Cigna to Follow State Recommendation and Drop Denticare
Denticare of California Inc., the Laguna Niguel-based managed care firm that state auditors blasted in June for denying dental care to indigent patients, will not be renewed as its Medi-Cal subcontractor by Cigna Healthplan of Southern California.
Denticare thus will lose about 115,000 Medi-Cal patients in Southern California when the contract expires Jan. 31.
Foundation Health Corp., Denticare’s parent company, announced the non-renewal Monday afternoon. A Foundation spokesman said Cigna had notified Denticare in a letter dated Oct. 27.
Cigna had no comment Monday on its action.
Foundation, in its statement, downplayed the impact that the loss of the 115,000 Medi-Cal patients will have on its business. It said the Cigna contract accounted for $8.4 million in revenue in the year ended June 30, compared to total Foundation revenue of $1.5 billion.
The Department of Health Services, in its June 16 audit report, cited Denticare for denying care to some Medi-Cal recipients, needlessly delaying care to others and improperly diverting fees from dentists into the company’s own coffers.
The report said Denticare took eight to 12 weeks to respond to requests to authorize treatment--a process that should take only seven days. The plan also failed to assign many patients--especially children--to dentists in a timely fashion, the state said.
Auditors said that of the $6.9 million the state paid under the Medi-Cal dental contract in 1992, Denticare kept $3.2 million for administration, marketing and quality assurance; Cigna took $753,000 for its overhead, and only $2.97 million--43%--went to the dentists for actual patient care.
Denticare disputed those numbers and some of the audit report’s conclusions, but the state stood by its figures. The department recommended that Cigna drop Denticare as its subcontractor.
The audit process is still not complete. Cigna and Denticare responded to the initial report and are awaiting final word on what sanctions, if any, will be imposed.
“Denticare is cooperatively seeking a satisfactory resolution of any outstanding issues with regulatory agencies,” Charles R. Upton, Denticare’s new president, said in a statement Monday. Upton, a retired Air Force colonel, was named to the post in September.
Denticare still faces lawsuits by a whistle-blowing former employee alleging wrongful termination and by dentists seeking money they say the network improperly withheld from them.
