CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 316Introduced by Assembly Members Ramos and Robert RivasJanuary 30, 2019 An act to add Section 14132.235 to the Welfare and Institutions Code, relating to health care. LEGISLATIVE COUNSEL'S DIGESTAB 316, as introduced, Ramos. Medi-Cal: benefits: beneficiaries with special dental care needs.Existing law establishes 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 under the Medi-Cal program, including certain dental services that are referred to as Denti-Cal, and dental managed care plans.This bill would require the department to implement a payment adjustment to Medi-Cal providers who render dental services to Medi-Cal beneficiaries, as specified. The bill would not limit the provision or scope of Medi-Cal benefits covered under existing law. The bill would require the department to seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement the bill. The bill would authorize the department to implement these provisions, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action, and would require the department to subsequently adopt regulations, as specified, by July 1, 2022. The bill would require the department, commencing January 1, 2020, to provide the Legislature with semiannual status reports to the Legislature until regulations have been adopted.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. (a) Denti-Cal is the Medi-Cal dental care component program that was established soon after the 1966 creation of the Medi-Cal program, and it delivers dental services through a fee-for-service model. Dental services are also provided to beneficiaries enrolled in Medi-Cal dental managed care plans.(b) According to an audit conducted by the California State Auditor in 2014, only 43.9 percent of children enrolled in the Denti-Cal program had seen a dentist in the previous yeara utilization rate that was the 12th-worst among states that submitted data to the federal Centers for Medicare and Medicaid Services. Eleven California counties either did not have any Denti-Cal providers or did not have any providers willing to accept any new patients if the children received coverage through Medi-Cal. Additionally, the Little Hoover Commission found that only 26 percent of eligible California adults with Denti-Cal coverage saw a dentist in 2014, according to February 2016 State Department of Health Care Services data.(c) It is widely recognized that people with significant and chronic medical, physical, mental, behavioral, or developmental conditions or disabilities have greater challenges obtaining dental services and maintaining good oral health than other individuals. Providing care for these individuals very often requires treating providers to spend additional time and furnish other resources to deliver dental services. Denti-Cals current reimbursement structure is based on a healthier population, and does not acknowledge the additional costs of providing care for persons with special dental care needs, and inhibits providers ability to receive proper payment for their care. With regard to medical health care, as seen in Medicaid, Medicare, and other payers, payment adjustments can be used to compensate providers that treat higher need patients for the extra time and resources needed to complete these patients care. There is currently no such payment adjustment in Denti-Cal for providers that treat patients with special dental care needs.(d) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, it is the intent of the Legislature to provide a payment adjustment to Medi-Cal providers who render dental services to reimburse for the extra time needed to treat patients with special dental care needs, as described in this section.SEC. 2. Section 14132.235 is added to the Welfare and Institutions Code, immediately following Section 14132.23, to read:14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 316Introduced by Assembly Members Ramos and Robert RivasJanuary 30, 2019 An act to add Section 14132.235 to the Welfare and Institutions Code, relating to health care. LEGISLATIVE COUNSEL'S DIGESTAB 316, as introduced, Ramos. Medi-Cal: benefits: beneficiaries with special dental care needs.Existing law establishes 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 under the Medi-Cal program, including certain dental services that are referred to as Denti-Cal, and dental managed care plans.This bill would require the department to implement a payment adjustment to Medi-Cal providers who render dental services to Medi-Cal beneficiaries, as specified. The bill would not limit the provision or scope of Medi-Cal benefits covered under existing law. The bill would require the department to seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement the bill. The bill would authorize the department to implement these provisions, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action, and would require the department to subsequently adopt regulations, as specified, by July 1, 2022. The bill would require the department, commencing January 1, 2020, to provide the Legislature with semiannual status reports to the Legislature until regulations have been adopted.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION
Assembly Bill No. 316
Introduced by Assembly Members Ramos and Robert RivasJanuary 30, 2019
Introduced by Assembly Members Ramos and Robert Rivas
January 30, 2019
An act to add Section 14132.235 to the Welfare and Institutions Code, relating to health care.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 316, as introduced, Ramos. Medi-Cal: benefits: beneficiaries with special dental care needs.
Existing law establishes 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 under the Medi-Cal program, including certain dental services that are referred to as Denti-Cal, and dental managed care plans.This bill would require the department to implement a payment adjustment to Medi-Cal providers who render dental services to Medi-Cal beneficiaries, as specified. The bill would not limit the provision or scope of Medi-Cal benefits covered under existing law. The bill would require the department to seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement the bill. The bill would authorize the department to implement these provisions, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action, and would require the department to subsequently adopt regulations, as specified, by July 1, 2022. The bill would require the department, commencing January 1, 2020, to provide the Legislature with semiannual status reports to the Legislature until regulations have been adopted.
Existing law establishes 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 under the Medi-Cal program, including certain dental services that are referred to as Denti-Cal, and dental managed care plans.
This bill would require the department to implement a payment adjustment to Medi-Cal providers who render dental services to Medi-Cal beneficiaries, as specified. The bill would not limit the provision or scope of Medi-Cal benefits covered under existing law. The bill would require the department to seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement the bill. The bill would authorize the department to implement these provisions, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action, and would require the department to subsequently adopt regulations, as specified, by July 1, 2022. The bill would require the department, commencing January 1, 2020, to provide the Legislature with semiannual status reports to the Legislature until regulations have been adopted.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. (a) Denti-Cal is the Medi-Cal dental care component program that was established soon after the 1966 creation of the Medi-Cal program, and it delivers dental services through a fee-for-service model. Dental services are also provided to beneficiaries enrolled in Medi-Cal dental managed care plans.(b) According to an audit conducted by the California State Auditor in 2014, only 43.9 percent of children enrolled in the Denti-Cal program had seen a dentist in the previous yeara utilization rate that was the 12th-worst among states that submitted data to the federal Centers for Medicare and Medicaid Services. Eleven California counties either did not have any Denti-Cal providers or did not have any providers willing to accept any new patients if the children received coverage through Medi-Cal. Additionally, the Little Hoover Commission found that only 26 percent of eligible California adults with Denti-Cal coverage saw a dentist in 2014, according to February 2016 State Department of Health Care Services data.(c) It is widely recognized that people with significant and chronic medical, physical, mental, behavioral, or developmental conditions or disabilities have greater challenges obtaining dental services and maintaining good oral health than other individuals. Providing care for these individuals very often requires treating providers to spend additional time and furnish other resources to deliver dental services. Denti-Cals current reimbursement structure is based on a healthier population, and does not acknowledge the additional costs of providing care for persons with special dental care needs, and inhibits providers ability to receive proper payment for their care. With regard to medical health care, as seen in Medicaid, Medicare, and other payers, payment adjustments can be used to compensate providers that treat higher need patients for the extra time and resources needed to complete these patients care. There is currently no such payment adjustment in Denti-Cal for providers that treat patients with special dental care needs.(d) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, it is the intent of the Legislature to provide a payment adjustment to Medi-Cal providers who render dental services to reimburse for the extra time needed to treat patients with special dental care needs, as described in this section.SEC. 2. Section 14132.235 is added to the Welfare and Institutions Code, immediately following Section 14132.23, to read:14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. (a) Denti-Cal is the Medi-Cal dental care component program that was established soon after the 1966 creation of the Medi-Cal program, and it delivers dental services through a fee-for-service model. Dental services are also provided to beneficiaries enrolled in Medi-Cal dental managed care plans.(b) According to an audit conducted by the California State Auditor in 2014, only 43.9 percent of children enrolled in the Denti-Cal program had seen a dentist in the previous yeara utilization rate that was the 12th-worst among states that submitted data to the federal Centers for Medicare and Medicaid Services. Eleven California counties either did not have any Denti-Cal providers or did not have any providers willing to accept any new patients if the children received coverage through Medi-Cal. Additionally, the Little Hoover Commission found that only 26 percent of eligible California adults with Denti-Cal coverage saw a dentist in 2014, according to February 2016 State Department of Health Care Services data.(c) It is widely recognized that people with significant and chronic medical, physical, mental, behavioral, or developmental conditions or disabilities have greater challenges obtaining dental services and maintaining good oral health than other individuals. Providing care for these individuals very often requires treating providers to spend additional time and furnish other resources to deliver dental services. Denti-Cals current reimbursement structure is based on a healthier population, and does not acknowledge the additional costs of providing care for persons with special dental care needs, and inhibits providers ability to receive proper payment for their care. With regard to medical health care, as seen in Medicaid, Medicare, and other payers, payment adjustments can be used to compensate providers that treat higher need patients for the extra time and resources needed to complete these patients care. There is currently no such payment adjustment in Denti-Cal for providers that treat patients with special dental care needs.(d) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, it is the intent of the Legislature to provide a payment adjustment to Medi-Cal providers who render dental services to reimburse for the extra time needed to treat patients with special dental care needs, as described in this section.
SECTION 1. (a) Denti-Cal is the Medi-Cal dental care component program that was established soon after the 1966 creation of the Medi-Cal program, and it delivers dental services through a fee-for-service model. Dental services are also provided to beneficiaries enrolled in Medi-Cal dental managed care plans.(b) According to an audit conducted by the California State Auditor in 2014, only 43.9 percent of children enrolled in the Denti-Cal program had seen a dentist in the previous yeara utilization rate that was the 12th-worst among states that submitted data to the federal Centers for Medicare and Medicaid Services. Eleven California counties either did not have any Denti-Cal providers or did not have any providers willing to accept any new patients if the children received coverage through Medi-Cal. Additionally, the Little Hoover Commission found that only 26 percent of eligible California adults with Denti-Cal coverage saw a dentist in 2014, according to February 2016 State Department of Health Care Services data.(c) It is widely recognized that people with significant and chronic medical, physical, mental, behavioral, or developmental conditions or disabilities have greater challenges obtaining dental services and maintaining good oral health than other individuals. Providing care for these individuals very often requires treating providers to spend additional time and furnish other resources to deliver dental services. Denti-Cals current reimbursement structure is based on a healthier population, and does not acknowledge the additional costs of providing care for persons with special dental care needs, and inhibits providers ability to receive proper payment for their care. With regard to medical health care, as seen in Medicaid, Medicare, and other payers, payment adjustments can be used to compensate providers that treat higher need patients for the extra time and resources needed to complete these patients care. There is currently no such payment adjustment in Denti-Cal for providers that treat patients with special dental care needs.(d) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, it is the intent of the Legislature to provide a payment adjustment to Medi-Cal providers who render dental services to reimburse for the extra time needed to treat patients with special dental care needs, as described in this section.
SECTION 1. (a) Denti-Cal is the Medi-Cal dental care component program that was established soon after the 1966 creation of the Medi-Cal program, and it delivers dental services through a fee-for-service model. Dental services are also provided to beneficiaries enrolled in Medi-Cal dental managed care plans.
### SECTION 1.
(b) According to an audit conducted by the California State Auditor in 2014, only 43.9 percent of children enrolled in the Denti-Cal program had seen a dentist in the previous yeara utilization rate that was the 12th-worst among states that submitted data to the federal Centers for Medicare and Medicaid Services. Eleven California counties either did not have any Denti-Cal providers or did not have any providers willing to accept any new patients if the children received coverage through Medi-Cal. Additionally, the Little Hoover Commission found that only 26 percent of eligible California adults with Denti-Cal coverage saw a dentist in 2014, according to February 2016 State Department of Health Care Services data.
(c) It is widely recognized that people with significant and chronic medical, physical, mental, behavioral, or developmental conditions or disabilities have greater challenges obtaining dental services and maintaining good oral health than other individuals. Providing care for these individuals very often requires treating providers to spend additional time and furnish other resources to deliver dental services. Denti-Cals current reimbursement structure is based on a healthier population, and does not acknowledge the additional costs of providing care for persons with special dental care needs, and inhibits providers ability to receive proper payment for their care. With regard to medical health care, as seen in Medicaid, Medicare, and other payers, payment adjustments can be used to compensate providers that treat higher need patients for the extra time and resources needed to complete these patients care. There is currently no such payment adjustment in Denti-Cal for providers that treat patients with special dental care needs.
(d) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, it is the intent of the Legislature to provide a payment adjustment to Medi-Cal providers who render dental services to reimburse for the extra time needed to treat patients with special dental care needs, as described in this section.
SEC. 2. Section 14132.235 is added to the Welfare and Institutions Code, immediately following Section 14132.23, to read:14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
SEC. 2. Section 14132.235 is added to the Welfare and Institutions Code, immediately following Section 14132.23, to read:
### SEC. 2.
14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.(c) As used in this section, the following terms shall have the following meanings:(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.
14132.235. (a) For purposes of improving access to dental care for Medi-Cal beneficiaries with special dental care needs, the department shall implement a payment adjustment, as defined in subdivision (c) of this section, to Medi-Cal providers who render dental services to Medi-Cal beneficiaries with special dental care needs.
(b) A Medi-Cal provider shall document in the patients medical record the necessity for any additional time to be expended to treat a Medi-Cal beneficiary with special dental care needs.
(c) As used in this section, the following terms shall have the following meanings:
(1) Medi-Cal beneficiary with special dental care needs means a Medi-Cal beneficiary with chronic medical, physical, mental, behavioral, or developmental conditions or other disabilities that complicate his or her dental care or require the dental provider to provide additional expertise, actions, and resources.
(2) Payment adjustment means the additional reimbursement provided to a Medi-Cal provider for treating a Medi-Cal beneficiary with special dental care needs. This payment is an adjustment to compensate for the extra time needed to render dental services to a Medi-Cal beneficiary with special dental care needs that would not otherwise have been expended on a Medi-Cal beneficiary without special dental care needs.
(3) Dental services means dental benefits included in the Medi-Cal schedule of benefits.
(d) This section does not limit the provision of, or scope of, Medi-Cal benefits.
(e) The department shall seek any necessary approvals from the federal Centers for Medicare and Medicaid Services to implement this section. The department shall implement this section only in a manner that is consistent with federal Medicaid law and regulations, and only to the extent that the necessary approvals are obtained and federal financial participation is not jeopardized.
(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2022, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing January 1, 2020, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.