Page 29 - Bulletin Vol 28 No 1 - Jan. - April 2023 FINAL

Legal Article |Medicaid Compliance Changes (cont.)

a lawyer or consultant engaged by the dental practice to meet the compliance program requirements can
serve as the compliance officer.

Compliance program requirements identify “risk areas” that are subject to the compliance program. Staff
training, monitoring for compliance and corrective action, when indicated, to prevent and identify
potential or actual fraud, waste and abuse in those areas is important. The new Medicaid rules identify 10
risk areas. Two new risk areas have been identified as specifically requiring this compliance oversight.

These are contractors (an independent contractor associated with the dental practice, for example) and
ordered services (prescriptions, devices, lab tests, as examples).

These Medicaid compliance requirements may appear to be burdensome and costly in the context of the
challenges that dental practices must contend with in the pandemic/post pandemic era. However,
compliance is a requirement for dentists who participate with Medicaid and managed care and meet or
exceed the threshold. An effective compliance and training program can prevent the time-consuming and
potentially costly situation of an audit.

Amy Kulb, a partner in the law firm Jacobson, Goldberg, and Kulb, LLC has been practicing healthcare
law since 1980. Amy began her career at the Office of Professional Discipline. She joined Jacobson
Goldberg & Kulb in 1986, concentrating on representing dentists and other health professionals in
OPD, audits and all practice related matters.

On September 10th NCDS will be partnering with the Oral Cancer
Foundation to raise money and awareness for Oral Cancer with a
5K walk/run at Bethpage State Park. This will be the first ever Oral
Cancer Walk on Long Island. Members will be receiving an email
with a flier to encourage your patients to register to participate
and donate. Please help us fight oral cancer by posting the flier at
your front desk. You can also register and/or donate right now
by using this QR Code:

Nassau County Dental Society ⬧ (516) 227-1112 |