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CalAIM 1915(b) – Dental FFS and DMC Performance Reporting 

On December 29, 2021, the federal Centers for Medicare and Medicaid Services approved the California Advancing and Innovating Medi-Cal (CalAIM) Section 1915(b) Waiver, which seeks to transform and strengthen the Medi-Cal Program, including Dental Managed Care (DMC). As a component of the CalAIM 1915(b) Waiver Special Terms and Conditions (STCs), DHCS is required to monitor DMC performance in Annual Dental Visits, Preventive Dental Services, and Use of Sealants for children and adults. Specifically, STC C. Dental, #27 Plan Parity with FFS, requires each DMC plan to meet parity with the fee-for-service delivery system by December 31, 2022. Please refer to the DMC performance fact sheets shown below.

福利和机构代码报告 

California Welfare and Institutions (WIC) Codes Sections 14132.915, 14196, 14309 14459 and 14459.6 specify Medi-Cal Dental data reporting requirements for pediatric and adult dentistry. This also includes additional reporting requirements for utilization data such as, on a “per-provider” basis and annual service utilization through service categories including examination, prevention, treatment, and general anesthesia. The WIC codes align Dental Fee-For-Service and Dental Managed Care annual and quarterly reporting requirements.

绩效衡量

General Anesthesia Report

Per Provider Report

访问 DHCS 数据用于研究和公共卫生

访问受保护的 DHCS 数据用于研究和公共卫生网页是为研究和公共卫生目的向加州医疗保健服务部 (DHCS) 申请受保护数据的主要门户。受保护数据是指包含机密信息的任何数据，否则公众无法获取。 本网站不用于申请公开数据。  

Medi-Cal 牙科投诉和申诉报告

加州卫生与公众服务局开放数据门户

开放数据门户向公众提供非机密的健康和人类服务数据。 DHCS 正在积极向加州卫生与公众服务局 (CalHHS) 开放数据门户添加数据，并且最近将 Medi-Cal 牙科数据添加到开放数据门户。 开放数据门户上的大型数据集可以轻松排序，并且比大型 PDF 更具可读性。