Children's dental centers in Valley get state reprieve

Image Via Fresno Bee

Children's dental surgeons have reason to smile this week. 

The state Department of Health Care Services announced Monday that pediatric dental-surgery centers that provide care for poor children should be exempt from a 10% cut in Medi-Cal reimbursements.

Four of the centers are in the central San Joaquin Valley, including the Fresno Dental Surgery Center. The others are in Visalia, Tulare and Atwater.

The state said the exemption is necessary to maintain access to dental services. The exemption still needs approval by the federal Centers for Medicare and Medicaid Services; the state is proposing it be effective Dec. 1.

The Valley centers provide care for thousands of children who are too young, too scared or have too much dental decay to be treated at a regular dental office. At the centers, the children are sedated so they are not traumatized and to allow multiple procedures to be done in one sitting.

The state's exemption proposal was cause for celebration Monday, said Alan J. Vallarine, owner of the Fresno Dental Surgery Center.

"We are so thankful to get this 10% exemption. Otherwise, we were going to be history," Vallarine said.

The children's dental centers are among health providers in California that are subject to Medi-Cal cuts under Assembly Bill 97, which was approved by the Legislature in 2011.

Providers fought the legislation in court, but earlier this year, the state received federal approval to reduce payments to dentists, doctors, pharmacists and clinics. The state began implementing the cuts last month.

Pediatric dental-surgery centers said the cut would force them to close and more lower-income children would be seen in hospital emergency departments in pain. Last month, they took their cause to legislators, asking for letters of support.

Most of the children seen in dental surgery centers are on Denti-Cal, the dental branch of Medi-Cal, the state-federal insurance for the poor. Vallarine said his Fresno center provided care to 4,059 patients last year and all but 46 were covered by Medi-Cal.

Vallarine said the proposed exemption comes in the nick of time to save pediatric dental surgery centers, but even with the proposed reprieve on the 10% cut, he could owe the state about $1 million in retroactive payments back to 2011. "I'm not sure what they are going to do," he said.

Tony Cava, a spokesman for the Department of Health Care Services, said the state still is considering what to do about the back payments but added that the state won't surprise providers with a bill.

Statewide, 14 centers provide at least 95% of their Medi-Cal services to children and are proposed to be exempt from the 10% reimbursement cut.

Read more here: http://www.fresnobee.com/2013/11/25/3632030/childrens-dental-centers-get-state.html#storylink=cpy