Dental News

Denti-Cal reimbursement bill update.

April 18, 2017

At the end of 2016, we discussed a proposed bill (AB 15) in the California state legislature aimed at increasing reimbursement rates for providers under the Denti-Cal program. This bill was drafted in direct response to comparatively low reimbursement rates in California, which some have blamed for the “silent, hidden epidemic of tooth decay and disease” in the Golden State. AB 15 cleared the State Assembly Health Committee last month with a few notable amendments.

As of our previous post, the bill had not yet been given a specific funding source. The recently amended bill, now cites the Healthcare Treatment Fund as the direct source of funding for these increased reimbursement rates.

This fund was created following the passage of the California Healthcare, Research, and Prevention Tobacco Tax Act of 2016 (Prop. 56). It is expected to earn $1.2 billion from the tobacco tax hikes in the next fiscal year.

Another notable amendment to the draft bill is the way in which it puts a number on its proposed increases in reimbursement rates for the 15 most common preventive oral procedures. Rather than allude to vaguely “increasing” the rates, the bill clarifies that it looks to “double” Denti-Cal provider reimbursement rates for the 2017-18 fiscal year. If passed, these higher reimbursements rates will help encourage California dentists to participate in the program.

These important amendments will hopefully give the bill further traction as it makes its way to the next hearing at the Assembly’s Committee on Appropriations. We’ll provide any updates here, so stay tuned.