide reimbursement for dental 262 services provided in a mobile dental unit, except for a mobile 263 dental unit: 264 (a)Owned by, operated by, or having a contractual 265 agreement with the Department of Health and complying with 266 Medicaids county health department clinic services program 267 specifications as a county health department clinic services 268 provider. 269 (b)Owned by, operated by, or having a contractual 270 arrangement with a federally qualified health center and 271 complying with Medicaids federally qualified health center 272 specifications as a federally qualified health center provider. 273 (c)Rendering dental services to Medicaid recipients, 21 274 years of age and older, at nursing facilities. 275 (d)Owned by, operated by, or having a contractual 276 agreement with a state-approved dental educational institution. 277 Section 8.This act shall take effect July 1, 2023.