Dental photo

Credit: Alameda County Public Health Section

In a move that affects millions of California students who rely on Medi-Cal for dental services, reimbursement rates for dentists who care for low-income children will exist cutting, the Department of Health Care Services appear Thursday.

Dental affliction has emerged equally an of import factor in depressing school attendance and academic operation amidst low-income students, and advocates said the reduction in reimbursement fees volition make it more than difficult for students to obtain care. As it stands, one-half of children under historic period 21 enrolled in Medi-Cal'south dental program did not have a single dental visit in 2011, according to a January 2022 report by The Children's Partnership, a nonprofit grouping that studies children's dental wellness.

Dentists who accept Medi-Cal for children'southward care will accept their fees reduced by 10 pct starting next month. In improver, the land will apply the fee reduction retroactively to June 1, 2022 and seek to recover overpaid funds. Current Medi-Cal dental reimbursement rates in California rank near the lesser of the nation, according to the California Society of Pediatric Dentistry, and the number of dentists who take Medi-Cal payments is express.

"It's well-nigh unfortunate," said Lindsey Robinson, president of the California Dental Association and a pediatric dentist in Grass Valley. "Dental caries is the well-nigh mutual affliction of childhood, and the majority of the affliction burden is in underserved kids," said Robinson. "These are the kids who are going to be impacted in a large way, considering access to a dentist for treatment is going to be restricted."

Update:  The Department of Wellness Care Services disputed the idea that a reimbursement charge per unit decrease would make it more difficult for children on Medi-Cal to receive dental services. The department has a federally canonical monitoring programme to measure patient access to Medi-Cal dental services, said Norman Williams, deputy director of the Department of Health Care Services, and at that place are 15,281 active Medi-Cal dental providers with offices in all 58 counties. "If our access monitoring program indicates that dental care access is insufficient for Medi-Cal members, we will take immediate activity to address the problem," he said. To improve the 50 percent utilization charge per unit of Medi-Cal dental services by children, the department has strengthened outreach to Medi-Cal families and implemented provider operation measures, he said. "There are many reasons that some children don't see dentists on a regular basis," Williams noted, adding, "Our monitoring plan's purpose is to ensure that these children take access to care."

Dental problems go on California students out of schoolhouse for an estimated 874,000 days a year, costing schools about $29.7 million in lost attendance based-funding, co-ordinate to the 2007 California Health Interview Survey, an ongoing statewide survey by the Middle for Health Policy Research at UC Los Angeles. The written report is still considered the benchmark for children'due south oral health. To address student needs, schools take struggled to provide a dental safety net by establishing school-based dental intendance.

"If kids are not healthy, they are going to miss school and if they are in pain, it'due south going to affect learning," said Hedy Chang, director of Attendance Works, a nonprofit group that studies student attendance issues.

Exempt from the ten percent fee cutting are nonprofit pediatric dental surgery centers that provide "at least 99 percent of their services under general anesthesia to children with severe dental disease." These centers serve children who have "rampant disease" or who are too immature to exist effectively managed without anesthesia, said Robinson from the California Dental Association. The services are valuable, she noted, but preventive dental care is crucial.

"Otherwise, we'll never get on tiptop of it," said Robinson. "In my practice, it'southward very disheartening to run across these kids come up in with an amount of decay that is about entirely preventable."

By the end of 2013, about 5 meg children – roughly half of the children in the land – are expected to be enrolled in Medi-Cal, according to The Children's Partnership. The rate reduction, which applies to many Medi-Cal services in addition to dental care, was approved by the country legislature in 2022 and signed into constabulary past Gov. Jerry Brownish as a toll-cutting measure. The implementation of the rate change had been stalled in court proceedings until June.

"The State'southward conclusion ways that families will face even greater hurdles getting care for their children," said Jenny Kattlove, managing director of strategic health initiatives at The Children's Partnership, "resulting in pain and suffering amid children who become without necessary care, expensive emergency room visits for preventable dental problems, and missed schoolhouse and piece of work due to dental issues."

Efforts to reform the Medi-Cal system for children'south dental care have failed, said Ray Stewart, executive managing director of the California Society of Pediatric Dentistry. "The Denti-Cal system in California is cleaved across repair," said Stewart. "I think the future is very grim and the large losers are children."

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