Proposed Bills Seek to Improve Denti-Cal

California legislators may soon overhaul its state-run dental program for low-income individuals and families. Two bills are making their way through the state legislature. One would expand the program, granting more access to residents. The other would increase dentists’ reimbursement through program participation.

A recent report found that Denti-Cal dentists were reimbursed at a rate of about 35 percent of the current national average for common procedures.

Denti-Cal, California’s state-run dental program for low-income individuals and families, is the focus of two new bills going before state lawmakers. The proposed legislation aims to improve the program and expand access for residents of California, in addition to increasing dentists’ reimbursement through program participation.

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According to a report in California Healthline, Assembly Bill 753 would use money from California’s new tobacco tax to expand access to the Denti-Cal program. The bill would also require that dentists receive greater reimbursement for 20 of the most common dental procedures, such as X-rays and fillings.

A 2014 state auditor’s report showed that, for the most common dental procedures, Denti-Cal reimbursement rates averaged about $21.60, which is only 35 percent of the current national average. As a result, many dentists in the state do not participate in the program simply because they cannot afford to.

The new tobacco tax is expected to generate up to $1.2 billion in the coming year, and if the new bill passes, $300 million would be earmarked for Denti-Cal improvements. Much of the funds would be allocated for payments to dentists who provide preventative dental care to adult patients. The state already has one program, the Dental Transformation Initiative, that provides extra reimbursement, from state and federal dollars, to dentists who provide preventative services to pediatric patients.

Assembly Bill 15, which was introduced late last year, would also help improve payment rates for dentists in the state by requiring reimbursement to be doubled for the 15 most common prevention and treatment services.

However, some dentists in California are concerned that the proposed legislation will not be enough to entice more dentists into the Denti-Cal program. John Blake, D.D.S., explained that, while expansion of the Denti-Cal program could help increase access to preventative care, many adults already have complicated dental problems. Dentists could find themselves between a rock and a hard place if these issues are detected during routine cleanings or other basic screening procedures.

Blake says, “The adult population is a different beast from a treatment standpoint. We’ve done all this cleaning, but now we need root canals and extractions…how do we cover this?”

Assembly Bill 15 will be reviewed by the Assembly’s Committee on Appropriations, but a hearing date has not yet been scheduled. In the meantime, many dentists believe that using tobacco tax money to expand the Denti-Cal program and increase payment rates makes sense, even though there are still many questions regarding adult patients’ potential dental issues. According to Blake, most dentists are simply seeking reimbursement that matches the national average, even with California’s higher cost of living and business costs.

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