Dental Benefits

CDA is taking action to help dentists navigate a rapidly-shifting marketplace and to help sustain the financing and delivery systems in which dentists can most effectively provide quality oral health care to their patients.

Prepare to apply for CalHealthCares student loan repayment or practice support grant
11/11/2019
Eligible dentists and dental students in California can apply Jan. 13 to Feb. 7, 2020, for student loan repayment of up to $300,000 or a practice support grant — also up to $300,000 — through the CalHealthCares program. To improve their chances of scoring highly, applicants are encouraged to prepare early by reviewing all materials, including eligibility requirements and Q&A, and attending an upcoming live webinar or watching a recorded webinar.
Not your father's Medi-Cal
10/21/2019
Improvements to the Medi-Cal Dental program continue with new options for dentists who treat Medi-Cal members, including the ability to provide fluoride treatment and fluoride varnish as a benefit once every four months for patients under age 6. The increase in the benefit periodicity underscores the state’s commitment to regular preventive oral health visits for young children in California.
$300K opportunity for dentists who relocate, commit to Medi-Cal
09/24/2019
California dentists who are willing to relocate, expand or establish a new practice to an area of highest patient need and commit to serving Medi-Cal beneficiaries for at least 10 years can apply in January 2020 to receive up to $300,000 in grant funding through the state’s CalHealthCares program to support related costs.
'Life-changing' grants awarded to 38 dentists committed to Medi-Cal
08/19/2019
Marc Bernardo, DMD, MPH, and Michelle Galeon, DMD, are among the first recipients of a new grant funded by Proposition 56, a voter-approved tobacco tax that CDA and other health care organizations sponsored in 2016. The grant program awarded $10 million in debt relief to 38 dentists (up to $300,000 each) in exchange for the dentists maintaining a 30% or more Medi-Cal patient caseload for five years.
New state program awards $10.5M in grants to dentists
07/11/2019
The Department of Health Care Service’s new program designed to expand access to care for Medi-Cal patients has awarded $10.5 million to 40 dentists to pay student loan debt. Approximately 1,300 health care providers, including 350 dentists, applied to the CalHealthCares program, which offers up to $300,000 in debt relief in exchange for meeting certain criteria.
Participate in study to evaluate the Dental Transformation Initiative
07/03/2019
To understand how well the Dental Transformation Initiative program is meeting its goals, the Department of Health Care Services has contracted with Mathematica, an external, independent research organization, to evaluate DTI as outlined in the Centers for Medicare & Medicaid Services Special Terms and Conditions.
Budget deal makes multiyear commitment to increased provider rates
07/01/2019
As part of the finalized 2019-20 California state budget, the Legislature and Gov. Gavin Newsom approved a continuation of supplemental Medi-Cal provider rates, including significant dollars for dentists serving Medi-Cal patients. An additional $20 million was dedicated to dentists through a recently launched student loan repayment program.
California-contracted dentists should prepare for a quality assessment review, says Delta Dental
05/14/2019
Delta Dental of California notified California dentists in its FYI newsletter that dentists should be prepared for a quality assessment review. CDA members are encouraged to review the on-site QA review checklist provided in the April 9 newsletter to ensure compliance. On-site reviews are part of Delta Dental’s quality assessment program for contracted dentists in California, mandated by the California Department of Managed Health Care.
Deadline to cash Delta Dental settlement checks approaching
04/17/2019
Delta Premier Providers who are class members of the Delta Dental class action lawsuit have until June 14, 2019, to cash their settlement checks. The $65 million settlement is the result of legal action CDA filed against Delta on behalf of members. Most settlement checks sent to approximately 14,000 class members have been cashed, but the class action settlement administrator reports that more than 500 settlement checks have yet to be cashed.
Promising changes for providers: Demystifying the state dental program
04/02/2019
Dentists who want to better understand recent changes to the Medi-Cal Dental Program, including the substantial rate increases and a streamlined application process for providers, can attend a course this May at CDA Presents The Art and Science of Dentistry in Anaheim. The course is hosted by CDA Public Affairs and is intended both for current and potential providers.
Prop. 56 dentists loan repayment program opens April 1, awards up to $300K
03/19/2019
A new loan repayment program is available for dentists and physicians who provide direct patient care to Medi-Cal beneficiaries. Eligible dentists may apply through Physicians for a Healthy California to receive up to $300,000 to apply toward their student loans in exchange for a five-year service obligation as a Medi-Cal provider.
CDA bill makes silver diamine fluoride a covered Medi-Cal benefit
03/19/2019
Silver diamine fluoride would become a covered benefit as a treatment option for tooth decay for specified Medi-Cal Dental Program enrollees under a new bill authored by Sen. Richard Pan. Senate Bill 154 would make SDF a covered benefit if applied as part of a patient’s comprehensive treatment plan and with the patient’s written informed consent.
State program expands provider incentives to new counties
02/14/2019
Dentists in 26 counties have a new opportunity to participate in the Dental Transformation Initiative to help improve dental health for low-income children enrolled in the Medi-Cal Program while receiving enhanced reimbursement by meeting specific incentive metrics. As part of California's 1115 waiver, the DTI focuses on high-value care, improved access to dental care, and the use of performance measures to improve the program through four “domains.”
Medi-Cal Dental Program improvements aim to recruit, retain providers
01/24/2019
Through the improved Medi-Cal Dental Program, more than 13 million individuals are eligible for dental benefits, and a streamlined application and significant rate increases are prompting more dentists to join the program as providers. The changes follow years of action to improve the program, including CDA’s efforts to educate the public and policymakers about the importance of good oral health care. Jennifer Kent, director of the California Department of Health Care Services, in this Q&A discusses the program’s recent changes and what dentists can expect as providers.
Prop. 56 Dental Loan Repayment Program will award up to $300K
01/10/2019
Preliminary criteria for the Prop. 56 Dental Loan Repayment Program were recently announced by the California Department of Health Care Services. The program will repay up to $300,000 toward student loans for dentists who commit to serving Denti-Cal beneficiaries. Applications will open this spring with participants selected no later than July 1.
Smile, California: Helping Medi-Cal members use their dental benefit
12/17/2018
A campaign to increase Medicaid-enrolled members’ use of Medi-Cal’s dental benefit was launched recently by the California Department of Health Care Services as part of an integrated plan to improve the overall performance of the state’s dental program. The “Smile, California” campaign will educate eligible members about the free and low-cost services available to maintain good oral health and make it easier for members to access care. Outreach efforts also focus on recruiting and maintaining providers.
In California, saving teeth and money — one mouth at a time
11/23/2018
At the children’s dental clinic that Dr. John Blake runs in Long Beach, children as young as 2 or 3 show up with blackened teeth and swollen faces, unable to eat because of the pain and in need of whole mouth restorations. In California, tooth decay in children outpaces the national average. Hoping to save both teeth and money, the state is addressing the problem with an overhaul of Denti-Cal, part of the Medi-Cal health system for low-income Californians.
New Delta Dental rule can affect dentists' fees
11/13/2018
CDA Practice Support continues to receive calls from member dentists regarding Delta Dental of California’s recently implemented contractual change under Participating Dentist Rule 2, Basis of Fees. In a letter mailed to participating providers in January, Delta Dental of California shared revisions to its provider participation documents. Specifically, Appendix A – California Participating Dentist Rule 2 — was revised.
Does the Jan. 1 Medicare deadline apply to you?
11/05/2018
The Centers for Medicare and Medicaid Services earlier this year published a final rule revising the Medicare Advantage program (Part C) and Prescription Drug Benefit program (Part D) regulations. The final rule rescinds a previous CMS rule that required dentists who provide dental care and prescriptions for Medicare Advantage patients and Part D beneficiaries to be enrolled in Medicare or to have opted out in order for their services to be covered.
No changes to Covered California dental plan offerings for 2019
10/29/2018
Covered California, the state’s health insurance marketplace for the federal Affordable Care Act, has released the participating dental plans for the 2019 benefit year, maintaining the same dental plans offered for 2018. Open enrollment for 2019 coverage begins Nov. 1 and ends Jan. 31, 2019. Adults and children may enroll in Covered California’s individual and family plans as an optional benefit.
Higher reimbursement rates in effect for Medi-Cal dental program
10/18/2018
New state revenue from the taxation of tobacco products, along with support from legislators and Gov. Jerry Brown, is putting over half a billion dollars toward increased Medi-Cal dental provider reimbursements for 2018-19. The higher reimbursement follows years of activity to improve the Medi-Cal dental program and increase access to oral health care for California’s 13.5 million Medi-Cal members.
Eligible Premier providers to receive settlement payments
09/17/2018
Approximately 14,000 dentists are expected to receive payments by the end of October as part of CDA’s settlement agreement with Delta Dental. The agreement, which was approved by the court in May and followed by a 60-day appeal period, provides $65 million to Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.” Dentists who did not have their fees reduced improperly by the inflationary adjustment percentage will not receive payments.
CDA Presents course will explain promising changes to state's dental program
08/21/2018
Promising changes to the Medi-Cal dental program, including substantial rate increases and a streamlined provider application that saves applicants significant time, are making it more enticing for dentists to become Denti-Cal providers. Now, dentists have an opportunity to learn the details about these changes and additional Denti-Cal program investments at CDA Presents The Art and Science of Dentistry in September.
Disaster assistance available for Denti-Cal providers, beneficiaries
08/13/2018
Denti-Cal providers and beneficiaries in nine counties impacted by the Carr and Cranston fires will receive processing exceptions to expedite replacement of removable dental appliances, a special Denti-Cal Bulletin states. According to the August Bulletin, claims will be accepted without requiring prior authorization and will not be rejected due to frequency limitations for subsequent removable appliances for eligible beneficiaries.
Delta Dental settlement notices mailed to eligible providers
07/24/2018
A class action settlement administrator has mailed allocation notices to approximately 14,000 Premier providers eligible for payments under CDA’s settlement agreement with Delta Dental. Although eligible dentists do not need to file a claim in order to receive their portion of the $65 million settlement, they should read the notice carefully and supply any requested changes of address.
Eligible Premier providers to be mailed Delta Dental settlement notices
07/11/2018

Dentists eligible for payments under CDA’s settlement agreement with Delta Dental should expect to receive allocation notices within a few weeks. The class action settlement administrator plans to mail letters to approximately 14,000 Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.”

Dentists receive unprecedented $30M for student loan repayment in state budget
06/27/2018
The 2018-19 state budget signed by Gov. Jerry Brown dedicates $210 million from the Proposition 56 Tobacco Tax revenue to Denti-Cal providers, a $70 million increase from last year’s amount. And a new aspect in this year’s budget is an additional one-time allocation of $30 million toward a program that would repay student loans for dentists who commit to serving Denti-Cal beneficiaries and locate their practice in a county or region that lacks adequate providers.
Top 8 questions asked about the Delta Dental settlement
06/12/2018
CDA Practice Support is hearing from members who have questions about the Delta Dental settlement, which CDA secured final court approval of in late April. Provided here are members’ top questions, compiled and answered by Practice Support. Questions include “What started the legal action that led to this settlement?” and “Are there any benefits beyond the $65 million payment?”
CDA secures final court approval of $65M Delta Dental settlement for dentists
05/01/2018

A San Francisco Superior Court judge has granted final approval of the $65 million amended settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists. The comprehensive settlement is the result of a lengthy legal battle that CDA initiated in 2013 after learning of Delta Dental’s plans to reduce Premier provider rates by 8 to 12 percent. CDA brought the litigation in order to protect the rights of its members and to require Delta Dental to honor the terms of its contracts.

Little Hoover Commission examines changes in Denti-Cal program
04/23/2018
California's Little Hoover Commission, an independent state oversight agency, held a special hearing March 22 to assess progress within the Denti-Cal program since the commission released the April 2016 report titled Fixing Denti-Cal. The commission heard from several panels, including Denti-Cal providers who serve the population in a variety of settings. CDA member dentist Nagaraj Murthy, DDS, spoke about his experiences as a long-term Denti-Cal program provider.
CDA, CSPD, sponsor bill to expand health plan coverage for dental anesthesia
04/09/2018
If enacted, Assembly Bill 2643, co-sponsored by CDA and the California Society of Pediatric Dentistry, would require medical insurance plans to cover general anesthesia costs in the dental office setting when a patient’s developmental or other physical condition prevents that patient from receiving dental treatment unless deeply sedated but does not necessitate a hospital setting for care.
Silver diamine fluoride covered under Denti-Cal with CDA-sponsored bill
04/04/2018
CDA is sponsoring new legislation that will allow dentists who provide care in the Medi-Cal dental program to be reimbursed when using silver diamine fluoride as a caries arresting agent. With the passage of Senate Bill 1148, SDF will be placed in dentists’ tool belts as an evidence-based option to manage dental caries when used as part of a comprehensive treatment plan, particularly beneficial with patients who present challenges to receiving traditional treatment.
Delta Dental settlement information available online
03/02/2018
Dentists seeking information regarding CDA’s amended settlement agreement with Delta Dental can find all related information posted at DeltaDentalofCaliforniaSettlement.com. Under the settlement agreement, Delta Dental must pay $65 million to Premier Providers whose rates were impacted by an inflationary guard. Not every Premier Provider had his or her fees reduced by this procedure, but those who did will receive some proportionate reimbursement.
Proposed 2018-19 state budget increases Proposition 56 funding
01/10/2018
The following is a statement from Natasha Lee, DDS, president of the California Dental Association regarding Gov. Jerry Brown’s proposed 2018-19 state budget that was released today.
Quick reference guide, more details on Denti-Cal adult benefit restoration in 2018
01/04/2018
Beginning Jan. 1, 2018, adults enrolled in the Denti-Cal program are eligible for an expanded set of dental benefits. The Department of Health Care Services on Nov. 9 issued a special provider bulletin to clarify the dental services that providers may render, bill and be reimbursed for by Denti-Cal in 2018, including scaling and root planing, partial dentures and posterior root canals.
Court grants preliminary approval of $65M Delta Dental settlement agreement
01/02/2018
In a hearing on Dec. 27, a San Francisco Superior Court judge granted preliminary approval of the amended settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists. After an error in the financial calculations was discovered during the validation CDA required of the prior settlement amounts, the new settlement includes an agreement by Delta Dental to pay an unprecedented monetary award of more than $65 million and expands the number of dentists eligible for awards to more than 14,000.
CDA negotiates larger settlement for Delta Dental Premier dentists
12/15/2017
A revised proposed settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists has been filed in Superior Court. The revised settlement includes an agreement by Delta Dental to pay an unprecedented monetary award that nearly doubles the amount the parties had previously agreed upon to more than $65 million.
Stakes high for California without renewed CHIP funding
12/11/2017
Despite broad bipartisan support, Congress neglected to take action to extend Children’s Health Insurance (CHIP) funding before it expired Sept. 30. The consequences of Congress’ delay are creating stressful uncertainty for states and families across the country. Sixteen states, including California, will run out of funding for the CHIP program by the end of January. CDA is calling on its members to help protect coverage for children and hard-fought improvements in the Denti-Cal program.
Supplemental reimbursements receive federal approval
12/05/2017
Significant rate increases for hundreds of procedures covered by Denti-Cal have been approved by the federal government. The supplemental payments of 40 percent are the result of CDA-sponsored Proposition 56 and the unprecedented investment of $140 million in the Denti-Cal program, which will be matched with federal dollars for a potential total of $350 million for fiscal year 2017-18.
Protect dental coverage for millions: Urge your representatives to extend CHIP funding
11/27/2017
California’s CHIP funding will run out next month and the state will be confronted with a huge budget gap for CHIP children’s Medi-Cal coverage, potentially as much as $1 billion dollars or more. CDA is calling on dentists to act now to protect dental and health care coverage for millions of children and pregnant women in California. Contact your senators and representative in Congress to urge them to take swift action to extend CHIP funding.
New benefits for Denti-Cal adults in 2018
11/02/2017
More than 7 million adults enrolled in Denti-Cal, California’s Medicaid dental program, will have a fully restored package of dental benefits in 2018. The adult benefit package was drastically cut in 2009 due to the state budget crisis and was partially restored in May 2014. The restoration of the adult dental benefit services is a result of legislative action taken during the 2017-18 budget process.
Latest effort to derail ACA fails, sparing California a $139M budget loss
10/24/2017
A last-ditch health care bill to replace the Affordable Care Act failed to advance in the Senate prior to the Sept. 30 budget reconciliation deadline. CDA, the California Medical Association and California Hospital Association sent letters to members of the California congressional delegation asking them to oppose the Graham-Cassidy Block Grant amendment to the American Health Care Act due to the negative implication for Californians.
Open enrollment for 2018 Covered California dental plans begins Nov. 1
10/16/2017
Covered California, California’s health insurance marketplace for the federal Affordable Care Act, has released the participating dental plans for the 2018 benefit year. Despite concerns about marketplace challenges, limited plan offerings and premium increases around the country, California’s marketplace remains stable and high-performing.
Delta hearing scheduled for Oct. 11
10/02/2017
A case management conference related to CDA's proposed settlement agreement with Delta Dental has been rescheduled for Oct. 11, from the previous date of Aug. 25. The hearing was scheduled to provide additional time for CDA, Delta Dental and the court to review procedures that were used to estimate the impact of the inflation adjustment percentage.
Rate changes ahead for Covered California
08/31/2017
Covered California, California’s health-based marketplace, released in early August its proposed 2018 rates for the individual health plan market. The proposed 2018 rates include an average weighted rate increase of 12.5 percent for health coverage. Eleven health plans that currently participate in Covered California will continue participating in the state-based marketplace in 2018.
Rate increases and benefit restoration for Denti-Cal program
08/14/2017
The Department of Health Care Services on June 30 announced hundreds of procedure codes will receive a 40 percent supplemental rate increase as the result of Proposition 56, the tobacco tax measure sponsored and supported by CDA and approved by voters last November. Over $1 billion of the tobacco tax revenue is allocated to improved payments to physicians and dentists who treat Medi-Cal patients.
State could face $30B in new costs under BCRA
07/17/2017
A new analysis from the California Department of Health Care Services and the Department of Finance finds that California could face more than $30 billion annually in additional health care costs over the next decade under the Senate proposal to repeal and replace the Affordable Care Act. The Senate bill, called the Better Care Reconciliation Act (BCRA), would increase state costs even more than the $24.3 billion estimate under the House’s American Health Care Act proposal. A comparative chart offered here outlines the current proposals and the implications nationally.
Rate increases expected for hundreds of procedures under state program
07/07/2017
As California’s new fiscal year starts, dentists can expect significant reimbursement increases for hundreds of procedures covered by Denti-Cal because of the passage of CDA-sponsored and supported Proposition 56, the tobacco tax measure. With anticipated federal participation, it is expected that an estimated $300 million in additional funding will be committed to increasing coverage for dental care in the program.
Hearing date for Delta Dental settlement to be rescheduled
06/21/2017
A San Francisco Superior Court judge has delayed dates related to CDA’s proposed settlement agreement with Delta Dental — the June 26 deadline to opt out or object to the proposed settlement and the Aug. 31 hearing on final approval. The action will provide additional time for CDA, Delta Dental and the court to review procedures that were used to estimate the impact of the inflation adjustment percentage (INAP). Delta Dental’s INAP is the basis for the alleged underpayment to class members.
CDA engages policymakers as ACA reform efforts continue
06/21/2017
The House of Representatives’ vote May 4 to approve the American Health Care Act is the first step down a long, winding road of a possible repeal or replacement of the Affordable Care Act. CDA and other health care organizations have expressed their concerns to policymakers that the AHCA would harm Californians due to the erosion of pre-existing condition protections, decrease patient access to physicians and dentists and cause over 3 million Californians to lose health care coverage.
State budget more closely honors will of Prop. 56 voters
06/16/2017
Gov. Jerry Brown and the California Legislature engaged in heated negotiations before passing a final budget by a constitutionally mandated deadline of June 15. A major focus of those negotiations was the use of Proposition 56 tobacco tax revenues, for which CDA and its partners engaged in an internal and external advocacy campaign.
Delta Dental proposed settlement notices mailed
05/30/2017
Dentists who are part of a class action lawsuit against Delta Dental of California should have received by mail a notice of the proposed settlement. Preliminary approval of the proposed settlement by a San Francisco Superior Court judge on April 21 triggered a settlement administrator to issue formal notices to dentists who are part of the class. The notices were mailed on May 11.
Medicare opt-out excludes Medicare Advantage
05/23/2017
As most know, the Affordable Care Act of 2010 allows nonphysician health care providers to enroll as providers in the Medicare program or, alternatively, to formally opt out of Medicare. Most dentists have chosen to opt out of Medicare, but there’s another Medicare category that dentists should consider: Registering with Medicare as an Ordering and Referring provider.
Delta Dental proposed settlement notices to be mailed by May 12
05/02/2017
A San Francisco Superior Court judge has granted preliminary approval of a proposed settlement between CDA and Delta Dental of California. The preliminary approval triggers a settlement administrator to issue formal notices to the class of dentists who are affected by the proposed settlement. Dentists should expect to receive their formal notices in the mail in mid-to-late May.
Get answers from Practice Support experts at CDA Presents
04/14/2017
Addressing patients’ clinical needs is what every dentist is taught in dental school. What a dentist is not taught is how to run a small business with employees and how to navigate patients’ benefit plans. CDA Practice Support experts will be on-site at CDA Presents Anaheim, at the Member Benefits Center, to answer members’ questions about dental benefits, employment and regulatory issues. Additionally, each expert will present a free one-hour lecture at The Spot Educational Theater. Topics include the dental benefits grievance process, HIPAA compliance essentials and lesser known employment laws.
Action needed to remain on Denti-Cal patient referral list
04/10/2017

Each year, the Denti-Cal patient referral list is “refreshed” to help ensure it is current and accurate. Toward this goal, dentists who were added to the Denti-Cal patient referral list prior to Dec. 1, 2016, and who wish to remain on the list must complete and submit a new Medi-Cal Dental Patient Referral Service form within 35 business days of receiving the form. The form was mailed to providers on March 10.

Two ways to learn about Denti-Cal improvements in Anaheim
04/04/2017
The California Department of Health Care Services will present two different programs at CDA Presents The Art and Science of Dentistry this year that highlight the incentive opportunities available through the Dental Transformation Initiative and provide insight on how to successfully navigate the most common challenges Denti-Cal providers face.
State awards $150 million to Local Dental Pilot Projects
03/21/2017
In February 2017, the Department of Health Care Services announced the 15 selected proposals for Local Dental Pilot Project (LDPP) funding, with awards totaling $150 million over four years. Local Dental Pilot Projects are one of the four domains of the Dental Transformation Initiative and part of California’s 1115 waiver, or Medi-Cal 2020. The DTI represents a huge $740 million investment in the Denti-Cal Program and the oral health of Californians.
CDA achieves significant settlement in Delta legal action
03/07/2017
After a long legal battle against Delta Dental, CDA achieved a favorable outcome on behalf of dentists regarding Delta's attempt to reduce Premier Provider reimbursement rates. In a letter to members, CDA President Clelan Ehrler, DDS, MS, outlines the successful outcome and provides a summary of settlement details.
Medicare Part D enrollment, opt-out deadline extension
02/16/2017
CDA reminds dentists that the Centers for Medicare and Medicaid Services last October moved the Medicare Part D enrollment deadline from Feb. 1, 2017, to Jan. 1, 2019. Dentists should either enroll as a Medicare Part D "ordering/referring provider" or opt out of the Medicare program entirely by the January 2019 deadline.
New resources for dentists treating young children
02/14/2017
First-time resources available to participating Denti-Cal providers resulted in increased access to care for the nearly 6 million California children enrolled in the Medicaid dental program in the first half of 2016. In 2016, the Department of Health Care Services rolled out the 1115 waiver, known as Medi-Cal 2020, which allocated $740 million to the Dental Transformation Initiative.
CDA urges use of Prop. 56 funding as voters intended
01/25/2017
The 2017-18 state budget proposed by Gov. Jerry Brown calls for using tobacco tax-generated funds from Proposition 56 to offset the state’s current obligations to Medi-Cal rather than provide additional funding for provider reimbursement rates. This proposal disregards the will of the voters and the ballot measure’s provisions.
Opportunities for dentists serving low-income children
12/19/2016
Dentists in California now have an opportunity to participate in the Dental Transformation Initiative to help improve dental health for low-income children enrolled in the Denti-Cal program, while receiving enhanced reimbursement by meeting specific incentive metrics. As part of California's 1115 waiver, known as Medi-Cal 2020, the DTI focuses on high-value care, improved access and utilization of performance measures to drive delivery system reform.
Medicare Part D enrollment deadline now January 2019
11/17/2016
The Centers for Medicare and Medicaid Services has again extended the deadline for dentists to either enroll as a Medicare Part D "ordering/referring provider" or opt out of the Medicare program entirely. The previous deadline was Feb. 1, 2017, but it has now been extended to Jan. 1, 2019.
Covered California embedded children's dental plans released
11/10/2016
The 2017 open enrollment period for Covered California, California’s health insurance marketplace for the federal Affordable Care Act, continues through Jan. 31. CDA reported in September on the partial list of participating dental plans for 2017. The complete list of providers, along with the 2017 embedded children’s dental plans, has now been released.
'Meaningful use' funds must be claimed by Dec. 31
10/31/2016
Under the provisions of the American Recovery and Reinvestment Act, participating Denti-Cal providers may receive up to $63,750 in incentive payments for implementing an electronic health record system and eventually achieving “meaningful use.” The program will close to new registrants on Dec. 31, and any dentist who has not started in the incentive program will lose the opportunity to claim those dollars.
State launches children's disease management pilot
10/12/2016
Beginning in January 2017, dentists in select California counties will have an opportunity to participate in an innovative pilot that seeks to assess and manage caries risk and emphasize the provision of preventive services to Denti-Cal-enrolled children ages 6 and under.
Gov. Brown signs CDA-sponsored loan repayment bill
10/06/2016
In the final weeks of the state’s 2016 legislative session, Gov. Brown signed into law several bills that impact dentists, including CDA-sponsored Assembly Bill 2485 (Santiago, D-Los Angeles). Taking effect immediately as an urgency statute, AB 2485, the Dental Corps Loan Repayment Program, revises in the applicant’s favor provisions regarding program eligibility, application, selection and placement.
Delta's Medicare requirement won't apply in California
09/28/2016
Recent contractual amendments made by Delta Dental of Michigan, Ohio and Indiana effective Jan. 1, 2017, state that dentists who chose to opt out of Medicare Part D in these three states will no longer be eligible to remain Delta Dental network providers. Delta Dental of California verified that it is not adopting the same policy.
Apply for LDPP funding by Sept. 30
09/26/2016
The deadline to apply for Local Dental Pilot Project funding under Domain 4 of the Dental Transformation Initiative is Saturday, Sept. 30. Fifteen pilot projects will be selected to commence in January 2017.
Preliminary list of participating Covered California dental plans released
09/15/2016
Covered California, California's health insurance marketplace for the federal Affordable Care Act, has released some of the participating dental plans for the 2017 benefit year. Covered California's open enrollment period for 2017 coverage begins on Nov. 1 and ends Jan. 31, 2017.
Lecture at CDA Presents to cover ins and outs of Denti-Cal
08/29/2016
A retooled and refocused lecture on the Denti-Cal program will take place at CDA Presents The Art and Science of Dentistry in San Francisco in September. Presented by CDA’s Public Policy department and the California Department of Health Care Services, “The Ins and Outs of California’s Denti-Cal Program” will highlight the many recent improvements to Denti-Cal.
Local Dental Pilot Project application deadline nears
08/01/2016
The deadline to apply for Local Dental Pilot Project funding under Domain 4 of the Dental Transformation Initiative has been extended to Sept. 30 as a result of a delay in the development of a budget template for the application. The California Department of Health Care Services opened its application cycle for LDPP proposals developed under the Medi-Cal 2020 Waiver June 1.
06/22/2016
The state Assembly has unanimously approved legislation that begins to address administrative problems in the Denti-Cal program recently highlighted in a scathing report by California’s Little Hoover Commission (LHC), an independent state oversight agency.
Local Dental Pilot Project application process opens
06/08/2016
The California Department of Health Care Services has opened its application cycle for proposals for Local Dental Pilot Projects (LDPP) being developed under the Medi-Cal 2020 Waiver.
New law requires accurate dental plan provider directories
05/03/2016
A law created by Senate Bill 137 goes into effect on July 1 and requires all health plans to maintain accurate provider directories. This law requires dentists contracted with dental plans to respond to a plan’s request for accurate directory information within 30 days or face payment delays, reimbursement reductions or, ultimately, termination of their participating provider agreement.
Take action to enroll or opt out of Medicare
04/19/2016
CDA Practice Support continues to receive many questions about the approaching deadline for  providers to opt in or out of the Medicare system. The Q-and-A below provides some basic facts about Medicare, dentistry and participating as a Medicare provider.
04/07/2016
CDA is urging the state to take immediate steps to improve its Medi-Cal dental program, Denti-Cal, after the release of a highly critical report by the Little Hoover Commission, an independent state oversight agency.
Dentists must give timely practice updates
04/06/2016
Beginning July 1, a new law will take effect requiring dental plans to comply with uniform standards and provide timely updates (practice address, license number, etc.) to their provider directories. The intent of the new law, SB 137, is to provide patients with more accurate and complete information as to which providers are participating in the plan's provider network.
Legislative deal prevents loss of dental funding
03/18/2016
The state Legislature and governor recently agreed to a deal, supported by CDA, that will preserve $1.3 billion in federal funding for Medi-Cal. The agreement reforms the state’s managed care organization (MCO) tax to comply with federal requirements that the tax apply to all managed care health plans, not just those that serve Medi-Cal patients, in order to preserve the federal matching money the tax brings to the state.
Covered California dental enrollment exceeds 140,000
02/15/2016
Enrollment in the family dental benefit plan product offered through Covered California, California’s health benefit marketplace created by the federal Affordable Care Act, now exceeds 144,000 enrollees according to Covered California representatives. Here is what dentists need to know.
CDA wins key ruling in Delta case
01/28/2016
A letter from CDA President Ken Wallis, DDS

I am writing to share positive news about CDA's legal action against Delta Dental. A superior court judge has issued a preliminary ruling in favor of CDA regarding our association's standing to represent members in the case.
CDA supports, protects dentistry in 2015
12/14/2015
CDA is helping member dentists meet today's challenges of practicing the way they want, providing excellent care to their patients and giving back to their communities. Here are highlights of those achievements in 2015.
Covered California dental enrollee numbers hit 60,000
12/11/2015
The open enrollment period for health and dental coverage offered through Covered California, California's benefit marketplace created by the federal Affordable Care Act continues through Jan. 31. Since open enrollment began on Nov.1, more than 60,000 enrollees have selected dental coverage through Covered California's Family Dental Plans or California Covered for Small Business.
CDA-secured rate cut reversal takes effect
11/13/2015
In a significant victory for CDA advocacy, the California Department of Health Care Services has announced that the federal Centers for Medicare and Medicaid Services (CMS) has approved the 10 percent rate cut reversal for dental services that was included in the 2015-16 California budget. CDA strongly advocated for the rate cut reversal, which applies to Denti-Cal and not broadly to all Medi-Cal providers.
$750 million investment coming for Denti-Cal
11/11/2015
California and the federal government have reached a significant agreement that will ensure an additional $750 million investment in California’s Denti-Cal program over a five-year time frame.  The majority of the funding focuses on the medical portion of the state’s Medicaid program, including investments in the state’s public hospital system and a county-based pilot project to provide more integrated care for high-risk, vulnerable populations. The goal is to reform the delivery system and develop outcome improvements with the long-term goal of reducing costs to the state and federal government.
Hearing set for CDA v. Delta
11/02/2015
CDA is scheduled to present further evidence in its legal case against Delta Dental at a hearing scheduled Nov. 16 in San Francisco Superior Court. This is a further hearing on CDA’s “standing” as an association to represent its members in challenging Delta’s actions relating to reduced fee reimbursements to Premier dentists under the Delta Participating Dentist Agreement (“PDA”). While arguments on CDA’s legal standing to represent members in the case were presented earlier this year, the judge had remaining questions and allowed both parties to gather evidence to present at the upcoming hearing.
Special hearing highlights deficiencies of Denti-Cal
10/01/2015
CDA participated in a special hearing recently to review the deficiencies of the state’s Denti-Cal program. An independent oversight committee held a meeting at the state Capitol to delve into the problems highlighted in a report that found that California’s 2014 reimbursement rates for the 25 most common Medicaid dental services were well below those in the comparable states of New York, Texas and Florida.
Denti-Cal general anesthesia changes coming
09/17/2015
The California Department of Health Care Services (DHCS) recently released a Denti-Cal Provider Bulletin outlining the modified policy for the administration of general anesthesia and intravenous sedation. Effective Nov. 1, Denti-Cal providers will be required to submit a Treatment Authorization Request (TAR) for the provision of intravenous sedation and general anesthesia services.
California making strides in dental care measurement
08/11/2015
As the dental insurance marketplace continues to increase focus on improved quality of care, accountability and value, California’s Health Benefit Exchange (Covered California) has taken the first steps in further ensuring Californians receive quality dental care. Specifically, it has announced that it will require all dental plans offering coverage through the Exchange to adopt the Dental Quality Alliance’s (DQA) Pediatric Quality Measures Set.
Report shows Denti-Cal reimbursement rates lagging
07/06/2015
A new review of the state’s Denti-Cal program provides further evidence that current rates are insufficient and that there has been a significant decline in participating providers since 2008. Just released by the state Department of Health Care Services, the report shows that while there has been a nearly 40 percent increase in enrolled children and 77 percent increase in enrolled adults, there has been a double-digit decrease in providers in that same timeframe.
CDA pleased by state reversal of Denti-Cal cuts
06/16/2015
The state's reversal of the 10 percent rate cuts for Denti-Cal providers, which have been in effect since 2013, is a positive first step in ensuring access to care for the program's beneficiaries. Gov. Jerry Brown and legislative leaders made an announcement of a budget deal that will allow the rate changes to take effect July 1 pending federal approval.
Medicare provider enrollment date pushed back again
06/15/2015
The federal Centers for Medicare and Medicaid Services (CMS) has again changed the compliance date for dentists desiring to opt out of the Medicare program. The new date, June 1, 2016, comes some two weeks after CMS moved the date from June 1 of this year to Jan. 1 of next year.
Anthem Blue Cross announces provider fee reduction
05/26/2015
Anthem Blue Cross has notified CDA that it is making changes to participating dentist agreements and is currently in the process of notifying impacted providers of “fee adjustments” that will go into effect Aug. 1. A CDA-sponsored law requires insurers to provide no less than 45 business days’ notice of any material change to contracts or payment plans
Changes in enrollment deadline for Medicare
05/18/2015
The Centers for Medicare and Medicaid Services (CMS) has announced that the new compliance date for enrollment or opt out for dentists to the Medicare program is Jan. 1, 2016. The original deadline was June 1. Dentists are encouraged to consider June 1 as a soft compliance date to get their forms in so as not to have their status or patient benefits lapse while forms are being processed.
CDA urges response to governor's silence on Denti-Cal
05/14/2015
CDA is disappointed that the May revision to the 2015-16 state budget released by Gov. Jerry Brown is silent on the statewide crisis in access to dental care and is urging the administration and Legislature to take action in their upcoming budget negotiations.
Ruling in Delta case favorable for CDA
04/16/2015
The San Francisco Superior Court judge presiding over the CDA v. Delta Dental case issued her final ruling denying Delta Dental’s motions attempting to have the case dismissed. The final ruling confirmed a tentative ruling of the same nature just weeks prior.
CDA disappointed with Supreme Court Medicaid ruling
04/06/2015
The U.S. Supreme Court has ruled that providers cannot sue states or state officials in an effort to increase Medicaid reimbursement rates. In a 5-to-4 decision, justices indicated that complaints about low reimbursement rates should instead be filed with the Centers for Medicare and Medicaid Services, the federal agency that oversees the Medicaid program.
CDA wins tentative ruling in Delta Dental case
03/24/2015
The San Francisco Superior Court judge presiding over the CDA v. Delta Dental case issued her tentative ruling at a March 18 hearing denying Delta Dental's motions attempting to have the case dismissed. While her rulings in open court are currently tentative, the judge stated that she would issue a final order soon and it would be consistent with these tentative rulings. This is positive news for CDA and CDA member Premier dentists, however, there is still a long way to go in the litigation.
CDA's calls to fix Denti-Cal are heard
03/20/2015
CDA's advocacy urging the state to fix the broken Denti-Cal program has captured the attention of lawmakers who expressed outrage in two legislative hearings about the program's failure to provide access to care due to glaring oversight issues and extremely low reimbursement rates. CDA members testified at two joint oversight hearings of the Senate Health Committee, Assembly Health Committee and the Joint Legislative Audit Committees in March.
CDA continues legal challenge against Delta
02/23/2015
In a Superior Court hearing scheduled for late March in San Francisco, CDA will counter motions made by Delta Dental regarding CDA’s legal action filed last year. During the hearing, which was postponed from January, a judge is expected to hear arguments on two Delta motions — one to dismiss the case and the other challenging CDA’s standing as an association to represent the interests of its members in court.
Whether to opt in or out as a Medicare provider
02/16/2015
A requirement dentists need to keep in mind this year is the designation of their status with the Medicare program. CDA is receiving an increasing number of inquiries about what to consider when choosing your status. Conversations with the ADA and the Medicare administrator for California indicate that additional information, and reminders about the requirement, will be needed as the deadline nears.
12/15/2014
The California Dental Association is urging immediate steps to address critical issues with the state Denti-Cal program that is failing to provide adequate access to care for millions of low-income children who are at risk of developing dental disease. An audit issued by the Bureau of State Audits validates what CDA has experienced with the program for many years. The audit, California Department of Health Care Services: Weaknesses in its Medi-Cal Dental Program Limit Children's Access to Dental Care, states that nearly 56 percent of the 5.1 million children enrolled in Denti-Cal in 2013 did not receive any dental care last year.
Provider reimbursement cuts announced by Anthem
10/16/2014
CDA has learned that Anthem Blue Cross has sent notices to more than 7,000 California dentists in various geographical areas announcing a “fee adjustment” in a number of regions. This “adjustment” appears to be scheduled to go into effect Jan. 1, 2015. Anthem is making other amendments to the Anthem Participating Dentist agreements as well, which apparently will be summarized on a CD to be enclosed with the notice.
Deadline to opt in/out as Medicare provider
10/02/2014
There are two important reasons why dentists need to pay attention to upcoming changes and understand the potential impact to dental patients and one's dental practice. First, with 35,000 licensed dentists in California and more than 5 million Californians enrolled in Medicare, simple arithmetic shows that there are 143 Medicare patients per dentist in the state. Secondly, CMS issued a recent rule requiring all physicians and eligible professionals — including dentists — who prescribe Part D-covered drugs to be enrolled in Medicare or opt out for those prescriptions to be covered under Part D by June 1, 2015.
CDA legal action against Delta: Next steps
09/18/2014
In an effort to keep members informed about the legal action against Delta Dental, CDA is providing an update on the next steps. Hearings have been scheduled in the coming months related to the case pending before arbitrators and a separate action filed in Superior Court. In the arbitration, a hearing has been scheduled for next June, after an arbitration panel denied a motion by Delta to dismiss the case. A panel of three arbitrators found that there is sufficient evidence to allow the individual dentists to proceed with claims that Delta’s attempt to change key provisions of its participating dentist agreements violated the legal doctrine of “good faith and fair dealing.”
Delta Dental legal action: a letter from CDA's president
07/29/2014
A legal action was filed in August 2013 by CDA and several individual dentists challenging, in part, Delta’s attempt to change Premier provider agreements. Prior to the filing, CDA learned informally of a planned rate reduction of 8 to 12 percent. A recent decision by arbitrators will allow the arbitration to proceed despite a motion by Delta to dismiss it.
Arbitrators rule against Delta Dental's most recent motion
07/17/2014
In August 2013, CDA and several individual dentists filed a legal action against Delta Dental challenging, in part, its attempt to change Premier provider agreements. In response to this action, Delta filed a motion to dismiss the entire matter. After considering the motion, the arbitrators rejected Delta Dental's recent motion to dismiss the entire action, and found that there was sufficient evidence to allow the individual dentists to proceed on their claims that Delta's attempt to change key provisions of its participating dentist agreements violated the legal doctrine of "good faith and fair dealing." The decision will allow the arbitration to proceed.
CDA provides guidance on navigating Adult Denti-Cal
07/07/2014
Although federally required adult dental services have been available to beneficiaries of Medi-Cal, adult optional Medi-Cal dental benefits were eliminated in July 2009, except for beneficiaries who are pregnant or residing in a skilled nursing facility or intermediate care facility. With many benefits for adults restored May 1, the recent CDA Presents lecture in Anaheim titled Adult Denti-Cal Services: Navigating the Renewal Program explained the treatment options and requirements of newly reestablished Denti-Cal benefits for adults. Presenters Tom Holloway, DDS, Nagaraja Murthy, DDS, and Nirmala Prabhu, DMD, offered valuable information concerning common denial codes in treatment authorization requests and claims, ways to reduce unnecessary denials and specific criteria for common restored procedures.
07/01/2014
Cigna Dental recently notified contracted providers across the country about upcoming PPO network structure changes and directory enhancements. A May 22 correspondence outlines Cigna's intent to streamline the names of its networks by moving to two network names, rather than the four that currently exist. CDA has expressed concerns with the proposed cost effectiveness designation of dentists to Cigna and is currently working with the ADA and Cigna to learn more about the program and the plan's methodology.
State budget fails to address low Denti-Cal rates
06/23/2014
Despite the efforts of dozens of health care organizations including CDA, which have sought at a minimum a reversal of last year's 10 percent reimbursement rate cut for Medi-Cal/Denti-Cal providers, the 2014-15 state budget approved by the Legislature June 15 did not include any reimbursement rate increases. The governor's administration indicated that the increased costs of providing Medi-Cal/Denti-Cal coverage due to the state's expansion of eligibility and higher than expected enrollment have made it more difficult for the state to restore funding for reimbursement rates.
06/16/2014
CDA learned in late May that Delta Dental of California began distributing a new Participating Provider Agreement (Commercial Fee-for-Service) to newly contracting California providers. For those newly contracting providers, this new agreement appears to be an all-inclusive provider agreement for both the Delta Dental Premier and PPO products. CDA understands that Delta Dental will no longer offer separate Premier and PPO provider agreements to newly contracting dentists. Along with the new Provider Agreement, newly contracting dentists will receive the Delta Dental Premier Addendum.
CDA files new legal action against Delta
04/23/2014
CDA received a ruling on April 10 from the arbitrators hearing the case against Delta Dental, who decided that CDA cannot participate as a claimant in the arbitration because CDA itself is not a party to the Premier provider agreement that contains the arbitration clause. However, CDA can still offer legal representation to all dentists who are parties to the binding arbitration and will continue to work with and support them throughout the proceedings.
Tips for dentists handling return of Adult Denti-Cal
04/22/2014
May 1 marks the date of formal restoration of adult benefits in the Denti-Cal program. CDA offers a few suggestions to help dentists make sure they are prepared for the program to return: familiarize yourself with the benefits available to adults; confirm that you are an enrolled provider in the Denti-Cal program; and attend the lecture that will cover the renewed program at CDA Presents The Art and Science of Dentistry in Anaheim.
CDA legal action against Delta takes shape
03/10/2014
CDA’s arbitration with Delta took a step forward on Feb. 25 with a “preliminary hearing” conference call with the panel of arbitrators assigned to the case. The purpose of the call was to schedule dates for different stages of the arbitration. In light of the extensive briefing that has already been submitted by both parties, the panel of three arbitrators has indicated it will likely decide two significant issues by early April.
02/25/2014
Nearly five years after the state eliminated dental benefits for adult beneficiaries in the Medi-Cal program, many of those benefits are being restored as of May 1, 2014. This comes largely as a result of the pent up need for dental care, so visibly demonstrated at CDA Cares.
Arbitrators appointed for CDA legal action against Delta
02/24/2014
CDA’s legal action against Delta took a step forward with a decision by the American Arbitration Association to select three arbitrators to hear and decide the case. The selection of an arbitration panel meant the case was able to move forward with a preliminary conference scheduled Feb. 25.
01/14/2014
Denti-Cal providers received positive news Jan. 9 regarding CDA efforts to stop the state from implementing retroactive reimbursement cuts, which were not included in Gov. Brown’s proposed 2014-15 budget. CDA advocated strongly against the 10 percent “clawback” of payments made since June 2011, citing the devastating impact on the provider network and patients’ ability to access care.
01/09/2014
Denti-Cal providers received positive news regarding retroactive reimbursement cuts in Gov. Brown’s proposed 2014-15 budget released Jan. 9. The spending plan does not include a 10 percent “clawback” of payments made since June 2011 when the state authorized Medi-Cal reimbursement cuts as part of its budget.
Legal action against Delta awaits decision on arbitrator
12/17/2013
CDA’s legal action against Delta remains in the preliminary stages, with the parties awaiting appointment of an arbitrator. Delta has requested appointment of a three-arbitrator panel, which delayed the appointment process while the parties attempted to resolve the issue.
10/29/2013
The Department of Health Care Services (DHCS) is implementing cuts for Denti-Cal providers that were originally authorized through the state budget process in 2011.  Initially, it was thought that the 10 percent rate cut applied to all services provided on and after Sept. 5, 2013. However, recent clarification by the state explained that it is implementing the cuts on all payment checks cut on Sept. 5 and ongoing, even if the services were provided in previous months.
Delta responds to CDA arbitration demand
10/23/2013
On Oct. 1, Delta Dental of California issued a formal Answer to the Demand for Arbitration. Delta asserts that it has the right to amend Participating Dentist Agreements based on language in the contracts and its notification to the Department of Managed Health Care indicating that it intends to revise the provider agreements.
CDA, coalition file petition to stop Medi-Cal rate cuts
09/30/2013
CDA and a coalition of health care organizations aiming to stop Medi-Cal rate cuts implemented by the state filed a petition with the Supreme Court on Friday. The Petition for Writ of Certiorari asks the Court to reverse the decision by the Ninth Circuit Court of Appeals upholding the rate cuts.
CDA seeks to derail Delta rate cut process
09/18/2013
The lengthy arbitration process between CDA and Delta Dental has commenced, with the parties entering into discussions about the selection of an arbitrator. Delta is expected to file a formal response to the demand for arbitration on or before Oct. 1.
What CDA's legal action means to providers
09/18/2013
CDA’s legal action challenges both Delta’s right to make certain amendments to dentists’ individual contracts and reduce Premier fees unilaterally. CDA will request that the arbitrator, once appointed, maintain the status quo until a final ruling is made in the binding arbitration.
09/12/2013
California is reaching the final phases of its transition of the Healthy Families Program (HFP) to the Medi-Cal program. Since Jan. 1, 2013, the children getting health and dental coverage through the HFP have been moving to receive their care through the Medi-Cal program. Approximately 850,000 of the 880,000 children have been transitioned to date. Sept. 1 marked the transition of approximately 8,000 children who live in mostly rural California counties.
CDA provides answers about Delta Dental legal action
09/04/2013
CDA’s legal action against Delta Dental of California, filed on Aug. 14, has prompted member questions about the next steps in the process. In order to help members understand the legal action, CDA has prepared a FAQ document. CDA will continue to provide regular updates on developments in the case.
08/19/2013
After a series of court decisions upholding the legality of the state’s 10 percent reduction to Medi-Cal provider reimbursement rates, the Department of Health Care Services (DHCS) has announced that it will begin implementing the cuts for Denti-Cal providers on Sept. 5. The Department’s announcement states that the prospective rate reduction will be phased in by provider type, beginning with dental and medical transportation and ending with pharmacies, physicians and distinct-part nursing facilities on Jan. 9, 2014.
08/14/2013
On behalf of its members, the California Dental Association — along with several individual dentist providers — has taken legal action against Delta Dental of California by filing a demand for binding arbitration in response to Delta’s notice dated Aug. 1, informing providers of changes to key provisions in their agreements.
08/01/2013
In an ongoing series, CDA is profiling members who have taken different approaches to how they practice in order to counter changes in the profession such as an overall drop in adults seeking dental care, the decline in the economy and real estate market, increased regulatory compliance, reduced reimbursement rates and more. The fourth article in the series features a dentist who is analyzing how to meet the patient demand of a high-volume PPO practice.
07/26/2013
The California Medi-Cal Dental Program (Denti-Cal) is informing dentists across the state that it is OK to provide dental services to children on Medi-Cal, including foster children, if they come to their office without a BIC (Medi-Cal) card. In a notice recently sent out in the Denti-Cal Bulletin newsletter, the state's Department of Health Care Services clarifies that in accordance with the California Medi-Cal Dental Program Provider Handbook, no identification verification is required in certain circumstances.
07/24/2013
The Dental Benefits Research Task Force recently heard the results of a CDA survey that delved into the patterns of dental consumers. The survey, conducted in May, gathered feedback from California adults. The Task Force, which is identifying strategies and recommendations to enhance the position of providers and patients in the dental benefits marketplace at the request of the 2011 House of Delegates, analyzed several key findings from the survey.
07/09/2013
In a four-part series, CDA is profiling members who have taken different approaches to how they practice in order to counter changes in the profession such as an overall drop in adults seeking dental care, the decline in the economy and real estate market, increased regulatory compliance, reduced reimbursement rates and more. The second article in the series features two dentists who practice in San Francisco. In 2008, both dentists decided to end their participation as a contracted provider with dental plans. Five years have passed and both continue to operate on one fee schedule.
07/02/2013
While California providers are still waiting to hear from Delta Dental of California about expected fee reductions for its Premier Plan, Missouri dentists received a letter recently from Delta Dental of Missouri that outlined plans in that state to reduce reimbursements to providers who participate in Delta’s Premier and PPO networks. The fee reduction, which went into effect July 1, averages 7 percent. Delta Dental of California has not been forthcoming with its reasons for cutting reimbursement rates, nor has it officially informed California providers about its intentions; however, the reductions are expected to be an average of 8 to 12 percent implemented later this year.
06/28/2013
The California Dental Association applauds the governor’s signature of a new state budget plan that includes the restoration of Adult Denti-Cal services.
06/24/2013
In a four-part series, CDA is profiling members who have taken different approaches to how they practice in order to counter changes in the profession such as an overall drop in adults seeking dental care, the decline in the economy and real estate market, increased regulatory compliance, reduced reimbursement rates and more. The first article in the series features a dentist who practices in Stockton with a diverse population, including low-income patients. During the last five to 10 years, she has made several changes in her practice to become more efficient.
Legislature approves restoring Adult Denti-Cal
06/18/2013
The effort to restore Adult Denti-Cal benefits is one step closer to reality after the Legislature voted on a new state budget plan. The funding, which is a result of the leadership exhibited by Senate President Pro Tem Darrell Steinberg (D-Sacramento), still needs the governor’s signature. Steinberg made the restoration of Adult Denti-Cal a top priority after his visit last August to CDA Cares in Sacramento.
CDA-sponsored bill advances over opposition from dental plans
06/12/2013
Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18, authored by Assemblyman Dr. Richard Pan (D-Sacramento) and sponsored by CDA, overcame strong objections from dental plans and health plans.
CDA wins Adult Denti-Cal spot in budget deal
06/11/2013
The move to restore adult Denti-Cal benefits is one step closer to reality after the governor and state lawmakers agreed to include funding in a preliminary budget deal. The restoration of benefits, which still needs final budget approval, would begin in May 2014, with a proposed annual cost of $77 million.
Mixed news for Denti-Cal adult benefits
05/31/2013
Two significant but conflicting developments in the longstanding effort to rebuild the oral health care safety net in California have occurred. In a disappointing move, on the same day that the state Senate Budget and Fiscal Review Committee endorsed restoring Medi-Cal adult dental benefits, the U.S. 9th Circuit Court of Appeals on May 24 denied a petition filed by CDA and a coalition of health care organizations aiming to stop the state from implementing a 10 percent reduction in Medi-Cal provider reimbursement rates.
05/30/2013
CDA is sponsoring legislation to apply key patient protections and market reforms, including a minimum loss ratio on patient premiums, to dental plans participating in California’s new health plan marketplace, the Covered California health benefit exchange. The Affordable Care Act (ACA) includes many consumer-focused provisions that have already gone into effect, but that only apply to medical plans. Assemblymember Dr. Richard Pan (D-Sacramento), who chairs the Assembly Health Committee, has introduced AB 18, sponsored by CDA, that if passed by the legislature and signed by the Governor, would represent the first time these federal patient protections would be applied to dental plans participating in the small group market inside and outside the new health benefit exchange created by ACA.
05/10/2013
As part of an effort to simplify providers’ participation in the state’s Medi-Cal Dental Benefits Program (Denti-Cal), CDA, with the cooperation of the State Department of Health Care Services’ Dental Services Department, has developed a guide to working within the program. The guide, entitled “Denti-Cal Provider Guide,” is divided into two main sections:  Processing a Denti-Cal Patient Through the Dental Practice; and the Denti-Cal Billing Process.
05/01/2013
Ann Milar, CDA dental benefits analyst, weighs in on why all dental offices must make sure they have the correct address on file with their contracted plans. This will ensure that the offices receive necessary credentialing paperwork, tax documents and other written communication from plans in a timely manner and avoid the potential of being unknowingly terminated as a participating provider.
03/25/2013
The next wave of the Healthy Families Program transition to the Medi-Cal program is set to occur on April 1.  It is important to note that the federal Centers for Medicare and Medicaid Services is requiring the state to again seek approval before they initiate this next phase (Phase 1c). There will be seven counties involved in the transition.
03/19/2013
The CDA Dental Benefits Research Task Force has moved into the analysis and problem-solving phase of its efforts to identify strategies to enhance the position of providers and patients in the dental benefits marketplace. Walt Weber, DDS, chair of the task force, said there are a variety of things they are looking at and made it clear the group is ratcheting up its discussions.
03/04/2013
In a letter from CDA President Lindsey Robinson, DDS, the association is urging Delta Dental to communicate answers to providers about its impending rate reduction. Dr. Robinson’s message to members and the letter to Delta are posted here.
March 2013
03/01/2013
The March 2013 issue of the CDA Update features ways CDA Presents is valuable for new dentists. Specifically, six courses that new dentists will benefit from are highlighted. Spotlighting the key role that sterilization volunteers play at CDA Cares clinics, Diane E. Morgan-Arns, who served as the lead for sterilization at the CDA Cares Modesto and Sacramento clinics, and Eve Cuny, director of Environmental Health and Safety at the UOP, Arthur A. Dugoni School of Dentistry are interviewed.
02/19/2013
If the state gets the approval, Phase 1b of the Healthy Families Program transition will begin on March 1.
01/31/2013
The CDA Dental Benefits Research Task Force heard from a dental economics expert with the ADA and learned about Oregon’s Coordinated Care Organizations at its January meeting.
01/24/2013
California continues to move toward the Jan. 1, 2014, implementation of national health care reform, and CDA has been working closely with policymakers on issues important to dentistry.
01/10/2013
The CDA Dental Benefits Research Task Force heard from group practice and network management experts at its December meeting. The task force, which is identifying strategies to enhance the position of providers and patients in the dental benefits marketplace at the request of the 2011 House of Delegates, heard from Gary Pickard, director of plan relations at Pacific Dental Services; Jeffrey Parker, CEO, and Burt Arthur, CFO of Sarrell Dental Center in Alabama; and Michael Grossman, DDS, former president and CEO of First Dental Health.
12/31/2012
California is continuing to move forward with the transition of 875,000 children currently enrolled in the Healthy Families Program (HFP) to the Medi-Cal program, which is expected to begin on Jan. 1. For many months, advocates were pushing for the delay of the transition, but recently, many of those advocates have sensed the inevitability of the transition. The focus of many organizations has turned to ensuring the transition goes smoothly for families and on monitoring access to care as the transition occurs.
Dental benefit experts speak at House of Delegates
12/05/2012
As part of its continued efforts to keep members up-to-date on the changing landscape of the dental benefits industry, CDA invited three experts in the field to speak to the 2012 House of Delegates last month.
10/31/2012
The CDA Dental Benefits Task Force, which was approved at the 2011 CDA House of Delegates to develop a deeper understanding of the underlying pressures and trends in dental care financing, conducted several information gathering meetings this year. A summary of the task force’s work was presented to the 2012 House of Delegates on Nov. 10.
May 2012
05/01/2012

Top Stories: Dental benefit bills pass first test; CDA Presents offers tips on improving practices; Sacramento CDA Cares adds premier sponsor

February 2012
02/01/2012

Top Stories: CDA wins Medi-Cal rate court case; Dental team ‘on board’ for CDA Cares; Guide for New Dentist available on Compass website

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