Or. Admin. Code § 410-123-1250

Current through Register Vol. 64, No. 1, January 1, 2025

Section 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.

Or. Admin. Code § 410-123-1250

DMAP 65-2019, adopt filed 12/26/2019, effective 1/1/2020; DMAP 50-2021, amend filed 12/24/2021, effective 1/1/2022; DMAP 63-2024, minor correction filed 02/21/2024, effective 2/21/2024; DMAP 139-2024, amend filed 12/06/2024, effective 1/1/2025

Statutory/Other Authority: ORS 679.543 & 414.065

Statutes/Other Implemented: ORS 414.065