07/07/2017

Rate increases expected for hundreds of procedures under state program


As California’s new fiscal year starts, dentists can expect significant reimbursement increases for hundreds of procedures covered by Denti-Cal because of the passage of CDA-sponsored and supported Proposition 56, the tobacco tax measure. With anticipated federal participation, it is expected that an estimated $300 million in additional funding will be committed to increasing coverage for dental care in the program. This is a step in the right direction to fixing Denti-Cal by improving woefully inadequate rates with estimated increases of 40 percent for many procedures. The state made the announcement June 30 and will make additional details public by the end of July as federal approvals are sought.

“This commitment of hundreds of millions of dollars that will go directly to care begins to make good on the commitment voters made by passing Proposition 56 to help underserved Californians,” said John Blake, DDS. “What’s more, these increases support the provision of routine care as well as the complex and costly care that so many people need but go without, reducing preventable emergency room visits.”

The rate increases are not the only investment the state is making in the Denti-Cal program as full adult dental benefits will be restored as of Jan. 1, 2018. These combined with the implementation of sorely needed changes in enrollment and billing procedures for Denti-Cal instituted by 2016 legislation by Assembly Member Jim Wood, DDS, (D-Healdsburg), and the Dental Transformation Initiative incentives for increased prevention, early intervention and care continuity for children’s services, will expand access to dental care for underserved Californians.

While significant uncertainty remains over the ongoing commitment of funding due to potentially significant cuts to federal Medicaid funding, underserved Californians who are in dire need of substantial dental care will have some immediate needs addressed. If Congress and the president do not make drastic cuts to the nation’s basic safety-net health system and tobacco tax revenue collections remain high, it is possible that the 2018-19 budget could make additional investments to Denti-Cal through Proposition 56 funding.

CDA’s legislative and regulatory advocates will closely monitor those funding sources through the fiscal year to ensure distribution of all funds the Legislature approved as well as continuing advocacy to improve the state’s Denti-Cal program.



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Gov. Jerry Brown and the California Legislature engaged in heated negotiations before passing a final budget by a constitutionally mandated deadline of June 15. A major focus of those negotiations was the use of Proposition 56 tobacco tax revenues, for which CDA and its partners engaged in an internal and external advocacy campaign.

CDA is excited to report that Proposition 56, co-sponsored by CDA to raise the state’s tobacco tax by $2, passed overwhelmingly in yesterday’s election with 62 percent of the vote. Winning a ballot measure campaign in California is a massive undertaking, especially with an opposition as powerful and well-funded as the tobacco industry.

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