Bill Text: CA AB1051 | 2015-2016 | Regular Session | Amended

---

Bill Title: Denti-Cal program: reimbursement rates.

Spectrum: Strong Partisan Bill (Republican 24-1-1)

Status: (Failed) 2016-11-30 - From Senate committee without further action. [AB1051 Detail]

Download: California-2015-AB1051-Amended.html

---

BILL NUMBER: AB 1051	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 2, 2016
	AMENDED IN SENATE  MAY 3, 2016
	AMENDED IN SENATE  JULY 15, 2015
	AMENDED IN ASSEMBLY  MAY 4, 2015
	AMENDED IN ASSEMBLY  APRIL 20, 2015

INTRODUCED BY   Assembly Member Maienschein
   (Principal coauthors: Assembly Members Lackey, Steinorth, and
Waldron)
   (Principal coauthor: Senator Nielsen)
   (Coauthors: Assembly Members Bigelow, Chang, Chávez, Dahle,
Gallagher, Jones, Kim, Linder, Mathis, Mayes, Olsen, and Wilk)
   (Coauthors: Senators Anderson, Bates, Berryhill, Cannella, Fuller,
Huff, Nguyen, Stone, and Vidak)

                        FEBRUARY 26, 2015

   An act relating to  Medi-Cal, and making an appropriation
therefor.   Medi-Cal. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1051, as amended, Maienschein. Denti-Cal  program.
  program: reimbursement rates. 
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid program provisions. Existing law provides for a schedule of
benefits provided under the Medi-Cal program, which includes certain
dental services that are referred to as Denti-Cal.
   This bill would  appropriate $200,000,000 from the General
Fund to the State Department of Health Care Services for the
Denti-Cal program. The bill would  require the 
department   State Department of Health Care Services
 to  allocate these funds to, among other things,
increase funding for preventative care and case management services,
as appropriate, to achieve significant long-term cost savings,
increased provider participation, and increased beneficiary
utilization under the Denti-Cal program.   increase
Denti-Cal provider reimbursement rates for the 15 most common
prevention, treatment, and oral evaluation services to the regional
average commercial rates, effective January 1, 2017. 
   Vote:  2/3   majority  . Appropriation:
 yes   no  . Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) California's Medicaid dental program, Denti-Cal, is charged
with providing an adequate level of dental coverage to 13 million
low-income Californians, including five million children.
   (b) Dental care, particularly preventative care, can have
significant long-term impacts. Tooth decay and disease are associated
with pregnancy risks, diabetes, and respiratory and heart disease.
Additionally, a lack of access to dental care among children can
result in missed school days, and ultimately poorer academic
performance.
   (c) Denti-Cal, as currently implemented and funded, is a failure.
Just 37.8 percent of California's five million Denti-Cal-eligible
children saw a dentist in the 2014 calendar year.
   (d) The Milton Marks "Little Hoover" Commission on California
State Government Organization and Efficiency and the California State
Auditor both note these low utilization rates, which stem from a
lack of providers and an uneven distribution of those providers that
do participate in the Denti-Cal program. Five counties have no
providers, and 14 counties only have providers that are not accepting
new patients.
   (e) The lack of providers is partly a result of low reimbursement
rates, which are typically one-third to one-half of the national
average for common procedures.
  SEC. 2.  (a)  The sum of two hundred million dollars
($200,000,000) is hereby appropriated from the General Fund to the
State Department of Health Care Services for the Denti-Cal program.
The   It is the  intent of the Legislature 
is  to attract and retain more  Denti-Cal 
providers, with an emphasis on underserved areas, and to increase
utilization of the program.
   (b)  The   Effective January 1, 2017, the
 State Department of Health Care Services shall 
allocate the funds appropriated in subdivision (a), as appropriate,
to accomplish both of the following: 
    (1)     Increase
  increase Denti-Cal provider  reimbursement rates
for the 15 most common prevention, treatment, and oral evaluation
services to the  Medicaid national average.  
regional average commercial rates.  
   (2) Increase funding for preventative care and case management
services, as appropriate, to achieve significant long-term cost
savings, increased provider participation, and increased beneficiary
utilization under the program.  
   (c) Any funds remaining after the allocation specified in
subdivision (b) shall be allocated to other uses that further the
intent of the Legislature, as described in subdivision (a),
including, but not limited to, increasing additional reimbursement
rates to the national average.