CDA wins state battle; eyes on Legislature after Supreme Court ruling

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. CDA also continues to advocate against the state’s prospective 10 percent provide rate cut that it began implementing last September.

“We are pleased that Denti-Cal providers will not face these retroactive cuts in a program that is chronically underfunded,” said CDA President James Stephens, DDS. “CDA will continue to raise awareness about the need to address funding issues as well as establish an oral health infrastructure, including a state dental director to support public oral health programs.”

CDA expects a Jan. 13 U.S. Supreme Court ruling will prompt the Legislature to take a closer look at Denti-Cal reimbursement rates, which are among the lowest in the nation.

The Supreme Court denied a petition filed by CDA and a coalition of health care organizations to hear a case regarding the state cuts to Medi-Cal reimbursement rates. The petition asked the Court to consider whether the federal Centers for Medicare and Medicaid Services abused its discretion in granting the state permission in 2011 to make the 10 percent reduction.

“We’re obviously disappointed with the Supreme Court’s ruling,” said CDA President James Stephens, DDS. “We know these fee reductions will have a direct impact on dentists’ ability to provide care to the state’s most vulnerable people, especially children.”

CDA will continue to work toward a legislative reversal of the reimbursement cuts and believes current rates are unsustainable, particularly as the state tries to accommodate millions of new patients as a part of health care reform.    

In addition to the governor’s budget forgiving the retroactive payments, it includes $17.5 million to increase outreach activities relating to Medi-Cal dental services for children, ages 0-3, which will provide education for parents of young children about the importance of early dental care. CDA has been strongly advocating for the state to create a dental director position that could oversee such activity as part of a comprehensive statewide oral health program focused on oral health care.

CDA will continue to keep members informed on this issue through cda.org, the Update, and e-newsletters.