06/23/2014

State budget fails to address low Denti-Cal rates


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. California already had among the lowest provider reimbursement rates in the country before last year's 10 percent cut was implemented.

The budget includes, however, a requirement that the Department of Health Care Services establish a list of performance measures to evaluate whether the Denti-Cal program is meeting certain quality and access criteria. This kind of evaluation should highlight the harmful impact of low rates and CDA will be an active participant in this process.