Dental Managed Care All Plan Letters

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2025 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 25-001	Disaster Assistance to Evacuated Members and Dental Offices	January 9, 2025 Revised: February 27, 2025 & April 22, 2025
APL 25-002	Continuity of Care for DMC Members on or after July 1, 2025 (Supersedes APL 17-011E)	March 25, 2025 Revised: May 23, 2025
APL 25-003	Transition Policy Guide	March 25, 2025
APL 25-004	2024-2025 Medi-Cal Dental Managed Care Plan MEDS/834 Cutoff and Processing Schedule	April 7, 2025
APL 25-005	2025 Deliverable Schedule 2025 Deliverable Schedule	April 23, 2025 Revised: May 6, 2025
APL 25-006	Standards for Determining Threshold Languages, Nondiscrimination Requirements, Language Assistance Services, and Alternative Formats (Supersedes APL 21-001) Threshold and Concentration Language for All Counties Notice of Nondiscrimination Template Notice of Availability Template Statement of Nondiscrimination for Small Sized Notices Template	May 19, 2025
APL 25-007	Dental Managed Care (DMC) Plan Member Soft Cap Limit	August 12, 2025
APL 25-008	Oral Health Performance Measures For Dental Managed Care Contracts Effective July, 1 2025 Attachment A: Performance Measures and Benchmarks Performance Measures Template	October 10, 2025
APL 25-009	Medi-Cal Dental Managed Care Plan Provider Directory Updates	October 17, 2025

2024 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 24-001	APL 24-001: Modifications to the Grievance and Appeals Deliverable Template For the Medi-Cal Dental Managed Care Program (Supplement APL 22-006) Grievance and Appeals Template	February 26, 2024
APL 24-002	Dental Coverage Disclosures	May 8, 2024
APL 24-003	Medical Loss Ratio Requirements for Subcontractors and Downstream Subcontractors	October 10, 2024
APL 24-004	2025 Deliverable Schedule 2025 Deliverable Schedule	December 16, 2024
APL 24-005	Dental Community Health Worker Services Benefit	December 19, 2024

2023 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 23-001	Teledentistry Expansion Policy	April 26, 2023
APL 23-002	Cost Avoidance and Post-Payment Recovery for Other Health Coverage Appendix A: OHC Code Descriptions and Scope of Coverage (COV) Codes Chart Appendix B: Naming Convention	April 26, 2023
APL 23-003	2023 Deliverable Templates (Supersedes APL 14-012)	June 8, 2023
APL 23-004	Updated Grievance and Appeals Submission Due Date (Supplement APL 22-006)	October 20, 2023
APL 23-005	2024 Deliverable Schedule (Supersedes APL 22-015)	December 21, 2023

2022 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 22-001	Provider Billing Practices	January 28, 2022

APL 22-002

Medi-Cal Dental Managed Care Plan Performance Measures

February 16, 2022

APL 22-003E (Revised)

Treatment of Recoveries Made by Managed Care Dental Plans of Overpayments to Providers

February 16, 2022

Revised:

April 20, 2022

APL 22-004

Current Dental Terminology 22

June 2, 2022

APL 22-005

Fraud, Waste and Abuse Reporting

June 24, 2022

APL 22-006

Grievance and Appeals Requirements Notice and "Your Rights" Templates (Supersedes APL 20-003)
APL 22-006 Member Notices:

Notice of Action

Notice of Appeal Resolution (NAR)

State Fair Hearing

July 22, 2022

APL 22-007

Payment Withhold for Performance Measures, Quality Metrics and Benchmarks (Supersedes APL 16-009)

APL 22-007 Attachment: DMC Performance Measures Quality Metrics and Benchmarks

July 22, 2022

APL 22-008

Guidance Regarding AB 1184

July 28, 2022

APL 22-009

Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 13-004)

August 19, 2022

APL 22-010

Managed Care Program Annual Report (MCPAR)

September 30, 2022

APL 22-011

Alternate Format Selection for Members with Visual Impairments

September 12, 2022

APL 22-012

Continued Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds

October 3, 2022

APL 22-013	Interoperability	December 1, 2022
APL 22-014	Long Term Care Integration	December 23, 2022
APL 22-015	2023 Deliverable Schedule	January 3, 2023

2021 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 21-001	Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services Threshold and Concentration Languages for All Counties Notice of Nondiscrimination Template Taglines Template	May 14, 2021
APL 21-002	Dental Managed Care (DMC) Dental Transformation Initiative (DTI) Change Log Clarification DTI Change Log Template	July 13, 2021
APL_21-003	Extension Of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated For Calendar Year 2021	July 30, 2021
APL 21-004	Current Dental Terminology 21	October 18, 2021
APL-21-005	CalAIM Requirements	November 23, 2021
APL-21-006	Calendar Year 2022 Deliverables Schedule	December 31, 2021

2020 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 20-001	Extension of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated For State Fiscal Year 2019-20	February 7, 2020
APL 20-002	Continuation of Supplemental Payments For Certain Dental Services Using Proposition 56 Tobacco Tax Funds for July 1, 2020 Through December 31, 2020	September 21, 2020
APL 20-003 (Supersedes APL 17-003E)	Centers For Medicare and Medicaid Services (CMS) Final Rule Revisions Effecting Grievance and Appeal Requirements; Revised "Your Rights" Attachments Grievance and Appeal Requirements; Revised Notice Templates and "Your Rights" Attachments APL 20-003 Member Notices: Notice of Action (NOA) Deny/Modify Delay Revised NOA Your Rights (Knox-Keene) Notice of Appeal Resolution (NAR) Overturn Uphold Revised NAR Your Rights (Knox-Keene) 1557 Notices Language Assistance Taglines Nondiscrimination Notice	December 14, 2020
APL 20-004	2021 Deliverables Schedule	December 23, 2020

2019 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 19-001	Early and Periodic Screening Diagnostic and Treatment (EPSDT) Services	January 25, 2019
APL 19-002	Extension of One-Year Supplemental Payment For Certain Dental Services Using Proposition 56 Tobacco Tax Funds Allocated for State Fiscal Year 2018-19 APL 19-002 Attachment: Proposition 56 Directed Payment Report Template (MS Excel)	February 11, 2019
APL 19-003	Payment Error Rate Measurement (PERM) Provider Update	March 20, 2019
APL 19-004	X12 274 Provider Network Data Reporting Requirements (Supersedes APL 17-010)	August 14, 2019

2018 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 18-001	Revised Grievance and Appeal Report APL 18-001 Attachment: Quarterly Grievance and Appeal Report Template (MS Excel)	January 3, 2018
APL 18-002	APL 18-002 Exhibit A, Attachment 5- Quality Improvement System (Supersedes APL 15-018)	January 22, 2018
APL 18-003E (Revised)	Network Adequacy Standards for Timely Access to Care for Routine and Specialist Appointments APL 18-003 Attachment: DMC Timely Access Template (MS Excel)	January 9, 2018 *Revised:* *March 15, 2018*
APL 18-004	Provider Screening / Enrollment and Credentialing / Recredentialing APL 18-004: Frequently Asked Questions (FAQ)	January 16. 2018
APL 18-005	Dental Transformation Initiative (DTI) Domain 2 Outreach	February 7, 2018
APL 18-006	Modifications to the Performance Measures and Benchmarks for the Medi-Cal Dental Managed Care Program (Supersedes APL 16-017) APL 18-006 Attachment: DMC Performance Measure Template	March 13, 2018
APL 18-007	Requirements for Oral Health Assessments	June 15, 2018
APL 18-008	Language Access Services for Limited-English Proficient and Non-English Proficient Individuals	May 1, 2018
APL 18-009	Requirements for Use of Non-Monetary Member Incentives APL 18-009 Attachment: Member Incentive (MI) Program Request for Approval Form	June 22, 2018
APL 18-010	Proposition 56 Directed Payment Expenditures for Dental Services for State Fiscal Year 2017-18	May 16, 2018
APL 18-011	Encounter Data Submission Reconciliation Form	June 25, 2018

2017 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 17-001	2017 Deliverables Schedule	January 24, 2017
APL 17-002	Member Handbook and Evidence of Coverage	May 24, 2017
APL 17-003E Superseded by APL 20-003	Grievance and Appeal Requirements; Revised Notice Templates and "Your Rights" Attachments APL 17-003 Member Notices: Notice of Action (NOA) Deny/Modify Delay NOA Your Rights (Knox-Keene) Notice of Appeal Resolution (NAR) Overturn Uphold NAR Your Rights (Knox-Keene) State Hearing Form 1557 Notices Language Assistance Taglines Nondiscrimination Notice	May 24, 2017
APL 17-004	Prior Authorization for Intravenous Sedation and General Anesthesia Services	June 28, 2017
APL 17-005	Reminder Regarding Requirement to Submit Specialty Referrals Report	July 28, 2017
APL 17-007	One-Year Supplemental Payment Using Proposition 56 Tax Funds	November 21, 2017
APL 17-008	Network Adequacy Standards for Time and Distance	November 8, 2017
APL 17-009	Full Restoration of Adult Dental Benefits for the Medi-Cal Dental Managed Care Program	November 27, 2017
APL 17-010	Plan Provider Network and Changes to Plan Provider Network	December 1, 2017
APL 17-011E	Transition of Care Policy	December 18, 2017 Revised: April 5, 2018
APL 17-012	2018 Deliverables Schedule	December 27, 2017

2016 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 16-001	Due Dates for All Dental Managed Care Contracts for Calendar Year 2016	January 14, 2016
APL 16-002	Discontinuation of Website Posting for All Plan Letters	January 29, 2016
APL 16-005	Registered Dental Hygienists in Alternative Practice Policy Amendments	January 20, 2016
APL 16-009	Waiver of the Capitation Payment Withhold for Performance Measures and Benchmarks	August 1, 2016
APL 16-010	Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.706: Special Rules for Temporary Management Effective July 5, 2016	January 20, 2017
APL 16-011	Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.710: Notice of Sanction and Pre-Termination Hearing	January 20, 2017
APL 16-013	Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.2: General Provisions, Definitions Effective July 5, 2016	January 20, 2017
APL 16-014	Final Rule Notice of Modernized Managed Care Regulations: 42 C.F.R. § 438.3 (d) Standard Contract Requirements and 42 C.F.R. § 440.262 Access and Cultural Considerations	January 20, 2017
APL 16-016	Emergency Dental Services	September 9, 2016
APL 16-017	Performance Measure Implementation	October 14, 2016
APL 16-019	Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.50: Public Health, Regulation, State Plan Requirements	January 20, 2017
APL 16-020	Final Rule Notice of Modernized Managed Care Regulation 42 C.F.R. § 438.3(f): Compliance with Applicable Laws and Conflicts of Interest Safeguards	January 19, 2017

2015 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 15-002	Department of Health Care Services Policy Updates Regarding Aggregate Data Reporting	March 27, 2015
APL 15-003	Participation of Allied Dental Professionals in the Dental Managed Care Program	May 20, 2015
APL 15-004	Clarification on Exhibit A, Attachment 3: Financial Information	March 12, 2015
APL 15-005	Prior Authorization for Intravenous Sedation and General Anesthesia Services	April 1, 2016
APL 15-006	Virtual Dental Home Implementation n the Dental Managed Care Program	June 1, 2015
APL 15-007	Transition to Post Adjudication Claims and Encounter Data Systems (PACES)	May 21, 2015
APL 15-009	Modifications to the Performance Measures and Benchmarks for the Medi-Cal Dental Managed Care Program	October 9, 2015
APL 15-014	Approval Process for Annual Rates Packages and Rate Adjustments	September 15, 2015
APL 15-015	Update Regarding Virtual Dental Home Implementation in the Dental Managed Care Program	September 2, 2015
APL 15-016	Increased Frequency Limitations for Certain Preventative Services for Beneficiaries Residing in Skilled Nursing Facilities and Intermediate Care Facilities	November 24, 2015
APL 15-018	Quality Improvement Projects Guidelines and Schedule	November 24, 2015
APL 15-019	Modification of Adjudication Criteria for D0145	December 2, 2015

2014 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 14-001	Revised: Due Dates for All Dental Managed Care Contracts for Calendar Year 2014	August 14, 2014
APL 14-002	Revised: Notice of Changes Regarding Adult Dental Services at Federally Qualified Health Centers and Rural Health Clinics and the Restoration of Some Adult Dental Benefits	August 19, 2014
APL 14-003	Update Regarding the Restoration of Some Adult Dental Services Effective May 1, 2014	May 16, 2014
APL 14-004	Consumer Satisfaction Survey	July 23, 2014
APL 14-007	Clarification on Exhibit A, Attachment 5, Provision L, to Include Requirements to Comply with the Program Integrity Provisions of 42 Code of Federal Regulations	August 25, 2014
APL 14-008	Expanded Services for Pregnant Beneficiaries Effective May 1, 2014	August 14, 2014
APL 14-009	Comprehensive Services for Pregnant Beneficiaries Effective October 1, 2014	October 1, 2014
APL 14-010	County Specific Benchmarks Effective January 1, 2013 for Geographic Managed Care and July 1, 2013 for Prepaid Health Plan	January 30, 2015
APL 14-012	Updated Performance Measures and Benchmarks Deliverable Template	October 21, 2014
APL 14-014	Due Dates for All Dental Managed Care Contracts for Calendar Year 2015	January 9, 2015
APL 14-017	Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Beneficiaries Under the Age of Twenty One	December 12, 2014

2013 Dental All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 13-000	Implementation Deliverable Requirements and Due Date for the GMC Plans	January 11, 2013
APL 13-001	Due Dates for All Deliverables for Calendar Year 2013	January 1, 2013
APL 13-002	Minimum Loss Ration Clarification	January 1, 2013
APL 13-004	Clarification on Exhibit A, Attachment 5: Provision N - Corrective Action Plan	January 1, 2013
APL 13-005	Clarification on Exhibit A, Attachment 6: Performance Measures and Benchmarks	January 1, 2013
APL 13-006	Clarification on Exhibit A, Attachment 7: Utilization Management	January 1, 2013
APL 13-007	Clarification on Exhibit A, Attachment 9: Provision B - Provider Grievances	January 1, 2013
APL 13-008	Clarification on Exhibit A, Attachment 10: Provision F - Federally Qualified Health Centers, Rural Health Clinics; and Indian Health Service Facilities	January 1, 2013
APL 13-009	Clarification on Exhibit A, Attachment 11: Provision B and H - Sub-provision 3 & 5, Timely Access, and Linguistic Services	January 1, 2013
APL 13-010	Clarification on Exhibit A, Attachment 17: Provision C - Marketing Plan	January 1, 2013
APL 13-011	Clarification on Delivery Methods and DHCS Contacts	January 1, 2013
APL 13-012	Healthy Families Reporting Aid Codes and Due Date	February 14, 2013
APL 13-013	Deliverables for Exhibit A, Attachment 12: Provision D - Health Education	March 1, 2013
APL 13-014	Clarification on Exhibit A, Attachment 9: Provision E - Provider Training	March 1, 2013
APL 13-015	Dental Managed Care Rates for 2013	April 26, 2013
APL 13-016	Implementation Deliverable Requirements and Due Date for the PHP Plans	June 13, 2013
APL 13-017	Some Adult Dental Services to be Restored May 1, 2014	October 4, 2013
APL 13-018	Dental Managed Care Revised Rates for 2013	September 13, 2013
APL 13-021	Insure Kids Now Website	October 16, 2013
APL 13-022	Due Dates for All PHP Deliverables for Calendar Year 2013-2014	November 19, 2013
APL 13-023	Implementing a new Encounter Data Capture and Transmission System	December 17, 2013

Last modified date: 10/27/2025 10:59 AM

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