DENTAL HEALTH: Denti-Cal Increases Reimbursements For Sealants
Delta Dental Plan, California's chief dental Medi-Cal contractor, instituted changes in its system last week to promote greater ease in providing the program's estimated 2.3 million children with dental sealants. As ordered by the state health department, the emergency regulations call for higher reimbursements for sealants to the approximately 9,000 participating Denti-Cal dentists. Specifically, the reimbursement rate for the sealant procedure has been increased from $9 to $15 per tooth, the "prior authorization" requirement for the procedure has been removed for sealants on first or second permanent molars of beneficiaries up to age 21 and x-rays, written justifications or other documentation are no longer required. "The new regulations encourage Denti-Cal dentists to offer sealants in any and every instance where the procedure can genuinely protect the oral health of our eligible beneficiaries," said Robert Pierson, chief of the office of Medi-Cal Dental Services. He continued, "California taxpayers are better served when we encourage preventive measures to head off more expensive, major restorative treatment later down the line." The new regulations will be retroactive to April 10, and dentists who performed sealants on low-income children prior to that date can resubmit their claims for reprocessing (release, 5/15). The new plan was made possible under the state's $2.1 million Children's Dental Health Initiative (see California Healthline, 5/14).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.