California Lawmakers Call for Review of Denti-Cal Program
Following recent criticism of Denti-Cal, two state lawmakers this month asked the Little Hoover Commission to review the program, the Sacramento Bee reports. Denti-Cal is the dental program for Medi-Cal, California's Medicaid program.
Assembly member Jim Wood (D-Healdsburg) and state Sen. Richard Pan (D-Sacramento) requested that the commission come up with recommendations to help Denti-Cal serve more low-income children (Sangree, Sacramento Bee, 4/20).
Denti-Cal serves about 2.7 million adults and children. That number could increase to 6.4 million as the result of the state's Medi-Cal expansion.
Advocates warn that the increase in Medi-Cal beneficiaries could add pressure to the dental program, which already has been facing problems in recent years.
Criticism of Denti-Cal
A state audit released in December 2014 found that Denti-Cal services have been provided to less than 50% of children enrolled in the program, largely because many dentists do not participate in the program because of low reimbursement rates.
Denti-Cal reimbursement rates for the 10 most commonly authorized procedures in 2012 averaged $21.60 -- about 35% of the 2011 national average. Those reimbursement rates have not increased since 2000 and were cut by 10% in 2013.
The audit also found that in 2013:
- Five counties with at least 2,000 children enrolled in Denti-Cal might not have had any participating dentists;
- 11 counties had no dentists who were accepting new Denti-Cal patients; and
- 16 counties appeared to have an "insufficient" number of providers accepting new Denti-Cal patients.
The report also criticized California's Department of Health Care Services for inadequate oversight of the program (California Healthline, 12/12/14).
Pan said, "They're running the program with a lack of oversight and a lack of accountability."
In March, state lawmakers voiced similar concerns during a joint Senate and Assembly health committee hearing, according to the Bee.
Eileen Espejo, health policy director at Children Now, said that the audit "gave policymakers more ammunition to hopefully make real changes."
Meanwhile, DHCS Director Jennifer Kent said she plans to make changes to the program to improve public perception, in part by:
- Increasing services in rural areas;
- Improving the reimbursement process; and
- Reducing red tape for providers.
Kent said, "I think in a year you're not going to be having the same conversation about the program" and instead will be focusing on "all the things that have improved" (Sacramento Bee, 4/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.