Dental Care Improvements in the Proposed 2020-25 Waiver

Dental Care Improvements in the Proposed 2020-25 Waiver

Dental care in MediCal has been administered by a separate managed care plan. There have been many problems: low rates, failure to update the benefits package for modern dental advances, inattention to wellness and prevention and a tendency to wait for care until too late so that teeth are pulled which could have been saved by earlier dental intervention. In general, poor children have only about half the access to and use of dental coverage as their middle class, privately insured counterparts.

All children above the age of 5 should be in dental care. The waiver proposes to get to 60% of MediCal children receiving dental care. When we did an Oversight Hearing on the program over 30 years ago, only 30% of children were getting annual care.

The waiver proposes a caries risk assessment bundle and silver diamine fluoride treatment for young children and for high risk and for institutional populations.

The waiver proposes to expand the Pay for Performance initiatives to statewide application to encourage use of prevention and establish and maintain dental homes.

Prepared by: Lucien Wulsin

Dated: 1/25/20