Health & Medicine

Western Dental won’t take new Denti-Cal patients

Reimbursement rates that are too low and have not been raised in 15 years are the reason Western Dental won’t accept new patients covered by Denti-Cal, the company announced Thursday.
Reimbursement rates that are too low and have not been raised in 15 years are the reason Western Dental won’t accept new patients covered by Denti-Cal, the company announced Thursday. Sacramento Bee file

Western Dental, the state’s largest provider of Denti-Cal services to low-income patients, said it will no longer accept new patients under the program at more than a dozen of its clinics starting June 1.

The reason, said Simon Castellanos, Western Dental’s chief executive, is that Denti-Cal’s reimbursement rates haven’t been raised in 15 years and are too low to allow providers with a high concentration of Denti-Cal patients to adequately cover costs.

About half of Western Dental’s patients are enrolled in Denti-Cal, he said.

“​We have been serving underserved communities in the state for over 50 years,” Castellanos said. “Unfortunately, given the situation with the Denti-Cal program, we have been forced to question participation in the program.”

The company also plans to close two clinics in undisclosed locations and to lay off 200 employees in California. The Orange County-based company employs about 3,600 people in dozens of clinics statewide.

Anthony Cava, spokesman for the state Department of Health Care Services, which oversees Denti-Cal, said department officials are “very concerned about the potential impacts to (Denti-Cal) beneficiaries resulting from any service reductions by Western Dental.”

“We are closely monitoring the situation, and DHCS will act swiftly to take action should it be necessary to ensure that our members have access to the quality dental services they need,” Cava said in an emailed statement.

A state auditor’s report in December took the program to task for treating less than half of the 5 million children signed up for low-income health services in California. Lawmakers echoed the critiques at a joint hearing of the Senate and Assembly health committees in March.

The auditor’s report said low reimbursement rates accounted for the relative scarcity of dentists willing to provide treatment for children eligible for Denti-Cal. In 2013, five counties lacked any active Denti-Cal providers for children, while a dozen counties had no dentists willing to accept new child Denti-Cal patients, the report said.

Many other counties, including Sacramento, El Dorado and Yolo, had too few dentists to serve the population of children receiving Denti-Cal benefits, it said.

Gov. Jerry Brown did not include more money for Denti-Cal in his revised May budget plan, but state lawmakers and patient advocates say it will be a point of negotiation in upcoming budget talks.

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