Mixed news for Denti-Cal adult benefits

Two significant but conflicting developments in the longstanding effort to rebuild the oral health care safety net in California have occurred. 

In a disappointing move, on the same day that the state Senate Budget and Fiscal Review Committee endorsed restoring Medi-Cal adult dental benefits, the U.S. 9th Circuit Court of Appeals on May 24 denied a petition filed by CDA and a coalition of health care organizations aiming to stop the state from implementing a 10 percent reduction in Medi-Cal provider reimbursement rates.

The decision essentially allows the state to implement a 2011 law that cuts Medi-Cal reimbursements to dentists, physicians, pharmacists and other Medi-Cal providers. Because the cuts have been blocked by court injunction since June 2011, the ruling would allow the state to recoup a portion of payments made to providers since that date.

“This decision will be devastating to an already fragile safety net that is about to experience tremendous growth with an additional one million children being added to the Medi-Cal program in California,” said CDA President Lindsey Robinson, DDS. “The state’s efforts to cut reimbursement rates will harm patients’ oral health and their ability to access care at a time when California is trying to recruit more providers into the system.”

In response, CDA is participating with a coalition of health care organizations in filing a motion requesting a Stay of Mandate. The motion asks the court to prevent the state from moving forward with the cuts while CDA and the coalition evaluate next steps and appropriate legal challenges. 

The court’s decision has implications for the discussions on restoring adult Denti-Cal services (which has been pushed strongly by Sen. President Pro Tem Darrell Steinberg since his visit to the CDA Cares free dental clinic in Sacramento last year),as the cuts would make it far more difficult for providers to participate in the program.

The effort to reinstate adult Denti-Cal services received a boost last week in the Senate Budget and Fiscal Review Committee. Four years after the program’s elimination, the committee voted 14-0 on May 24 to fully restore Medi-Cal adult dental benefits. Support for the proposal was led by Sen. Bill Monning (D-Carmel), who had visited the CDA Cares event in San Jose the previous weekend and specifically cited it as direct evidence of the extent of the oral health care access problem in California.

The proposal will now be part of the final budget negotiations between the Senate, Assembly, and governor in the coming weeks.

CDA will keep members informed on the developments and provide more information as it becomes available.

For more information on Denti-Cal, visit the “Major Issues” page.