Medi-Cal: dental care., the official text

An act to add Section 14132.24 to the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including dental care, as specified. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
This bill would make behavior management and desensitization services without an accompanying dental procedure covered benefits under the Medi-Cal program, subject to utilization controls, when a patient’s physical, behavioral, developmental, or emotional condition requires significant extra time, attention, or personnel, or requires such services preceding a dental visit, respectively, in order to safely deliver dental care. The bill would condition implementation of these provisions on the availability of federal financial participation and any necessary federal approvals having been obtained. The bill would, notwithstanding any other law, authorize the department to implement, interpret, or make specific these provisions by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions without taking any further regulatory action.

The people of the State of California do enact as follows:

SECTION 1.
Section 14132.24 is added to the Welfare and Institutions Code, to read:
14132.24.
(a) Behavior management, when a patient’s physical, behavioral, developmental, or emotional condition requires significant extra time, attention, or personnel to safely deliver dental care, is a covered benefit, subject to utilization controls.
(b) Desensitization services without an accompanying dental procedure, when a patient’s physical, behavioral, developmental, or emotional condition requires such services preceding a dental visit in order to safely deliver dental care, is a covered benefit, subject to utilization controls.
(c) (1) This section shall be implemented only to the extent that federal financial participation is available and not otherwise jeopardized, and any necessary federal approvals have been obtained.
(2) Notwithstanding any other law, the department, without taking any further regulatory action, may implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions.