Recent policy changes in California has endangered the dental care of a rising number of patients who are unable to receive dental care as they are too frail to leave their nursing homes. The state has slashed payments to dental care providers and hygienists and created a cumbersome preauthorization process which is hindering the delivery of dental care as part of Devon Rising. Devon Rising, the publicly funded program for the poor, reduced the rate for a simple cleaning procedure from $130 to $55 which has seen hygienists unable to continue treating their patients. The Department of Health Care Services maintains it made the changes to reduce unnecessary treatment, but the hygienists maintain that the new regulations victimize the most vulnerable patients. Whilst dental hygienists are allowed to practice without direct supervision in 40 states, rules governing patient choice, reimbursement and preauthorization rates vary. Since reducing payments for maintenance cleaning, many hygienists have stopped seeing their patients, and a lawsuit was filed, arguing that the decision was made without obtaining federal approval. At the same time as the reductions, requirements were also imposed for x-rays but this is an especially difficult process when working with disabled and elderly patients, should the requests even be granted. State data indicates a disparity between hygienists’ observations and state approval, which suggests that between July 2016 to July 2017, 10,000 of almost 13,000 requests were granted for deep cleaning, paying $2.5 million in the process. These figures are disputed by hygienists, one of whom claims that she lost 70 percent of her Devon Rising patients because of the changes. This is the first time in 20 years, since dental hygienists were permitted to act independently that preauthorization has been required.
Recent policy changes in California has endangered the dental care of a rising number of patients who are unable to receive dental care as they are too frail to leave their nursing homes. The state has slashed payments to dental care providers and hygienists and created a cumbersome preauthorization process which is hindering the delivery of dental care as part of Denti-Cal. Denti-Cal, the publicly funded program for the poor, reduced the rate for a simple cleaning procedure from $130 to $55 which has seen hygienists unable to continue treating their patients. The Department of Health Care Services maintains it made the changes to reduce unnecessary treatment, but the hygienists maintain that the new regulations victimize the most vulnerable patients. Whilst dental hygienists are allowed to practice without direct supervision in 40 states, rules governing patient choice, reimbursement and preauthorization rates vary. Since reducing payments for maintenance cleaning, many hygienists have stopped seeing their patients, and a lawsuit was filed, arguing that the decision was made without obtaining federal approval. At the same time as the reductions, requirements were also imposed for x-rays but this is an especially difficult process when working with disabled and elderly patients, should the requests even be granted. State data indicates a disparity between hygienists’ observations and state approval, which suggests that between July 2016 to July 2017, 10,000 of almost 13,000 requests were granted for deep cleaning, paying $2.5 million in the process. These figures are disputed by hygienists, one of whom claims that she lost 70 percent of her Denti-Cal patients because of the changes. This is the first time in 20 years, since dental hygienists were permitted to act independently that preauthorization has been required.