Healthy Families program transition nears completion

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 (Del Norte, Humboldt, Lake, Lassen, Modoc, Shasta, Siskiyou and Trinity). 

In addition, Gov. Jerry Brown’s Administration created one final phase of the transition (Phase 4b), which will begin Nov. 1, 2013. This phase was created in order to ensure the readiness of the health plans and to minimize any disruption in services to beneficiaries in the remaining 20 counties. Those counties are Alpine, Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Imperial, Inyo, Mariposa, Mono, Nevada, Placer, Plumas, Sierra, San Benito, Sutter, Tehama, Tuolumne and Yuba. There are approximately 27,000 children transitioning in this phase. 

It is expected that by Nov. 1, all of the 880,000 children in the Healthy Families Program will have been transitioned to the Medi-Cal program. 

Once beneficiaries transition into the Medi-Cal program, dentists will need to bill Denti-Cal for any dental services provided. Dentists who are not Denti-Cal providers, but would like to become one so that they may continue to serve their current patients when they transition into that service delivery system, should visit the Denti-Cal website (www.denti-cal.ca.gov) to download the Enrollment Application Package.  

If you are currently serving children through the Healthy Families Program and do not wish to continue to serve them after their transition to Medi-Cal, please notify the dental plans with whom you are currently contracted as soon as possible, and notify the Department of Health Care Services by completing this short form: surveymonkey.com/s/dc_provider_survey

Dentists will also want to notify their patients, advise them of the importance of continued care and support them in finding alternative care by referring them to the local dental society or advising them to contact DHCS at 800-322-6384.

Dentists, who currently serve HFP patients who have not transitioned yet or who are unsure if they have transitioned, can check eligibility through their normal HFP processes. If patients are no longer eligible with HFP, dentists can check their Medi-Cal eligibility by calling 800-456-2387.

Denti-Cal has posted several new Denti-Cal Bulletins providing detailed information on the Healthy Families Transition, which can be accessed at www.denti-cal.ca.gov.

CDA has been representing its members in all of the Administration’s implementation meetings with stakeholder organizations, and has held many separate meetings with the department, legislative leaders and staff and advocates over the last few months regarding the Healthy Families Program transition. Those efforts will continue.

CDA will keep members informed as this issue progresses. For more information, please contact Nicette Short, CDA manager, legislative affairs, at nicette.short@cda.org or 916-554-4970.