Last month, the California Department of Health Care Services (DHCS) informed the Anesthesia Medical Group of Santa Maria of a change in its provider status. Management at the medical center says that change means they'll no longer be able to provide anesthesia for pediatric dental care.
Two Santa Maria dentists we spoke to say several of their pediatric patients require general anesthesia in order to complete major dental services like teeth extractions and crown placements.
Following the recent notice from the DHCS, both dentists say hundreds of local kids may be left without access to the treatment they need.
“Maybe 25% of the patients that I see require some sort of general anesthesia in order to get their needed dentistry done,” said Dr. Rick Kleinsasser of Dentistry for Children in Santa Maria.
“We have worked with this group of anesthesiologists, me personally for seven years now,” added Dr. Andrew Van Sicklen of Surfin’ Smiles Dental Care. “Everything was going fine until this year.”
Both Dr. Kleinsasser and Dr. Van Silken say for several years, they've worked with the medical doctors at the Anesthesia Medical Group of Santa Maria to provide dental care at the Plaza Surgery Center for local kids requiring general anesthesia for their treatment.
In July, however, the Department of Health Care Services informed Santa Maria’s Anesthesia Medical Group that their provider status would be terminated immediately.
“Denti-Cal has decided to do something called 'dis-enrolling' a group of physicians that have been providing care for our patients for quite a few years, and they are claiming that these doctors were enrolled 'erroneously,’" Dr. Kleinsasser told KSBY.
According to the letter sent from the Department of Health Care Services to the Anesthesia Medical Group of Santa Maria, their Medi-Cal Dental Program provider status would be terminated because they were erroneously enrolled as a dental group provider instead of as a physician group.
In a statement to KSBY, the DHCS said doctors who provide dental anesthesia services can bill for dental anesthesia through Medi-Cal, just not through the Medi-Cal Dental program.
"The Medi-Cal Dental program is limited to paying dental providers, such as dentists and hygienists," a DHCS representative said. "Physicians with a medical general anesthesia permit who are contracted with an enrolled dental office to provide anesthesia services can be reimbursed for services through the Medi-Cal Dental program when billed by the enrolled dental office."
Meanwhile, Dr. Van Sicklen says every month, roughly 15 of his pediatric patients must be sedated for their treatment. He says last year, the Plaza Surgery Center saw more than 600 kids who needed general anesthesia for their dental work, adding that the dis-enrollment could leave them with few other treatment options.
“If this goes through and we are no longer able to work with them anymore, the kids that are too scared or nervous to do it in the office are going to have to go without care because it is unsafe to have it done there when they are moving around or scared and grabbing stuff,” Dr. Van Sicklen explained.
The Anesthesia Medical Group of Santa Maria says it is no longer able to provide general anesthesia for pediatric dentistry work. Rather, those services must be administered by dental anesthesiologists.
Dr. Kleinsasser says there aren’t many dental anesthesiologists in the area, so he has been asking his patients to wait until the situation is resolved.
“If these MDs don’t get re-enrolled, I imagine there is going to be a whole lot of patients who won’t be able to receive care,” Dr. Kleinsasser said.
The Anesthesia Medical Group of Santa Maria declined an opportunity for an on-camera interview, but their president, Nicholas Krier, sent a letter to the Department of Health Care Services asking to appeal the change.
