California Dental Care Program Returns Unspent Funds To Federal Government

July 9, 2007 – 11:21 pm | posted in Dentistry

More than $130 million in funds for a dental program for low-income California residents was not spent over the past seven years by the state and half of those funds were returned to the federal government, the Sacramento Bee reports. The program, Denti-Cal, is offered through Medi-Cal, California’s Medicaid program. Dentist and health care advocates say “the unspent money … is a result of the state erecting barriers that deter dentists from participating” in the program, according to the Bee.

Stan Rosenstein, director of Medi-Cal, said the refund to the federal government came after the state completed a prepaid contract with Delta Dental, a private health plan that administers Denti-Cal. Rosenstein said, “Over the course of a seven-year contract, (Delta Dental) has been paid $131 million more than their costs, so the state recovered the money.” Rosenstein added the state “didn’t lose” the Denti-Cal funds that were returned to the federal government, and the state will recapture the funds “when we spend money on other things” in Medi-Cal.

However, according to Liz Snow, chief strategist for the California Dental Association, the state’s explanation for the unspent funds “is not consistent with what we’re hearing” from dentists. Snow said the state is facing a shortage of dentists that will treat Denti-Cal beneficiaries because reimbursements for care are about one-third of payments for dental services from private insurers. As a result of the low reimbursement rates, the program’s 6.5 million beneficiaries have had “an exceptionally difficult time” finding a dentist who will treat them, Snow said.

Rosenstein said that all states are having access problems because of a shortage of dentists and low reimbursement rates. He noted that California is one of a few states that offer dental coverage to adults and that Denti-Cal recently expanded the services that it covers.

Wynne Grossman, executive director of the Dental Health Foundation, questioned the value of expanding the number of services covered when a shortage of dentists makes it difficult for a beneficiary to receive care. Meanwhile, dental health advocates are urging state lawmakers to include measures to improve access to dental care in health care legislation under consideration (Rojas, Sacramento Bee, 7/3).

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