A state judge has ruled that the California Department of Health Care Services (DHCS) illegally reduced payments for dental hygienists who work outside of the dental office. The department oversees the state's dental Medicaid program, Denti-Cal.
The decision came after eight independent hygienists sued DHCS after the department added preauthorization requirements and cut reimbursement rates for quarterly cleanings from $130 to $55. A Superior Court of California judge ruled that the changes were illegal because DHCS did not ask for permission from the U.S. Centers for Medicare and Medicaid Services (CMS) before making them.
The ruling requires DHCS to set aside the reimbursement rate changes and to obtain CMS authorization before making the reimbursement rate changes.
