County Pulse: Pediatric dental surgery centers are asking for relief from Medi-Cal cuts
11/06/2013 2:57 PM
11/08/2013 11:20 PM
The owners of pediatric dental surgery centers met with state health officials two weeks ago and will speak with top Medi-Cal officials next week, giving them hope that their surgery centers may get an exemption from a 10percent cuts to Medi-Cal reimbursements that threatens to devastate the facilities.
Some owners also are expecting visits to their surgery centers from higher-ups late this month.
As previously reported in The Modesto Bee, 18 facilities in the state, including Salida Surgery Center Dental Group and Central California Surgicenter in Atwater, treat thousands of low-income children who have severe caries. The children may need half their teeth treated with fillings, crowns or extractions. In the operating rooms, the youngsters are sedated to spare them the trauma of having multiple procedures done.
The Department of Health Care Services is preparing to ask the federal government for an exemption that was granted in Assembly Bill 97 for a nonprofit surgery center in Sonoma County, and the private centers are asking to be included. Without the exemption, the owners say, their facilities will be forced to close or severely cut back because a large percentage of their patients are on Medi-Cal. They don’t have enough privately insured patients to make up for the losses.
Owners said they don’t know when the state will make a decision, but they are getting political support from state and federal representatives from the Valley.
Health care providers challenged the 2011 cuts in court and lost, meaning the surgery centers are expected to return Medi-Cal payments received for more than two years.
Dr. Alan Vallerine, who has a Fresno surgery center, said the 10percent cuts forced him to stop accepting patients with Medi-Cal at his First Step Dental offices in Modesto and Merced. “I was losing $400 to $700 a day when we were trying to help these kids,” he said.
It appears hardworking underdog Jenny Kenoyer caught Modesto Councilwoman Stephanie Burnside by surprise in the District 5 race.
Burnside might have suffered from an anti-incumbency mood that wasn’t entirely recognized before the election. It reminds me of the March 2004 primary when long-term incumbents Pat Paul and Paul Caruso were ousted from the Stanislaus County Board of Supervisors. Before that election, political experts had suggested a scandal involving former Chief Executive Officer Reagan Wilson would not influence how people would vote.
That analysis was proven wrong when former Riverbank Mayor Bill O’Brien defeated Paul, a 16-year incumbent, and Jim DeMartini garnered enough votes to oust Caruso, who was seeking a fourth full term.
Burnside, the only incumbent on Tuesday’s Modesto ballot, was not at the center of controversy but sought re-election during a rocky period for Modesto City Hall. Bloggers these days can simply mention SCAP, NSP, “the courthouse” and Archway Commons, and readers know they are troubling issues that reflected poorly on city government.
I don’t know what textbook advice Burnside received during her lackluster campaign – she spent modestly and attended few candidate forums – but would conjecture that the political environment made her vulnerable. And Kenoyer’s legwork did the rest.
About This BlogThe Bee's Ken Carlson writes about county government and health issues in the Central Valley.
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