Dental care plan audited by California ceases operations

05/26/2012 12:00 AM

05/27/2012 2:36 PM

Community Dental Services, a managed-care dental plan with about 16,000 Medi-Cal members in Sacramento and Los Angeles counties, will cease operations and transfer its enrollees to Liberty Dental Plan on June 1, state officials announced Friday.

The move came in response to an audit by the Department of Managed Health Care, the results of which can't be released until it is finalized, said department spokeswoman Marta Bortner.

But during previous audits, the department identified problems with the way the plan approved or denied care, its grievance and appeal system and its oversight of quality of care, she said.

The plan informed the state during the audit that it would voluntarily cease operations.

"We are taking quick action to ensure that our Medi-Cal dental managed-care enrollees receive quality, timely services from our dental plans," said Toby Douglas, director of the Department of Health Care Services, which administers Medi-Cal.

That audit was prompted by a CHCF Center for Health Reporting story published in February in The Bee about Sacramento County's Medi-Cal dental managed-care program.

The story gave examples of children who had trouble obtaining treatment for painful, rotted or broken teeth, including some who endured pain for more than a year as they awaited care.

Community Dental Services, also known as SmileCare, represents about 12,200 Medi-Cal recipients in Sacramento and about 4,300 in Los Angeles County.

Those children can keep their dentist under Liberty, state officials said, or choose a new dentist in Liberty's network.

SmileCare's 4,000 members who have coverage outside of Medi-Cal also will be transferred to Liberty.

"There's no excuse for bureaucracy and lousy providers to get in the way of giving kids the critical medical care they deserve," said state Senate President Pro Tem Darrell Steinberg, D-Sacramento.

"Putting pressure on unreliable providers to get out of the program is a great first step to help these children and their families."

Steinberg has been among the most vocal critics of Sacramento County's dental managed-care program and has introduced legislation that would make managed care voluntary in Sacramento.

It is currently mandatory for children on Medi-Cal.

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