On Thursday, the state Senate Budget Committee's Subcommittee on Health and Human Services approved legislation by Senate President Pro Tempore Darrell Steinberg (D-Sacramento) that would allow Sacramento County children enrolled in Medi-Cal to obtain dental care outside of the county's managed care program, the Sacramento Bee reports.
Medi-Cal is California's Medicaid program (Bazar, Sacramento Bee, 3/23).
Sacramento County currently runs a mandatory managed care dental program, where the state pays private dental plans a fee each month to provide coverage for more than 110,000 child beneficiaries of Medi-Cal.
Following a previous Sacramento Bee article, Steinberg asked Department of Health Care Services Director Toby Douglas to take immediate action to improve the dental program.
The article scrutinized the dental program for long wait times and low rates of dental care among beneficiaries.
In the 2010-2011 fiscal year, fewer than one-third of Sacramento children with Medi-Cal visited a dentist, compared with a rate of nearly 50% statewide (California Healthline, 3/15).
Critics argue that the managed care plan encourages dentists to avoid seeing patients because the dentists receive payment regardless of whether children with Medi-Cal receive dental care.
Details of the Bill
The bill would give Medi-Cal beneficiaries a choice between the managed care dental program and a fee-for-service model that pays dentists or each visit they report. In California, only Los Angeles County currently offers that choice.
The legislation also would establish tougher dental plan standards and stricter oversight by state agencies.
The changes would take effect July 1 if the measure is approved by the Legislature and the governor. However, federal approval likely will be required to alter the dental program, according to the Bee.
Steinberg Allows for Improvements Without Legislation
Steinberg said that if the Sacramento County dental program improves significantly in the coming months, he may stop pushing for a fee-for-service alternative. He said, "There is a chance now for the plans themselves over the next two-plus months to dramatically improve their performance," adding, "Get to the statewide average. If you do that, it could be a different conversation and a different debate."
Douglas Not Focusing on Fee-for-Service Option
Steinberg told the subcommittee that Douglas has the authority to implement the fee-for-service option himself if he concludes that the managed care program is not working.
However, Douglas has not been receptive to a fee-for-service model in the county, according to the Bee.
Douglas told the subcommittee, "I'm 100% focused on making sure that managed care works now and we have a system that's accountable and we have the oversight, the monitoring and the right requirements on our plans" (Sacramento Bee, 3/23).