Senate Bill No. 192

Introduced By keating

A Bill for an Act entitled: "An Act allowing, for a period of 12 months for the purpose of selling the dental practice, the personal representative of the estate of a deceased dentist or the personal representative of a disabled dentist to manage, own, operate, or otherwise conduct CONTRACT WITH A DENTIST TO MANAGE an establishment where dental services are provided; prohibiting the personal representative from governing or interfering with the clinical aspects of dental practice; amending sections 37-4-101, 37-4-102, 37-4-103, and 37-4-327, MCA; and providing an applicability date."

Be it enacted by the Legislature of the State of Montana:

Section 1.  Section 37-4-101, MCA, is amended to read:

"37-4-101.   Definitions -- practice of dentistry. (1) Unless the context requires otherwise, in this chapter, the following definitions apply:

(a)  "Board" means the board of dentistry provided for in 2-15-1842.

(b)  "Conscious sedation" means a minimally depressed level of consciousness in which the patient breathes normally without assistance, retains protective reflexes, and responds to physical stimulation or verbal command in a manner appropriate to the patient's cognitive level. Conscious sedation is not a form of general anesthesia, and brief interludes of unconsciousness during conscious sedation do not bring conscious sedation within the scope of general anesthesia.

(c)  "Department" means the department of commerce provided for in Title 2, chapter 15, part 18.

(d)  "General anesthesia" means a state of unconsciousness intentionally produced by anesthetic agents, with absence of pain sensation over the entire body and a greater or lesser degree of muscular relaxation. The drugs producing this state can be administered by inhalation, intravenously, intramuscularly, or via the gastrointestinal tract. General anesthesia is divided into:

(i)  full general anesthesia, which means a level of consciousness in which the patient is without intact protective reflexes, is unable to maintain an airway, and is incapable of rational response to query or command; and

(ii) light general anesthesia, which means a level of consciousness in which the patient breathes normally without assistance and retains protective reflexes throughout most of the procedure.

(e)  "General anesthetic" means any recognized anesthetic agent, sedative, hypnotic, tranquilizer, or narcotic used in sufficient prescribed dosages for the purpose of inducing general anesthesia. The term general anesthetic does not include a nitrous oxide/oxygen mixture or any other anesthetic administered to produce conscious sedation.

(2)  A Except for the provisions of [section 5], a person is "practicing dentistry" under this chapter if he the person:

(a)  performs, attempts, advertises to perform, causes to be performed by the patient or any other person, or instructs in the performance of dental operations, oral surgery, or dental service of any kind gratuitously or for a salary, fee, money, or other remuneration paid or to be paid, directly or indirectly, to himself the person, any other person, or any agency;

(b)  is a manager, proprietor, operator, or conductor of a place where dental operations, oral surgery, or dental services are performed, unless the person is the personal representative of the estate of a deceased dentist or the personal representative of a disabled dentist, as provided in [section 5];

(c)  directly or indirectly, by any means or method, furnishes, supplies, constructs, reproduces, or repairs a prosthetic denture, bridge, appliance, or other structure to be worn in the human mouth;

(d)  places the appliance or structure in the human mouth or attempts to adjust it;

(e)  advertises to the public, by any method, to furnish, supply, construct, reproduce, or repair a prosthetic denture, bridge, appliance, or other structure to be worn in the human mouth;

(f)  diagnoses, professes to diagnose, prescribes for, professes to prescribe for, treats, or professes to treat disease, pain, deformity, deficiency, injury, or physical condition of human teeth, jaws, or adjacent structures;

(g)  extracts or attempts to extract human teeth or corrects, attempts, or professes to correct malpositions of teeth or of the jaw;

(h)  gives or professes to give interpretations or readings of dental roentgenograms;

(i)  administers an anesthetic of any nature, subject to the limitations provided in 37-4-511, in connection with a dental operation;

(j)  uses the words "dentist", "dental surgeon", or "oral surgeon", the letters "D.D.S.", "D.M.D.", or any other words, letters, title, or descriptive matter which that in any way represents him the person as being able to diagnose, treat, prescribe, or operate for any disease, pain, deformity, deficiency, injury, or physical condition of human teeth, jaws, or adjacent structures;

(k)  states, advertises, or permits to be stated or advertised, by sign, card, circular, handbill, newspaper, radio, or otherwise, that he the person can perform or will attempt to perform dental operations or render a diagnosis in connection therewith with dental operations; or

(l)  engages in any of the practices included in the curricula of recognized dental colleges."

Section 2.  Section 37-4-102, MCA, is amended to read:

"37-4-102.   Designations constituting prima facie evidence of practicing dentistry. Except for the provisions in [section 5], Whenever any person shall append appending the word "dentist" or the letters "D.D.S.", "D.M.D.", or like similar letters to his or her a person's name in any way for advertising or upon any door or sign or upon or in any writing or print, publish, or use the same in any way or cause either of the same to be done, the same shall be prima facie evidence that such on a door or a sign, in a printed or published form, or in any other type of advertisement is prima facie evidence that the person is engaged in the practice of dentistry and is subject to the regulations, convictions, and penalties of this chapter."

Section 3.  Section 37-4-103, MCA, is amended to read:

"37-4-103.   Exemptions. (1) A dental laboratory or dental technician is not practicing dentistry under this chapter when engaged in the construction, making, alteration, or repairing of bridges, crowns, dentures, or other prosthetic appliances, surgical appliances, or orthodontic appliances if the casts, models, or impressions on which the work is constructed have been made by a regularly licensed and practicing dentist and the crowns, bridges, dentures, prosthetic appliances, surgical appliances, or orthodontic appliances are returned to the dentist on whose order the work was constructed.

(2)  Section 37-4-101(2) and part 5 of this chapter do not apply to a legally qualified physician or surgeon or to a dental surgeon of the United States army, navy, public health service, or veterans' bureau or to a legal practitioner of another state making a clinical demonstration before a dental society, convention, or association of dentists or to a licensed dental hygienist performing an act authorized under 37-4-401 or 37-4-405.

(3)  Nothing in this chapter prevents This chapter does not prevent a bona fide faculty member of a school, college, or department of a university recognized and approved by the board from performing dental procedures necessary to his the faculty member's teaching functions. Nothing in this chapter prevents This chapter does not prevent students from performing dental procedures under the supervision of a bona fide instructor of a school, college, or department of a university recognized and approved by the board provided such if the dental procedures are a part of the assigned teaching curriculum.

(4)  This chapter does not prohibit or require a license with respect to the practice of denturitry under the conditions and limitations defined by Title 37, chapter 29. None of the regulations contained in this chapter apply to a person engaged in the lawful practice of denturitry.

(5) This chapter does not require the licensure of or prohibit the personal representative of the estate of a deceased dentist or the personal representative of a disabled dentist from managing, owning, operating, or otherwise conducting CONTRACTING WITH A DENTIST TO MANAGE THE DENTAL PRACTICE AT an establishment where dental operations, oral surgery, or dental services are provided if the personal representative in either case complies with the provisions of [section 5]."

Section 4.  Section 37-4-327, MCA, is amended to read:

"37-4-327.   Practicing dentistry without certificate -- penalty. (1) A Except as provided in 37-4-101 through 37-4-103, [section 5], and this section, a person who, as principal, agent, employer, employee, or assistant, practices dentistry or who does an act of dentistry without having first secured a certificate to practice dentistry from the department entitling him the person to practice in this state is guilty of a misdemeanor and on conviction in a district court may be fined an amount not less than $500 or more than $1,000 or be confined for a period not exceeding 6 months in the county jail.

(2)  Fines imposed and collected under this chapter, except those paid to a justice's court, shall must be paid into the treasury of the county in which the suits, actions, or proceedings are commenced. Money paid into the treasury over and above in excess of the amount necessary to reimburse the county for expense incurred by the county in a suit, action, or proceeding brought under this chapter shall must be deposited before January 1 of each year in the state special revenue fund for the use of the board, subject to 37-1-101(6)."

NEW SECTION. Section 5.  Twelve-month period for disposition of deceased or disabled dentist's practice by personal representative -- restrictions. (1) For the purpose of selling or otherwise disposing of a deceased or a disabled licensee's dental practice and for a period not to exceed 12 months, a person who is not licensed to practice dentistry but who is the personal representative of the estate of a deceased dentist or the personal representative of a disabled dentist may manage, own, operate, or otherwise conduct CONTRACT WITH A DENTIST TO MANAGE THE DENTAL PRACTICE AT an establishment where dental operations, oral surgery, or dental services are provided.

(2) A personal representative may not:

(a) govern the clinical sufficiency, suitability, reliability, or efficacy of a particular service, product, process, or activity as it relates to the delivery of dental care;

(b) preclude or otherwise restrict a dentist's ability to exercise independent professional judgment over all qualitative and quantitative aspects of the delivery of dental care;

(c) allow any person other than a dentist to supervise and control the selection, compensation, terms, conditions, obligations, or privileges of employment or retention of clinical personnel in the dental practice;

(d) determine or limit a fee charged by the dentist or limit the methods of payment accepted by a dentist or the dentist's practice; or

(e) limit or define the scope of services offered by the dentist.

(3) For the purposes of this section:

(a) "clinical" means having a significant relationship, whether real or potential, direct or indirect, to the actual rendering or outcome of dental care, the practice of dentistry, or the quality of dental care being rendered to a patient;

(b) "disabled" has the same meaning as provided for the term "PERMANENTLY AND TOTALLY DISABLED" in 15-30-111; and

(c) "personal representative" OF THE ESTATE OF A DECEASED DENTIST has the same meaning as provided for the term in 72-1-103.

(4) The 12-month period provided for in subsection (1) begins when:

(a) the personal representative of the estate of a deceased dentist files a verified copy of the death certificate of the deceased with the department; or

(b) the personal representative of the disabled dentist files a verified copy of a document signed by a licensed physician that attests to the dentist's disability.

NEW SECTION. Section 6.  Codification instruction. [Section 5] is intended to be codified as an integral part of Title 37, chapter 4, part 1, and the provisions of Title 37, chapter 4, part 1, apply to [section 5].

NEW SECTION. Section 7.  Applicability. [Section 5] applies to the sale or disposal of a dental practice managed, owned, operated, or otherwise conducted by the personal representative of a dentist whose death or disability occurs on or after [the effective date of this act].

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