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As of December 2022, 2.2 million people were enrolled in Medi-Cal fee-for-service, representing about 14.5% of all enrollees. [3] In the fee-for-service arrangement, health care providers submit claims to the Medi-Cal program for services rendered. [18]
With 13 million children and adults enrolled, Denti-Cal is the largest state-sponsored dental insurance program; Private contractor that administers Denti-Cal is Delta Dental. In 2016, the State of California awarded Delta Dental a new contract to provide administrative services for the Denti-Cal program, continuing the 42-year relationship [7]
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [ 1 ] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
As a result of the 2012–2013 budget deal, the HFP was discontinued [4] and Medi-Cal requirements were lowered so that HFP patients would qualify for Medi-Cal. Nearly 900,000 children were moved from the HFP into Medi-Cal beginning in 2013. [5] [6]
It was expanded to children ages 6–18 in 2004. L.A. Care announced that the Healthy Kids programs would end at the end of 2016 as a result of SB 75 – a California law implemented in May 2016 – which expanded full-scope Medi-Cal benefits to all low-income children regardless of immigration status.
Western Dental has almost 250 offices in California, Arizona, Nevada, and Texas, making it one of the largest dental service providers in the United States. [1] Up to 70% of its California patients are covered under the state's Denti-Cal health insurance program for low-income families.