BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 2207 (Wood) - Medi-Cal: dental program ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: June 28, 2016 |Policy Vote: HEALTH 9 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 11, 2016 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- *********** ANALYSIS ADDENDUM - SUSPENSE FILE *********** The following information is revised to reflect amendments adopted by the committee on August 11, 2016 Bill Summary: AB 2207 would enact an number of changes to the operation of the Denti-Cal program, relating to provider enrollment, program monitoring, and reporting. Fiscal Impact: One-time costs of $370,000 and ongoing costs of $340,000 per year for additional collection, analysis, and reporting of new performance measures by the Department of Health Care Services (General Fund and federal funds). Unknown costs to make administrative changes to the system for AB 2207 (Wood) Page 1 of ? enrolling Denti-Cal providers (General Fund and federal funds). The bill requires the Department to make several changes to the processes and systems for enrolling dental providers into the program, such as requiring the use of a dental-specific enrollment form, pursuing an automatic enrollment process for commercially-credentialed providers, and improving the system for maintaining the provider network. The Department has already began some of these processes, such as simplifying the paper enrollment application. Other activities, such as automatically enrolling commercially-credentialed providers have not begun and will impose unknown administrative costs to implement. On the other hand, improvements to the system for provider enrollment may reduce future administrative workload to process enrollment applications, which are currently very labor intensive to the Department and its fiscal intermediary. Unknown costs to provide additional Denti-Cal services, to the extent that the changes in the bill improve participation rates by dental providers, increasing the utilization of Denti-Cal services (General Fund and federal funds). Currently, the state spends about $1.2 billion per year on Denti-Cal for adults and children. Estimates of the utilization rates vary, but are all generally low. There are strong indications that low reimbursement rates and cumbersome administrative requirements on providers result in low participation rates by providers. To the extent that the administrative changes in the bill improve provider participation, there could be increased utilization. For example, for every 5% increase in annual utilization by children, the cost would be about $35 million per year. Unknown potential cost-savings due to increased use of preventative dental services (General Fund and federal funds). Regular dental care, particularly for children, is likely to prevent dental conditions, such as cavities, from becoming more serious health problems that require more costly interventions later. To the extent that the bill results in increased utilization of preventative dental services in Denti-Cal, there are likely to be reduced costs for more serious dental services. Whether those avoided costs are greater than the cost of providing greater access to preventative services is unknown. AB 2207 (Wood) Page 2 of ? Author Amendments: Clarify the requirements for deactivating a Denti-Cal provider, delay implementation for the collection of certain data, and make technical changes. -- END --