BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 2207 (Wood) - Medi-Cal:  dental program
          
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          |Version: June 28, 2016          |Policy Vote: HEALTH 9 - 0       |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: August 11, 2016   |Consultant: Brendan McCarthy    |
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          *********** 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  
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            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  
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          Author  
          Amendments:  Clarify the requirements for deactivating a  
          Denti-Cal provider, delay implementation for the collection of  
          certain data, and make technical changes.





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