04/23/2018

Little Hoover Commission examines changes in Denti-Cal program


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 hearing followed the commission’s November 2017 letter to Gov. Jerry Brown and the Legislature calling on the Department of Health Care Services to take additional action and prioritize access to critical dental services and preventive oral health care for the nearly 14 million Californians enrolled in the Denti-Cal program.

The commission heard from several panels, including Denti-Cal providers who serve the population in clinics, surgery centers and other settings and as individual practitioners. CDA member dentist Nagaraj Murthy, DDS, spoke about his experiences as a long-term Denti-Cal program provider. Murthy’s testimony highlighted the need for the Legislature and governor to make a stable commitment to the success of the program in partnership with providers.

“I ask the state to take action and institute processes that make the program stable and predictable on an ongoing basis. I believe this is the only way providers will gain trust and be willing to plan for the future with Denti-Cal as part of that plan,” Murthy said. 

The LHC’s April 2016 report called for a complete "reboot" of the Denti-Cal program, 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with reimbursement rates among the lowest in the nation, an abundance of restrictive rules, and a reliance on outdated paper-based administrative processes." The report laid out 11 recommendations intended as solutions for transforming a department culture long dominated by fraud prevention to one that balances the need to ease the path to enroll in the Denti-Cal program, reimburse dental professionals and ultimately expand access to dental care.

Since the release of the commission’s 2016 report, the Legislature passed Assembly Bill 2207, authored by Assemblymember Jim Wood, DDS (D-Healdsburg), which addressed some of the commission’s findings and recommendations. AB 2207 seeks to expedite provider enrollment and monitor dental service access and utilization through additional programmatic performance measures. The legislation also addressed the accuracy and quality of the Denti-Cal provider directory.

Between AB 2207 and CDA’s continued engagement with the Legislature and DHCS, several programmatic improvements have been achieved, including a new, streamlined Denti-Cal provider enrollment application, the restoration of adult dental services, the Dental Transformation Initiative and a 40 percent increase in reimbursement for hundreds of procedure codes due to the passage of Proposition 56.

In comments submitted in advance of the March 22 hearing, CDA recognized the department’s heightened awareness of the program challenges and acknowledged the new initiatives implemented within the program. However, it is still premature to evaluate whether these efforts will improve access to care for the nearly 14 million Californians enrolled in the program. CDA expects the state to continue its commitment to meaningful engagement with providers and to work in partnership with dentists who are committed to caring for their communities. In comments, CDA encouraged the state to pursue stability in base reimbursement rates over inconsistent, drastic shifts in reimbursement, benefits or eligibility, thereby reducing the confusion for beneficiaries while enabling providers to make sound business decisions that allow them to serve the Denti-Cal population.

CDA will continue to inform members about changes within the Denti-Cal program through the CDA Update, newsletter and cda.org. For more information, contact CDA Public Affairs at 916.554.4984. To automatically receive the monthly Denti-Cal Bulletin and related communications, sign up for the DHCS email list.



Related Items

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.

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.

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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