Or. Admin. Code § 410-123-1250 - HbA1c Testing
(1) Hemoglobin
A1c (HbA1c) testing for at risk members is within the scope of dental practice
for Oregon licensed oral health providers.
(2) Although not presumed to be a standard of
care, testing serves as a resource for dentists which supports identification
of those members with HbA1c levels that are above the "normal range", and that
can affect periodontal status, wound healing, infection control and other
conditions of the oral environment.
(3) Licensed oral health providers must share
the HbA1c test results with the member's primary care provider (PCP) to promote
care collaboration and avoid duplication:
(a)
If the test results indicate risk, the dental provider must establish
bi-directional communication with the member's PCP to communicate test results
and initiate a referral for evaluation, diagnosis, treatment, and collaboration
of care; and
(b) Communicate
progress of treatment and oral health status.
(4) Licensed oral health providers must
comply with OAR 410-130-0680, as it pertains to
blood testing, and 42 CFR §493 and OAR
333-024-0005 through
333-024-0055, as it pertains to
Clinical Laboratory Improvement Amendments (CLIA):
(a) For laboratory enrollment requirements
and processes, as identified at
https://www.oregon.gov/oha/PH/LaboratoryServices/ClinicalLaboratoryRegulation/Pages/index.aspx;
(b) Oregon licensed oral health providers and
facilities must apply for a Certificate of Waiver (CMS 1600), available on the
CLIA webpage, in order to perform any HbA1c testing; and
(c) Waived tests are not exempt from CLIA
certification, as stated on the website (Refer to
https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments)
and the CMS 1600.
(5) In
determining the need for dental HbA1c testing, dentists must consider member
risk factors based on appropriate, consensus-based guidelines and the dentist's
best clinical judgement.
(6)
Release of Information (ROI):
(a) Providers
must ensure a member's ROI is on file in the member's record;
(b) Shall the member not have a Primary Care
Provider (PCP), providers must:
(A) Inform the
member of the test findings and direct them toward resources containing more
information and encourage the member to become a patient of record with a PCP
for their other health needs; and
(B) Document actions in the member's record,
with follow-up at the next visit.
(c) Referrals must be tracked and documented
in the member's record;
(d)
Providers must provide sufficient information regarding the purpose of the test
and the procedure, including its relevance to both oral and general health, so
that a member can make an informed decision; and
(e) Members may decline testing.
Notes
Statutory/Other Authority: ORS 679.543 & 414.065
Statutes/Other Implemented: ORS 414.065
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