06/22/2016

Legislature starts addressing Denti-Cal report’s findings


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.

Assembly Bill 2207, authored by Assemblymember Jim Wood, DDS, (D-Healdsburg) seeks to streamline the Denti-Cal provider enrollment process, improve the linkage between health care and dental care, and improve the accuracy and quality of the Denti-Cal provider directory. The bill's provisions include:

  • Requiring the Department of Health Care Services (DHCS) to create a dental-specific enrollment form and an alternative automatic enrollment process for a provider already commercially credentialed by an insurance plan that participates in Denti-Cal.
  • No longer requiring providers to resubmit an enrollment application that has been deemed incomplete if the missing information is available elsewhere within the application packet.
  • Requiring a Medi-Cal managed care health plan to provide dental screenings for eligible beneficiaries as part of his or her initial health assessment and refer the patient to an appropriate Denti-Cal provider.
  • Requiring DHCS to remove a provider who has not participated in the program for more than one continuous year.

"The challenge to increase the number of providers cannot be met without improvements to the Denti-Cal program, and we are delighted that Dr. Wood is championing this cause," said CDA President Ken Wallis, DDS. "One-third of all adults and half of all children now rely on Denti-Cal for dental coverage and we must fix the program to have a functioning oral health care system in California. Yet, providers continue to be frustrated by the program's bureaucracy, paperwork and unique rules and requirements."

AB 2207 is now under consideration in the state Senate.

The LHC report, titled Fixing Denti-Cal, called for a complete "reboot" of Denti-Cal, finding the program to be one of the state government's "greatest deficiencies" and one that "has alienated the dental profession with reimbursement rates among the lowest in the nation, an abundance of restrictive rules, and a reliance on outdated paper-based administrative processes." These inefficiencies have increasingly come to light as 2.3 million people have recently enrolled in the state's optional expansion of its Medicaid program — nearly three times more than officials anticipated, according to the Department of Finance.

The commission lays out various recommendations, including setting a goal for 66 percent of eligible children to make annual dental visits, cutting red tape for dental providers and reorienting the program toward a focus on preventive care. The full LHC report is available at lhc.ca.gov.

Additionally, following the release of the LHC report, the Assembly and Senate Republican caucuses put forward a proposal, AB 1051 by Assemblymember Brian Maienschein (R-San Diego), to allocate an additional $200 million to Denti-Cal.

CDA keeps members informed on these bills through cda.org and the CDA Update.



Related Items

Assembly and Senate Republican leaders called on Gov. Jerry Brown to make additional funding for Denti-Cal a priority in this year's state budget. The legislative leaders have put forward a plan to increase funding for Denti-Cal "in a meaningful and responsible way." Specifically, they are pursuing a commitment of an additional $200 million, which will also pull down federal matching funds.

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.

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