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

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: 6/18/2025 9:05 AM

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