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 includes emergency and essential diagnostic and restorative dental services, and dental prophylaxis cleanings and dental examinations within the scope of benefits that may be provided to eligible recipients under the Medi-Cal program. Existing law authorizes specified Medi-Cal providers to recommend, after consultation with the beneficiary, and to receive reimbursement for, certain dental restorative materials other than the covered benefit of amalgam.
This bill additionally would authorize a provider of services for the treatment of dental caries
to provide, and receive reimbursement for, silver diamine fluoride when used as a caries arresting agent and billed as specified, if the provider first consults with the beneficiary and obtains written informed consent, and if the treatment is included as part of a comprehensive treatment plan. The bill would include a registered dental hygienist in alternative practice within the definition of a provider of services for the treatment of dental caries. The bill would authorize the department to establish appropriate utilization controls for patients eligible to receive services under the bill.