CDA, others advocate for improved Medi-Cal reimbursement rates

By DrBicuspid Staff

March 4, 2015 -- In a hearing on Wednesday in Sacramento, CA, the president of the California Dental Association (CDA) and other experts testified that California's very low Medi-Cal reimbursement rates had become an access-to-care issue when it comes to the state's children receiving necessary dental treatment.

Walter Weber, DDS, of Campbell, CA, said California's low reimbursement rates -- in some cases about a third of the national average for some dental procedures -- make it "unfeasible" for many practitioners to see Medi-Cal patients.

Dr. Weber was testifying at the Senate Health and Assembly Health Committees joint oversight hearing on "Do Medi-Cal Rates Ensure Access to Care?"

In December 2014, a 92-page state audit found that more than half of the 5.1 million children enrolled in Denti-Cal, California's Medicaid dental program, did not receive dental care last year, and some counties lack providers to meet patients' oral care needs.

The audit blamed poor provider participation and low reimbursement rates, some of which have not increased since 2000. Those rates were cut by 10% in 2013. The audit reported that California's reimbursement rates for the 10 dental procedures most frequently authorized for payment averaged $21.60 -- only 35% of the U.S. average, according to the report.

Jenny Kattlove, senior director of programs at the Children's Partnership, also testified that these children who are enrolled in Medi-Cal were not getting the treatment they needed. She advocated for state investment in the Virtual Dental Home, which she said is "cost-effective and safe."

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Copyright © 2015

Last Updated np 3/4/2015 2:58:12 PM

1 comment so far ...
3/9/2015 1:28:22 PM
Most of the Dentical fees have not changed since  1993. Only a few were changed in 2000. We are now at 25% of our UCR fee. Since the CA audit was done in Dec. 2013 the number of children on Dentical in Santa Barbara county has increased from 28,000 to 58,000. Those extra 30,000 patients were private patients that went from paying private fees to Dentical. Over 90% of the children in the city of Santa Maria are on it. Without a fee increase we be forced to downsize our office by 75%. These children will not have anywhere to go without driving 90 to 120 miles