Title of Regulation: 18VAC60-21. Regulations Governing the Practice of Dentistry (amending 18VAC60-21-30).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: February 22, 2017.

Effective Date: March 9, 2017.

Agency Contact: Sandra Reen, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4437, FAX (804) 527-4428, or email sandra.reen@dhp.virginia.gov.

Basis: Regulations are promulgated under the general authority of § 54.1-2400 of the Code of Virginia, which provides the Board of Dentistry the authority to promulgate regulations to administer the regulatory system.

Purpose: The purpose of the amendment is to reduce the possibility of fraud in the acquisition of prescription drugs by illegal use of a dentist's Drug Enforcement Agency (DEA) number. The board's amendment maintains access to the DEA registration for purposes of inspection or investigation but eliminates the posting requirement that made the DEA information readily accessible for any potential illegal prescriptions. The goal of protection of the health and safety of the public is enhanced by the security of a dentist's DEA registration.

Rationale for Using Fast-Track Rulemaking Process: This proposal is in response to a petition for rulemaking, which was supported by comments from 56 dentists. It will not be controversial because it is fully supported by the dental community and the board.

Substance: The posting requirements amendments allow a dentist who administers, prescribes, or dispenses Schedules II through V controlled substances to maintain a copy of his current registration with the federal Drug Enforcement Administration in a readily retrievable manner at each practice location rather than displaying it to the public along with his current license.

Issues: The advantage to the public is less risk of the illegal use of a dentist's DEA number to obtain controlled substances. There are no disadvantages. There are no advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. In response to a 2016 petition for rulemaking, the Board of Dentistry (board) is proposing a fast-track action to eliminate a posting requirement for dentists.¹

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. Currently, dentists who administer, prescribe, or dispense Schedules II through V controlled substances are required to post copies of their registrations that are issued by the United States Drug Enforcement Administration (DEA). The regulation requires licensees to display their current registrations with their current active licenses where they are "conspicuous and readable by patients in each dental practice setting."

The petitioner raised a concern that this information might be used for illegal purposes and thus requested that the board consider eliminating the posting requirement for DEA registrations. Accordingly, the board is proposing to amend the regulation to remove the "display" requirement and replace it with one that imposes a duty to maintain a copy of the current registration "in a readily retrievable manner at each practice location." The proposed amendment does not significantly affect costs. To the extent that not requiring the display of the DEA registration reduces the likelihood of fraud in the acquisition of prescription drugs by illegal use of a dentist’s DEA number, the proposal is beneficial. Thus the proposed amendment likely produces a net benefit.

Businesses and Entities Affected. The proposed amendment would affect the 7,147 licensed dentists² and 3,201 dental offices³ in the Commonwealth. All of the dental offices qualify as small businesses.

Localities Particularly Affected. The proposed amendment does not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendment will not affect employment.

Effects on the Use and Value of Private Property. The proposed amendment will not significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendment does not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed amendment does not significantly affect costs.

Alternative Method that Minimizes Adverse Impact. The proposed amendment does not adversely affect small businesses.

Adverse Impacts:

Businesses. The proposed amendment does not adversely affect businesses.

Localities. The proposed amendment does not adversely affect localities.

Other Entities. The proposed amendment does not adversely affect other entities.

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¹ More information about the petition for rulemaking is available on the Virginia Regulatory Town Hall at http://townhall.virginia.gov/L/viewpetition.cfm?petitionid=246.

² Data source: Department of Health Professions

³ Data source: Virginia Employment Commission

Agency's Response to Economic Impact Analysis: The Board of Dentistry concurs with the analysis of the Department of Planning and Budget.

Summary:

The amendments allow a dentist who administers, prescribes, or dispenses Schedules II through V controlled substances to maintain a copy of his current registration with the federal Drug Enforcement Administration in a readily retrievable manner at each practice location rather than displaying it to the public along with his current license.

18VAC60-21-30. Posting requirements.

A. A dentist who is practicing under a firm name or who is practicing as an employee of another dentist is required by § 54.1-2720 of the Code to conspicuously display his name at the entrance of the office. The employing dentist, firm, or company must enable compliance by designating a space at the entrance of the office for the name to be displayed.

B. In accordance with § 54.1-2721 of the Code a dentist shall display his dental license where it is conspicuous and readable by patients in each dental practice setting. If a licensee practices in more than one office, a duplicate license obtained from the board may be displayed.

C. A dentist who administers, prescribes, or dispenses Schedules II through V controlled substances shall display maintain a copy of his current registration with the federal Drug Enforcement Administration with his current active license in a readily retrievable manner at each practice location.

D. A dentist who administers conscious/moderate sedation, deep sedation, or general anesthesia in a dental office shall display his sedation or anesthesia permit issued by the board or certificate issued by AAOMS.