Judge rejects lawsuit to save Denti-Cal benefits

Jun 24, 2009

California lawmakers can move forward with their plan to eliminate Medi-Cal dental benefits after a California judge ruled against a lawsuit that claimed their proposed budget cuts were illegal, according to news reports.

In February, the state enacted a tentative budget that would eliminate nine Medicaid benefits that it determined were not mandated by the federal government. The cuts are slated to become permanent as of July 1.

In April, the California Primary Care Association (CPCA), which represents about 700 clinics and health centers statewide -- along with Clinicas del Camino Real and Southern Trinity Health Services -- filed suit to block the budget cuts, saying the state does not have the authority over clinics that are federally qualified to receive higher reimbursement rates in exchange for serving all patients. The lawsuit sought a writ of mandate preventing the state from eliminating Denti-Cal, chiropractic, optometry, podiatry, and psychology services when provided by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics.

The lawsuit argues that federal and state laws both define FQHC services in terms of the types of providers who render services rather than the types of services that are rendered; and that, consistent with federal law, California's definition includes the services of dentists, chiropractors, optometrists, podiatrists, and psychologists as FQHC core providers.

"California's Welfare and Institutions Code and State Plan clearly protect reimbursement for FQHC services that are provided by 'core' providers, as defined both federally and by the state," said Carmela Castellano-Garcia, president and CEO of the CPCA, when the lawsuit was announced. "The legal definition of 'physician' includes dentists, chiropractors, optometrists, podiatrists, and psychologists, and therefore means that their services are indeed not optional for FQHCs."

But in a ruling made public June 24, Judge Timothy Frawley of the Superior Court of California for the County of Sacramento rejected the CPCA's arguments, saying the state Legislature had the right to cut adult Denti-Cal and other benefits when it voted in February on various measures to reduce state spending.