Florida Senate - 2023 CS for SB 356 By the Committee on Banking and Insurance; and Senator Boyd 597-02910-23 2023356c1 1 A bill to be entitled 2 An act relating to the practice of dentistry; amending 3 s. 466.003, F.S.; defining the terms dental 4 laboratory technician and digital scanning; 5 amending s. 466.016, F.S.; requiring dentists to 6 provide each patient with specified information; 7 requiring individuals and entities that provide dental 8 services through telehealth to provide each patient 9 with specified information regarding the dentists 10 treating such patient; amending s. 466.018, F.S.; 11 requiring that there be a dentist of record for each 12 patient treated through telehealth; subjecting such 13 dentists to certain requirements; requiring 14 individuals and entities that provide dental services 15 through telehealth to make specified information 16 available to each patient before rendering such 17 services and at any time upon patient request; 18 providing construction; amending s. 466.019, F.S.; 19 defining the term advertisement; requiring that 20 advertisements of specified dental services provided 21 through telehealth contain a specified disclaimer; 22 amending s. 466.024, F.S.; specifying that only 23 certain dental practitioners may perform specified 24 functions of dentistry; amending s. 466.028, F.S.; 25 providing additional grounds for disciplinary action 26 against dental practitioners; amending s. 409.906, 27 F.S.; conforming a cross-reference; providing an 28 effective date. 29 30 Be It Enacted by the Legislature of the State of Florida: 31 32 Section 1.Present subsections (7) through (15) of section 33 466.003, Florida Statutes, are redesignated as subsections (9) 34 through (17), respectively, new subsections (7) and (8) are 35 added to that section, and present subsection (15) of that 36 section is amended, to read: 37 466.003Definitions.As used in this chapter: 38 (7)Dental laboratory technician means a person, other 39 than a dental hygienist or dental assistant, who is under the 40 direct supervision of a dentist, and pursuant to a prescription 41 from a dentist, designs, makes, repairs, or alters artificial 42 dental restorations for the correction of disease, loss, 43 deformity, malposition, dislocation, fracture, or injury to the 44 jaws, teeth, lips, gums, cheeks, palate, or associated tissues 45 or parts. 46 (8)Digital scanning means the use of digital technology 47 that creates a computer-generated replica of the hard and soft 48 tissue of the oral cavity using enhanced digital photography, 49 lasers, or other optical scanning devices. 50 (17)(15)School-based prevention program means preventive 51 oral health services offered at a school by one of the entities 52 defined in subsection (16) (14) or by a nonprofit organization 53 that is exempt from federal income taxation under s. 501(a) of 54 the Internal Revenue Code, and described in s. 501(c)(3) of the 55 Internal Revenue Code. 56 Section 2.Section 466.016, Florida Statutes, is amended to 57 read: 58 466.016License to be displayed. 59 (1)Every practitioner of dentistry or dental hygiene 60 within the meaning of this chapter shall post and keep 61 conspicuously displayed her or his license in the office wherein 62 she or he practices, in plain sight of the practitioners 63 patients. Any dentist or dental hygienist who practices at more 64 than one location must shall be required to display a copy of 65 her or his license in each office where she or he practices. 66 (2)Every dentist shall provide each of her or his patients 67 with the dentists name, contact telephone number, after-hours 68 contact information for emergencies, and, upon the patients 69 request, license information. 70 (3)Any individual, partnership, corporation, or other 71 entity that provides dental services through telehealth as 72 defined in s. 456.47 shall provide each patient with the name, 73 contact telephone number, after-hours contact information for 74 emergencies, and, upon the patients request, license 75 information of each dentist who provides dental services to the 76 patient through telehealth. 77 Section 3.Subsection (6) is added to section 466.018, 78 Florida Statutes, to read: 79 466.018Dentist of record; patient records. 80 (6)For any patient treated through telehealth as defined 81 in s. 456.47, there must be a dentist of record who remains 82 primarily responsible for all dental treatment on the patient 83 regardless of whether the treatment is rendered by the dentist 84 of record or by another dentist, dental hygienist, or dental 85 assistant rendering such treatment in conjunction with, at the 86 direction or request of, or under the supervision of such 87 dentist of record. A dentist of record for a patient treated 88 through telehealth is subject to all of the requirements of this 89 section applicable to dentists of record. 90 (a)Any individual, partnership, corporation, or other 91 entity that provides dental services through telehealth shall 92 make available the name, telephone number, practice address, and 93 state license number for the dentist of record and any other 94 dentist who will be involved in the provision of services to a 95 patient before the rendering of such services and at any time 96 requested by a patient. 97 (b)This subsection may not be construed to assign any 98 responsibility to a dentist of record for treatment rendered 99 pursuant to a proper referral to another dentist who is not in 100 the same practice with the dentist of record or to prohibit a 101 patient from voluntarily selecting a new dentist without 102 permission of the dentist of record. 103 Section 4.Section 466.019, Florida Statutes, is amended to 104 read: 105 466.019Advertising by dentists. 106 (1)As used in this section, the term advertisement means 107 a representation disseminated in any manner or by any means to 108 solicit patients and includes, but is not limited to, business 109 cards, circulars, pamphlets, newspapers, websites, and social 110 media. 111 (2)The purpose of this section is to ensure that the 112 public has access to information which provides a sufficient 113 basis upon which to make an informed selection of dentists while 114 also ensuring that the public is protected from false or 115 misleading advertisements which would detract from a fair and 116 rational selection process. The board shall adopt rules to carry 117 out the intent of this section, the purpose of which shall be to 118 regulate the manner of such advertising in keeping with the 119 provisions hereof. 120 (3)(2)An No advertisement by a licensed dentist may not 121 shall contain any false, fraudulent, misleading, or deceptive 122 statement or claim or any statement or claim which: 123 (a)Contains misrepresentations of fact; 124 (b)Is likely to mislead or deceive because in context it 125 makes only a partial disclosure of relevant facts; 126 (c)Contains laudatory statements about the dentist or 127 group of dentists; 128 (d)Is intended or is likely to create false, unjustified 129 expectations of favorable results; 130 (e)Relates to the quality of dental services provided as 131 compared to other available dental services; 132 (f)Is intended or is likely to appeal primarily to a 133 laypersons fears; 134 (g)Contains fee information without a disclaimer that such 135 is a minimum fee only; or 136 (h)Contains other representations or implications that in 137 reasonable probability will cause an ordinary, prudent person to 138 misunderstand or to be deceived. 139 (4)An advertisement of dental services provided through 140 telehealth as defined in s. 456.47 must include a disclaimer 141 that reads, in a clearly legible font and size, An in-person 142 examination with a dentist licensed under chapter 466, Florida 143 Statutes, is recommended before beginning telehealth treatment 144 in order to prevent injury or harm for each of the following 145 services, if advertised: 146 (a)The taking of an impression or the digital scanning of 147 the human tooth, teeth, or jaws by any means or method, directly 148 or indirectly. 149 (b)Furnishing, supplying, constructing, reproducing, or 150 repairing any prosthetic denture, bridge, or appliance or any 151 other structure designed to be worn in the human mouth. 152 (c)Placing an appliance or a structure in the human mouth 153 or adjusting or attempting to adjust the appliance or structure. 154 (d)Correcting or attempting to correct malformations of 155 teeth or jaws. 156 (5)(3)For purposes of this section, D.D.S. or D.M.D. are 157 synonymous and may be used interchangeably by licensed dentists 158 who have graduated from an accredited American dental school 159 with a D.D.S. or D.M.D. degree, when advertising dental 160 services. 161 Section 5.Present subsections (2) through (10) of section 162 466.024, Florida Statutes, are redesignated as subsections (4) 163 through (12), respectively, new subsections (2) and (3) are 164 added to that section, and present subsections (3), (5), (6), 165 and (8) are amended, to read: 166 466.024Delegation of duties; expanded functions. 167 (2)Only a licensed dentist, a dental hygienist under 168 general supervision, or a dental assistant under direct 169 supervision may take an impression of the human tooth, teeth, or 170 jaws, directly or indirectly and by any means or method, for the 171 purpose of the practice of dentistry. 172 (3)Only a licensed dentist, a dental hygienist under 173 general supervision, or a dental assistant or dental laboratory 174 technician under direct supervision may perform digital scanning 175 of the human tooth, teeth, or jaws, directly or indirectly and 176 by any means or method, for the purpose of the practice of 177 dentistry. 178 (5)(3)For all remediable tasks listed in subsection (4) 179 (2), the following disclaimer must be provided to the patient in 180 writing before any procedure is performed: 181 (a)The services being offered are not a substitute for a 182 comprehensive dental exam by a dentist. 183 (b)The diagnosis of caries, soft tissue disease, oral 184 cancer, temporomandibular joint disease (TMJ), and dentofacial 185 malocclusions will be completed only by a dentist in the context 186 of delivering a comprehensive dental exam. 187 (7)(5)A dental hygienist who performs, without 188 supervision, the remediable tasks listed in subsection (4) (2) 189 shall: 190 (a)Provide a dental referral in strict compliance with 191 federal and state patient referral, anti-kickback, and patient 192 brokering laws. 193 (b)Encourage the establishment of a dental home. 194 (c)Maintain professional malpractice insurance coverage 195 that has minimum limits of $100,000 per occurrence and $300,000 196 in the aggregate through the employing health access setting or 197 individual policy. 198 (8)(6)Notwithstanding subsection (1) or subsection (4) 199 (2), a dentist may delegate the tasks of gingival curettage and 200 root planing to a dental hygienist but not to a dental 201 assistant. 202 (10)(8)Notwithstanding subsection (1) or subsection (4) 203 (2), a dentist may not delegate to anyone other than another 204 licensed dentist: 205 (a)Any prescription of drugs or medications requiring the 206 written order or prescription of a licensed dentist or 207 physician. 208 (b)Any diagnosis for treatment or treatment planning. 209 Section 6.Present paragraph (mm) of subsection (1) of 210 section 466.028, Florida Statutes, is redesignated as paragraph 211 (pp), and a new paragraph (mm) and paragraphs (nn) and (oo) are 212 added to that subsection, to read: 213 466.028Grounds for disciplinary action; action by the 214 board. 215 (1)The following acts constitute grounds for denial of a 216 license or disciplinary action, as specified in s. 456.072(2): 217 (mm)Failure by the dentist of record, before the initial 218 diagnosis and correction of a malposition of human teeth or 219 initial use of an orthodontic appliance, to perform an in-person 220 examination of the patient or obtain records from an in-person 221 examination within the last 6 months and to perform a review of 222 the patients most recent diagnostic digital or conventional 223 radiographs or other equivalent bone imaging suitable for 224 orthodontia. 225 (nn)For dental services provided in-person or through 226 telehealth by an individual, a partnership, a corporation, or 227 any other entity, failing to provide each patient with the name, 228 contact telephone number, after-hours contact information for 229 emergencies, and, upon the patients request, the license 230 information of each dentist who is providing dental services to 231 the patient. 232 (oo)For dental services provided through telehealth by an 233 individual, a partnership, a corporation, or any other entity, 234 failing to designate a dentist of record and make available, 235 before the rendering of such services and upon the patients 236 request, the name, telephone number, practice address, and state 237 license number for the dentist of record and any other dentist 238 who will be involved in the provision of dental services to the 239 patient through telehealth. 240 Section 7.Subsection (6) of section 409.906, Florida 241 Statutes, is amended to read: 242 409.906Optional Medicaid services.Subject to specific 243 appropriations, the agency may make payments for services which 244 are optional to the state under Title XIX of the Social Security 245 Act and are furnished by Medicaid providers to recipients who 246 are determined to be eligible on the dates on which the services 247 were provided. Any optional service that is provided shall be 248 provided only when medically necessary and in accordance with 249 state and federal law. Optional services rendered by providers 250 in mobile units to Medicaid recipients may be restricted or 251 prohibited by the agency. Nothing in this section shall be 252 construed to prevent or limit the agency from adjusting fees, 253 reimbursement rates, lengths of stay, number of visits, or 254 number of services, or making any other adjustments necessary to 255 comply with the availability of moneys and any limitations or 256 directions provided for in the General Appropriations Act or 257 chapter 216. If necessary to safeguard the states systems of 258 providing services to elderly and disabled persons and subject 259 to the notice and review provisions of s. 216.177, the Governor 260 may direct the Agency for Health Care Administration to amend 261 the Medicaid state plan to delete the optional Medicaid service 262 known as Intermediate Care Facilities for the Developmentally 263 Disabled. Optional services may include: 264 (6)CHILDRENS DENTAL SERVICES.The agency may pay for 265 diagnostic, preventive, or corrective procedures, including 266 orthodontia in severe cases, provided to a recipient under age 267 21, by or under the supervision of a licensed dentist. The 268 agency may also reimburse a health access setting as defined in 269 s. 466.003 for the remediable tasks that a licensed dental 270 hygienist is authorized to perform under s. 466.024(4) s. 271 466.024(2). Services provided under this program include 272 treatment of the teeth and associated structures of the oral 273 cavity, as well as treatment of disease, injury, or impairment 274 that may affect the oral or general health of the individual. 275 However, Medicaid will not provide reimbursement for dental 276 services provided in a mobile dental unit, except for a mobile 277 dental unit: 278 (a)Owned by, operated by, or having a contractual 279 agreement with the Department of Health and complying with 280 Medicaids county health department clinic services program 281 specifications as a county health department clinic services 282 provider. 283 (b)Owned by, operated by, or having a contractual 284 arrangement with a federally qualified health center and 285 complying with Medicaids federally qualified health center 286 specifications as a federally qualified health center provider. 287 (c)Rendering dental services to Medicaid recipients, 21 288 years of age and older, at nursing facilities. 289 (d)Owned by, operated by, or having a contractual 290 agreement with a state-approved dental educational institution. 291 Section 8.This act shall take effect July 1, 2023.