The referral that never got logged
Your dentist says it was sent. The plan says it has nothing. Nothing is authorized, nothing is denied, and the clock never starts.
Dental Awards
Welcome to the first annual i can't smile, CALIFORNIA Dental Awards, honoring the Medi-Cal dental plans that do a truly remarkable amount with a truly remarkable number of specialists.
Seven categories, one for each kind of dentist the State says every plan must have. Two decided. Five still sealed.
Directories last checked . Next check: unannounced.
Programming note
The Los Angeles County ceremony has been postponed until further notice. Tonight's awards cover Sacramento County only, home of the State Capitol and the county where Medi-Cal members must join one of three dental plans, with few exceptions. In Los Angeles County, joining is optional. Los Angeles nominees are asked to keep their acceptance speeches on file.
Tonight's program
Seven envelopes
One for each kind of dentist on the State's list, in the State's order. Open ones hold a result: choose one and its show and scoreboard take the stage below. Sealed ones are still being counted, and the chips show the standards the State holds each type to.
-
Primary Care Dentists
Your main dentist, for checkups, cleanings, fillings and referrals. The plan assigns you one.
- Seen within 4 weeks
- 10 miles or 30 minutes
- 1 for every 2,000 members
Coming soon. The standards
-
Endodontics
The inside of the tooth and the tissue around its roots. Root canals.
- Adults seen within 30 business days of a referral
- Children within 30 calendar days
- 10 miles or 30 minutes
Coming soon. The standards
-
Oral and Maxillofacial Surgery
Surgery of the mouth, jaws and face, such as difficult extractions and jaw injuries.
- Adults seen within 30 business days of a referral
- Children within 30 calendar days
- 10 miles or 30 minutes
Coming soon. The standards
-
Orthodontics
Teeth and bites that do not line up. Braces.
- Adults seen within 30 business days of a referral
- Children within 30 calendar days
- 10 miles or 30 minutes
Coming soon. The standards
-
Pedodontics
An older name for pediatric dentistry: care for babies, children and teenagers, including children with special health care needs.
- Adults seen within 30 business days of a referral
- Children within 30 calendar days
- 10 miles or 30 minutes
Coming soon. The standards
-
Periodontics
The gums and the bone that hold teeth in place.
Gold Liberty Dental Plan, 2 periodontists listed
Checked . Watch the show
-
Prosthodontics
Replacing missing teeth. Crowns, bridges, dentures.
No winner 0 verified prosthodontists
Checked . Watch the show
The seven types, in this order: DHCS, Medi-Cal Dental Managed Care Methodology Overview, 29 August 2025. A category is won by the plan whose own directory lists the most different specialists of that kind at offices inside Sacramento County, each checked against the federal provider registry. The rules are in the rulebook. Descriptions are our plain summary of the American Dental Association's specialty definitions; primary care dentists as DHCS describes them in its June 2019 certification. The chips on the sealed envelopes are the standards DHCS lists beside each provider type in its 2025 report to the federal government, laid out line by line in the standards table.
Envelope seven, tonight's category
Prosthodontics
Before the envelope, a short lesson: what a prosthodontist is, why it matters, and how to read a directory listing. Then the show. Click, tap, swipe or use the arrow keys, with the sound on or off.
The scoreboard
Tonight's numbers, straight from the plans
Three Sacramento directories, searched for a prosthodontist on 14 September 2026, and checked against the federal provider registry the way the lesson describes.
0
Verified prosthodontists across all three Sacramento directories
551,922
Sacramento County members who must belong to one of the three plans
10
Endodontists Health Net offered when asked for dental prosthetics
3
Names in Liberty's prosthodontist results, each labeled General Dentist first
2,556
Sacramento-area listings in the California Dental Network (DentaQuest) directory file, none of them a prosthodontist
30
Business days a plan has to get an adult member a specialist appointment once the referral is authorized
| Plan | Where and how we searched | What came back |
|---|---|---|
| Health Net | Health Net Medi-Cal dental, adult directory, dentists by specialty, near Sacramento, CA. Prosthodontics is not offered as a specialty, so we chose the closest option, Dental Prosthetics. | 11 dentists: 10 listed as endodontics and 1 as periodontics. Prosthodontists: none. |
| California Dental Network (DentaQuest) | DentaQuest Find a Dentist, Medi-Cal DMC adult plan, within 50 miles of ZIP 95819, looking for a prosthodontics specialty filter. Then its downloadable directory file for the California Medi-Cal DMC adult plan, counted by ZIP code and specialty. | The specialty filter for that plan and area offers nine choices: dental anesthesiology, dental hygienist, denturist, endodontics, general dentistry, oral and maxillofacial surgery, orthodontics, pediatric dentistry and periodontics. Prosthodontics is not one of them. The downloadable file, dated 1 July 2026, has 2,556 listings in ZIP codes beginning 956, 957 or 958, and none is a prosthodontist. All 71 prosthodontist listings in the file are in Southern California. Prosthodontists: none. |
| Liberty Dental Plan | Liberty Medi-Cal dentist search, Medi-Cal GMC/PHP network, specialty prosthodontist, under 50 miles of Sacramento. | 8 listings, 3 names: one dentist at 6 offices, two more at 1 office each, the farthest in Stockton. Every listing says “General Dentist, Prosthodontics” and leaves the board certification field blank. The federal registry lists the dentist at the 6 offices as a general dentist; the other two names, as the directory spells them, returned no dentist in the registry. Verified prosthodontists: none. |
Where this comes from, and who answers for it. Every count above comes from the plans' own public provider directories, which state law and federal Medicaid rules require them to publish (HSC 1367.27; 42 CFR 438.10(h)), checked against the public NPI Registry. The plans publish these directories and answer for what is in them. We are not suggesting any dentist listed has done anything wrong; a general dentist may lawfully make dentures, and the label is the plan's. If you are one of those dentists and your listing is wrong, tell us and we will report it to the plan. Directories change weekly, so run the searches yourself and send us anything different.
On the record
Every prosthodontics count we have taken
We look again at random, and whenever a reader reports a change. Each check gets a dated row. Old rows stay.
| Checked | Health Net | California Dental Network (DentaQuest) | Liberty Dental Plan | Result | What changed |
|---|---|---|---|---|---|
| 0 | 0 | 0 (3 names, none verified) | No winner | First count. |
Next check: unannounced. Seen a prosthodontist appear in a directory? Tell us.
The part where we get real
No winners this time, folks.
The rest of this site is polished. This part is not. It is written for the people this actually happens to, and it says what we actually think. Where we state a rule, we quote it. Where we cannot prove something yet, we say so.
We are sorry to inform you
If you are a low-income resident of Sacramento County, you were placed in a Medi-Cal dental plan you did not pick, run by companies owned by insurance giants and a private equity firm, and as of tonight none of the three lists a verified prosthodontist. If you ever need one, the honest odds are that you will not see one through your plan. Not without a fight.
Even if your dentist refers you
A referral to a specialist the plan does not have puts the plan in an awkward spot, because the rules say it must send you outside its network and pay for it. That is the moment things tend to get strange. The plan may not want to sign a one-time agreement with an outside prosthodontist. It may point you to a community clinic that has no prosthodontist either, then to another. The referral may never make it into the system. You may be treated like a case number and told, warmly, that nothing went wrong. You may have to fight harder for a set of teeth than you have fought for anything in your life.
Why running straight to the State may not be your best first move
Here is the part almost nobody tells you. Complaining to the State is your right, and we show you how elsewhere on this site. But the State does not book your appointment. The plan does. The rule that gets you into a chair is this one, from the contract every Medi-Cal dental plan signs with DHCS:
DHCS Dental Managed Care contract, 2025, Exhibit A8, section 9
“If Contractor's provider network is unable to provide necessary services, covered under the contract, to a particular Member, Contractor must adequately and timely cover these services out-of-network for the Member, for as long as Contractor's provider network is unable to provide them.”
The next line says the plan must make sure the cost to you is “no greater than it would be if the services were furnished within the network.” The same words sit in federal Medicaid rules, 42 CFR 438.206(b)(4) and (5).
The contract even spells out the mechanics. Where the State has excused a plan from its distance standard for a type of specialist, the plan must help you get an appointment with an out-of-network specialist and “make its best effort to establish a Member-specific case agreement with an Out-Of-Network core Specialist at the Medi-Cal Fee-For-Service rate or a mutually agreed upon rate.” That outside specialist must be able to see you within the same time and distance standards, or the plan must arrange your ride. And once a specialist referral is authorized, an adult member must be offered the appointment within 30 business days.
In plain words: no prosthodontist in the network is the plan's problem to solve, on the plan's clock, at the plan's expense. The State pays each plan a flat amount per member per month whether you get care or not, so every outside referral comes out of that. Draw your own conclusions about the incentive.
DHCS DMC boilerplate contract, 2025: Exhibit A8, sections 5 and 9; Exhibit A11, sections 1, 3.2, 3.4 and 10. How the plans are paid.
Watch for these moves
Patterns to watch for, described in general terms. They are warnings, not findings about any one plan or person.
The clinic hop
You are sent to a community clinic that has no prosthodontist, then to another that does not have one either. Round and round.
The ticket to nowhere
A friendly voice opens a ticket. Nobody calls back. Call again and the ticket cannot be found.
The no-record record
You describe what happened, with dates. The plan says it has no record of your calls. Federal rules say it must keep one.
Your dentist is your best ally. Sometimes your only one.
Some general dentists know exactly what these plans are like. They know you cannot afford to go anywhere else and they know nobody else is coming, so they treat you themselves, as well as they can. Be grateful for those. Others may see something different: three things that could be done in one visit, spread across three visits weeks apart, because every visit bills. If your treatment plan looks like a calendar with no end, ask why.
If you were referred to a prosthodontist while in one of these plans, ask your dentist to help you fight. Ask them to put the referral in writing, into the plan's own system, and to send a copy to the plan's dental director, the one person California law makes answerable for dental decisions being made by qualified people. Keep copies of everything. If nothing comes back in writing, here is what to do.
Dentists of Sacramento, this part is for you
You know these networks better than your patients ever will. When a patient needs a specialist the plan does not have, put the referral in writing, demand the authorization, and keep demanding it. If a plan answers with pressure, a threat to hold payments, to end your contract, anything, write that down too. The Department of Managed Health Care and DHCS both take documentation from providers, and a dentist's paper trail is much harder to wave away than a patient's word. Enough of those trails, side by side, is what a real enforcement case is built from.
Being straight with you
- We believe, but cannot yet prove, that Sacramento members have gone a long time without real access to a prosthodontist, referral or no referral. We are looking for the records that would settle it: referral logs, authorization data and the State's network reviews.
- We do not know how many out-of-network case agreements any of the three plans has signed for prosthodontics, or whether the State has ever asked.
- Whether the State has excused any of the three plans from its access standards for prosthodontics, what the contract calls an alternate access standard, we cannot tell. The exceptions the State does publish are listed by ZIP code, never by kind of specialist. What it has published is in the rulebook section.
- The fines we have found are in our library. Whether fines that size change anything, judge for yourself.
Don't hold your breath. Hold the line.
The answers will come. Keep the trail. Stay the course. Be patient with everyone except the deadline.
Before you act on anything here, talk to a professional advisor, the Health Consumer Alliance, or the State departments. This is what we think and how we would fight. It is not legal advice.
Envelope six, awarded
Periodontics
Before the envelope, a lesson with pictures: what a periodontist is, what one actually does to a mouth, why the State says every plan must have them, and how to read a directory that lists the same name fifteen times. Then the show. Click, tap, swipe or use the arrow keys, with the sound on or off.
And the award goes to
The podium
Three plans serve Medi-Cal dental managed care members in Sacramento County. Between them, their directories list two periodontists. Not two each. Two. Please hold your applause until all the offices have been read.
Silver, shared
Health Net
1 periodontist
Gold
Liberty Dental Plan
2 periodontists
With a commanding lead of one periodontist.
Silver, shared
California Dental Network (DentaQuest)
1 periodontist
A tie, with a twist
Health Net and California Dental Network (DentaQuest) share silver with one periodontist each. It is the same periodontist. Liberty lists that one too, plus one more that neither of the other plans lists in its Sacramento area search. Bronze was not awarded. There were only three plans.
How we ranked: the number of different periodontists each plan's directory lists at an office inside Sacramento County, where their Sacramento members live. Offices in other counties are counted separately below and do not change the order. This ranks periodontists listed, which is not the same thing as periodontists you can book.
The league table
Three plans, by the numbers
What each plan's own directory listed on 14 September 2026, and what that works out to per member.
2
periodontists listed in the county
Liberty Dental Plan
- Sacramento County members
- 290,306
- Members per periodontist
- 145,153
- Offices in the county listing one
- 7
- Offices outside the county
- 6
1
periodontist listed in the county
Health Net
- Sacramento County members
- 192,121
- Members per periodontist
- 192,121
- Offices in the county listing one
- 7
- Offices outside the county
- 8
1
periodontist listed in the county
California Dental Network (DentaQuest)
- Sacramento County members
- 69,495
- Members per periodontist
- 69,495
- Offices in the county listing one
- 7
- Offices outside the county
- 8
The arithmetic
551,922 Sacramento County members across the three plans, by the State's count for August 2026. Two periodontists listed, as of 14 September 2026. That is one periodontist for every 275,961 members. Plan by plan: Liberty, one for every 145,153. Health Net, one for all 192,121. California Dental Network (DentaQuest), one for all 69,495. The State's own standard for dentists of every kind, general and specialist together, is one for every 1,200 members.
Members: the three rows in the State's Medi-Cal Managed Care Enrollment Report, already filtered to County: Sacramento, Plan Type: Dental, Enrollment Month: 2026-08. The report names the plans Liberty Dental Plan of CA/Sacramento, Health Net Community Solutions/Sacramento, one of Health Net's licensed companies, and California Dental Network/Sacramento. If that link ever stops working, open the report on the State's open data portal, choose Data Table, and set the same three filters. Periodontists and offices: each plan's own directory search on 14 September 2026, settings in the recount, office by office in the map.
On the record
Every periodontics count we have taken
We look again at random, and whenever a reader reports a change. Each check gets a dated row. Old rows stay.
| Checked | Health Net | California Dental Network (DentaQuest) | Liberty Dental Plan | Result | What changed |
|---|---|---|---|---|---|
| 1 | 1 | 2 | Gold: Liberty | First count. Silver shared by Health Net and California Dental Network (DentaQuest), the same periodontist. |
Next check: unannounced. Seen a periodontist appear, or vanish? Tell us.
Named because the plans name them
The two periodontists, as the directories list them
Where this comes from. Every name, office and detail on this page comes from the plans' own public provider directories, which state law and federal Medicaid rules require them to publish (HSC 1367.27; 42 CFR 438.10(h)). The awards go to the plans, because the plans publish these directories and answer for what is in them. We are not suggesting either dentist has done anything wrong. If you are one of these dentists and a listing is wrong, tell us and we will report it to the plan's directory team.
Periodontics
Dr Stephan Kohnen, DMD
Listed as a periodontist by all three plans, 39 times in the Sacramento area:
- Health Net, at 15 offices
- California Dental Network (DentaQuest), at 15 offices
- Liberty Dental Plan, at 9 offices
Periodontics
Dr Ramandeep Gill
Listed as a periodontist by one plan, 13 times:
- Liberty Dental Plan, at 13 offices
Not listed by Health Net or California Dental Network (DentaQuest) in their Sacramento area periodontics searches.
Why a Sacramento plan lists offices in other counties
Medi-Cal dental managed care runs in only two of California's 58 counties, Sacramento and Los Angeles. In 55 more, including Placer, El Dorado, San Joaquin, Solano and San Bernardino counties, Medi-Cal dental works through fee-for-service, so nobody who lives in those counties is a member of these plans. The one county left over is San Mateo, which builds dental into its medical plan instead. The directories list offices there anyway.
What the State actually measures is distance from the member's home: a dentist within 10 miles or 30 minutes of where the member lives. That standard counts general dentists and specialists together, so it says nothing about how far a member may have to travel to reach a periodontist. By the directories' own mileage, Stockton and Fairfield are about 40 miles from Sacramento.
Where the directories place them
Fifteen offices. Seven inside Sacramento County, eight outside it. Numbers match the table below.
| Pin | Office | County | HN | CDN | LDP |
|---|---|---|---|---|---|
| 1 | 3433 Arden Way, Sacramento Sacramento County | Sacramento | K | K | GK |
| 2 | 4010 Truxel Rd, Sacramento Sacramento County | Sacramento | K | K | GK |
| 3 | 7227 29th St, Sacramento Sacramento County | Sacramento | K | K | GK |
| 4 | 6406 Sunrise Blvd, Citrus Heights Sacramento County | Sacramento | K | K | GK |
| 5 | 7803 Madison Ave, Citrus Heights Sacramento County | Sacramento | K | K | GK |
| 6 | 9184 E Stockton Blvd, Elk Grove Sacramento County | Sacramento | K | K | G |
| 7 | 2260 E Bidwell St, Folsom Sacramento County | Sacramento | K | K | GK |
| 8 | 3840 El Dorado Hills Blvd, El Dorado Hills El Dorado County | El Dorado | K | K | GK |
| 9 | 4363 Golden Center Dr, Placerville El Dorado County | El Dorado | K | K | GK |
| 10 | 500 Auburn Folsom Rd, Auburn Placer County | Placer | K | K | G |
| 11 | 4060 Douglas Blvd, Granite Bay Placer County | Placer | K | K | G |
| 12 | 731 Sterling Pkwy, Lincoln Placer County | Placer | K | K | G |
| 13 | 2241 Sunset Blvd, Rocklin Placer County | Placer | K | K | · |
| 14 | 5756 Pacific Ave, Stockton San Joaquin County | San Joaquin | K | K | GK |
| 15 | 1955 W Texas St, Fairfield Solano County | Solano | K | K | · |
Dr Kohnen Dr Gill Not listed. HN is Health Net, CDN is California Dental Network (DentaQuest), LDP is Liberty Dental Plan.
Street addresses as the directories print them, without suite numbers. DentaQuest's search covered 50 miles from ZIP 95819 and Liberty's covered 45 miles from Sacramento. Health Net's directory was searched for periodontics near Sacramento, CA, then for Dr Kohnen by name in El Dorado, Placer, San Joaquin and Solano counties. The Rialto office is left out of this table because it is nowhere near Sacramento.
The fine print on the trophy
What the winners have to do to keep it
Rule 1
Contract with periodontists
Periodontics is on the State's list of provider types every Medi-Cal dental managed care plan must contract with, alongside six others.
DHCS DMC Methodology Overview, 29 August 2025; DHCS 2021 network adequacy certification; DHCS 2025 Network Adequacy and Access Assurances Report.
Rule 2
Have enough dentists, close enough
One dentist for every 1,200 members, and a dentist within 10 miles or 30 minutes of each member's home. Both standards count general dentists and specialists together, so neither says how many periodontists a plan needs.
DHCS DMC Methodology Overview, Tables 1 and 2; Welfare and Institutions Code 14197.
Rule 3
Offer appointments on time
Urgent dental appointments within 72 hours, other appointments within 36 business days, and preventive care within 40 business days. The plan must have “sufficient numbers of network providers” to keep meeting those standards.
California Code of Regulations, title 28, section 1300.67.2.2(c)(6) and (c)(7).
Rule 4
Keep the directory honest
Publish a directory that shows which providers accept new patients, update the online version at least weekly when told something has changed, and give the public a way to report listings that look wrong. Federal rules add each provider's languages and whether the provider will take new members.
Rule 5
Pick up for the secret shopper
DHCS says it surveys every dental managed care plan at least quarterly, contacting plan offices to ask about provider availability and how long it takes to get an appointment.
DHCS DMC Methodology Overview, Secret Shopper Surveys.
The rulebook
Network adequacy, in plain words
One idea judges every award: a plan paid to cover you must have enough dentists, of the right kinds, close enough, soon enough. The legal name is network adequacy. Seven parts below, each one opens. The standards table stays open.
Tap a part to open it. Links from other pages open the right part for you.
What the words mean
A plan's network is the list of dentists it has signed contracts with. As a member you use those dentists, unless the plan sends you somewhere else. The network is adequate when it can really serve everyone enrolled in it.
Federal Medicaid rules make every state that uses managed care write standards for this and enforce them. Each plan has to show the State that its network is “sufficient in number, mix, and geographic distribution to meet the needs of the anticipated number of enrollees in the service area.” The State reviews what the plans send, then gives the federal Centers for Medicare and Medicaid Services “an assurance of compliance” for each plan, once a year.
The federal rule lists the kinds of provider a state must set standards for. Pediatric dental is on it by name. For specialists, it leaves the choice to the state: “Specialist (as designated by the State), adult, and pediatric.” So which dental specialists count in California is up to the Department of Health Care Services. Here is what it chose.
Code of Federal Regulations, title 42, section 438.68(a) and (b) and section 438.207(b)(2) and (d).
The seven kinds of dentist on the State's list
DHCS writes it plainly in its network methodology: “DMC plans must contract with the following provider types or facilities based on contractual, State, or federal requirements”. Seven follow. In plain words:
| The State's term | What that dentist does |
|---|---|
| Primary care dentists | Your main dentist, for checkups, cleanings, fillings and referrals. Every member is assigned one, and the State counts general dentists as primary care dentists. |
| Endodontics | The inside of the tooth and the tissue around its roots. Root canals. |
| Oral and maxillofacial surgery | Surgery of the mouth, jaws and face, such as difficult extractions and jaw injuries. |
| Orthodontics | Teeth and bites that do not line up. Braces. |
| Pedodontics | An older name for pediatric dentistry: care for babies, children and teenagers, including children with special health care needs. |
| Periodontics | The gums and the bone that hold teeth in place. |
| Prosthodontics | Replacing missing or damaged teeth, from one tooth to all of them: crowns, bridges and dentures. |
The list: DHCS DMC Methodology Overview, 29 August 2025, section B. The descriptions are our plain summary of the American Dental Association's specialty definitions; the association recognizes twelve dental specialties, and the State's list uses six of them. Primary care dentists: DHCS's June 2019 network adequacy certification, which says members are assigned one on joining and that “General Dentists are considered PCDs.”
| Document | Names the specialties? | What it says |
|---|---|---|
| DHCS Methodology Overview, 29 August 2025 | Yes, all seven | Plans “must contract with” them. No number is set for any of them. |
| DHCS network adequacy certifications to the federal government, 2018, 2019, 2020 and 2021 | Yes, the six specialties | A footnote under each plan's specialist count, word for word the same for every plan in every year: “Specialist network is comprised of: endodontists, oral surgeons, orthodontists, pedodontists, periodontists, and prosthodontists.” The summary text of the 2021 edition lists only five, leaving out periodontists. |
| DHCS Network Adequacy and Access Assurances Reports to the federal government, 2022, 2023, 2024 and 2025 | Yes, all seven | Listed beside the State's standards for dentists per member and for appointment times, and from 2024 beside the distance standard too. No counts. |
| Published contract template, 2025 | No | Requires “adult and pediatric Specialists” and sets its minimum by pointing to a state law list of sixteen medical specialties. The details are in the Periodontics awards. |
| Dental All Plan Letters, 2013 to 2023 | No | Of the 125 letters from those years that we read, none lists which specialists a network must include. |
| Welfare and Institutions Code 14197 | No | Gives dental plans their own distance standard and appointment deadlines. Its list of specialists is medical. |
Who must be there, in the State's own words
DHCS, Medi-Cal Dental Managed Care Methodology Overview, 29 August 2025
“DMC plans must contract with the following provider types or facilities based on contractual, State, or federal requirements”
The list that follows in the methodology: primary care dentists, endodontics, oral and maxillofacial surgery, orthodontics, pedodontics, periodontics and prosthodontics. DHCS said the same to the federal government in its network adequacy certifications from 2018 to 2021, including the 2021 one, where each plan's specialist network “is comprised of: endodontists, oral surgeons, orthodontists, pedodontists, periodontists, and prosthodontists.” Its reports since 2022 list the same types. So the nominations were easy. On 14 September 2026 we searched each Sacramento plan's own provider directory for periodontists, and wrote down exactly what it said.
What the State told Washington the networks held
In September 2021 DHCS certified to the federal government that its Sacramento plans held 24, 58 and 59 specialists. That is the count under the definition above, the one that includes periodontists and prosthodontists.
Access Dental Plan 24, Health Net 58, Liberty 59, each in a table headed “Contracted Specialists” with the six specialties named in the footnote beneath it. DHCS gives its own source for the figures as the plans' Provider Network Reports of May 2021. It is the last published document we can find that puts a number on any plan's specialist network. The June 2019 certification had put the same three plans at 95, 72 and 72. The reports DHCS has sent Washington for 2022 through 2025 answer yes or no for each plan without counting anybody. The full record is in the rulebook section.
The published contract requires specialists. It never says which ones.
The methodology says these provider types are “outlined in their DMC contract agreement.” The signed contract for each plan is not public. What DHCS publishes is the boilerplate, the template every plan signs, and a signed contract can add to a template, so everything below is about the template and nothing below is a claim about what any plan’s signed copy says. We read the template, all 323 pages. It does require specialists, in Exhibit A8: “Contractor shall maintain an adequate Network that includes adult and pediatric Specialists, and at a minimum, core Specialists as described in Welfare and Institutions Code, Section 14197(h)(2)”. It makes plans “Submit a complete list of specialists by type within Contractor's network.” But it never says which types, and the one place it sets a floor is that cross-reference.
Follow the cross-reference and you leave dentistry altogether. Section 14197 defines a specialist as cardiology, nephrology, dermatology, neurology, endocrinology, ophthalmology, ear nose and throat, orthopedic surgery, gastroenterology, physical medicine and rehabilitation, general surgery, psychiatry, hematology, oncology, pulmonology, and infectious diseases. Sixteen medical specialties. Not one of them is a dental specialty, and the word dentist does not appear anywhere in the section.
The statute is the general network adequacy law for all Medi-Cal managed care, and it was written with dental plans in mind: it sets a dental time and distance standard of ten miles or thirty minutes, and it gives dental plans their own appointment deadlines. The specialist list is the part that was never adapted. So a Sacramento plan is told to contract with periodontists and prosthodontists in a methodology document, while the published template of its contract sets the minimum specialist network by pointing at a list of physicians. Whether any plan’s signed contract adds a dental list, nobody outside DHCS and the plans can see. One detail leans toward a single State definition rather than three negotiated ones: the six-specialty footnote is word for word identical under all three plans, in every certification from 2018 to 2021.
None of this means plans may skip specialists. The same template gives adults a specialist appointment within 30 business days of an authorized referral, and state law gives children one within 30 calendar days. It orders plans to provide “a record/tracking mechanism for each authorized, denied, or modified referral”, to “offer second opinions by specialists to any Member upon request”, and to file a Specialty Referral Report twice a year showing “how many referrals were made per month to specialists with the detail for each referral, timeliness of receipt and review, and the result of each referral”. The referral clocks, the tracking and the reports all assume the specialists are there. The gap is narrower and stranger than a missing requirement: nothing public tells a plan which kinds of dental specialist it must have, except the methodology and the State's own reports to Washington.
DHCS, Dental Managed Care Network Adequacy Certification, prepared for the Centers for Medicare and Medicaid Services, September 2021, Attachments A, B and C, Figure 4 in each. DMC boilerplate contract, 2025, Exhibit A8, Section 5 and its deliverables list, item 5; Exhibit A11, Section 2.5, specialty services and the Specialty Referral Report, and the specialist appointment standard in the same exhibit. Welfare and Institutions Code section 14197: the specialist definition, the dental time and distance standard and the dental appointment deadlines. The definition sat at subdivision (h)(2) when the section was enacted in 2017, which is the subdivision the contract still cites; later amendments moved it to (i)(2) without changing the list.
The four tests
DHCS says its yearly review checks four things: “Provider to Member Ratios”, “Mandatory Provider Types”, “Time or Distance” and “Timely Access”. Here is what each one asks of a plan.
Test 1
Enough dentists
One full-time primary care dentist for every 2,000 members, and one full-time dentist of any kind, general or specialist, for every 1,200. Each dentist counts once, however many offices list them. In DHCS's words, “each unique provider is only factored in once in the ratio”.
Contract template, 2025, Exhibit A8, section 3; Methodology Overview, Table 2; 2019 certification, footnote 1.
Test 2
The right kinds
A contract with each of the seven types above. No number is attached to any of them, and DHCS told the federal government so itself, in each certification from 2019 to 2021: “While there are no established ratios for dental specialties delineated in either federal or state laws, DHCS evaluated the specialist network for each DMC plan.”
2019, 2020 and 2021 certifications, Specialist Network and Out-of-Network Access; 2024 network certification summary.
Test 3
Close enough
A dentist within 10 miles or 30 minutes of the member's home. DHCS maps members and offices once a year, ZIP code by ZIP code. A plan that cannot meet it somewhere, after trying every reasonable way to sign dentists closer, can ask DHCS for an exception, called an alternative access standard. An approved exception lasts three contract years.
Welfare and Institutions Code 14197; Methodology Overview, Alternative Access Standard Requests; 2025 report, analysis methods.
Test 4
Soon enough
Routine and preventive appointments within 4 weeks. Emergencies within 24 hours. A specialist within 30 business days of an authorized referral for adults, and 30 calendar days for children. DHCS checks with secret shopper calls, but for 2024 it wrote that it is “not including the results” in its federal report. The Department of Managed Health Care, which licenses the plans, runs its own clocks; see the fine print on the trophy.
2025 report, standards 3 to 6; 2021 certification, Figure 3; 2024 network certification summary, Timely Access.
Straight from the 2025 report
Eight standards, and who they cover
DHCS's 2025 report to the federal government lists each dental standard with the provider types it covers. The six specialties sit beside primary care dentists on most lines, prosthodontists and periodontists included.
| The standard | Primary care dentists | The six specialties | How DHCS checks it |
|---|---|---|---|
| 30 minutes from a member's home | Yes | Yes | Mapping |
| 10 miles from a member's home | Yes | Yes | Mapping |
| Seen within 4 weeks | Yes | No | Secret shopper calls |
| Seen within 30 business days, adults | No | Yes | Secret shopper calls |
| Seen within 30 calendar days, children | No | Yes | Secret shopper calls |
| Seen within 24 hours, emergency | Yes | Yes | Secret shopper calls |
| One full-time primary care dentist for every 2,000 members | Yes | No | Directory review |
| One full-time dentist of any kind for every 1,200 members | Yes | Yes | Directory review |
DHCS, 2025 Network Adequacy and Access Assurances Report, tab II, Program-level standards: the rows Specialty details, Standard type, Standard description and Analysis method. Every row that covers the specialties names them: “Endodontists, Oral and Maxillofacial Surgeons, Orthodontists, Pedodontists, Periodontists, and Prosthodontists”. The 2024 report lists the same, numbered differently. Neither report counts anyone.
What the State has reported about Sacramento
Until 2021, DHCS sent Washington a written certification each year with numbers in it, including a count of each plan's specialists. From the 2022 contract year it switched to a federal form, the Network Adequacy and Access Assurances Report. None of the reports DHCS has sent Washington since has counted anybody, and no published report since has counted specialists.
| Certification | Access Dental Plan | Health Net | Liberty Dental Plan |
|---|---|---|---|
| June 2018, from plan reports of March 2018 | 55 for 136,500 members | 67 for 129,289 members | 67 for 162,191 members |
| June 2019, from February 2019 | 95 for 129,048 members | 72 for 126,887 members | 72 for 163,269 members |
| August 2020, from March 2020 | 30 for 122,066 members | 50 for 127,369 members | 50 for 162,842 members |
| September 2021, from May 2021 | 24 for 140,215 members | 58 for 152,656 members | 59 for 183,148 members |
| 2022 to 2025 | Not reported | Not reported | Not reported |
Each count covers all six specialties together, with each dentist counted once. Member numbers are the ones printed beside each plan's dentist ratio in the same report. California Dental Network (DentaQuest) joined in July 2025, after the counting stopped. The outside review described below prints each plan's total dentists for 2023, with no specialist count, and its totals are five to eight times the 2021 ones: Liberty, for example, 1,385 dentists for 215,479 Sacramento members, against 243 in 2021. Figure 4 of each plan's attachment in the 2018, 2019, 2020 and 2021 certifications; members from Figure 1.
The certifications record more than counts.
- In April 2018 DHCS put Health Net and Liberty on corrective action plans for “failure to substantiate timely access to specialist appointments”. It closed both on 17 September 2018.
- In 2019 its test calls found the plans' reported networks had providers “listed at locations they were not practicing at”, and on 8 May 2019 it put every dental plan on a corrective action plan to fix those lists. It found the errors did not change the dentist ratios, because each dentist is counted once.
2018 certification; closure letters to Health Net and Liberty, 17 September 2018; 2019 certification, Network Capacity.
| Year covered | DHCS's answer | Exceptions it listed for Sacramento |
|---|---|---|
| 2022 | Health Net and Liberty in Sacramento: “Yes, the plan complies based on all analyses”. Access Dental Plan in Sacramento: “No, the plan does not comply based on all analyses”, because of “members in two zip codes in Sacramento County which must travel more than 10 miles or 30 minutes”. | Health Net and Liberty, each approved in July 2021. Access Dental Plan: “None”, and DHCS asked it on 2 June 2023 for a revised request. |
| 2023 | Access Dental Plan, Health Net and Liberty in Sacramento: “Yes, the plan complies based on all analyses”. | “None”, for each of the three. |
| 2024 | Access Dental Plan, Health Net and Liberty, now one answer per plan for both counties: “Yes, the plan complies based on all analyses”. | None listed. DHCS's own summary for the year says it approved one for Liberty in two ZIP codes, Rio Vista (94571) and Isleton (95641), and gives Liberty's reasons as “providers not accepting new payors, providers not wanting to participate in Medi-Cal, or the plan rates being too low.” |
| 2025 | Access Dental Plan, discontinued on 1 July 2025, and California Dental Network (DentaQuest), Health Net and Liberty: “Yes, the plan complies based on all analyses”. | None listed. |
DHCS Network Adequacy and Access Assurances Reports: 2022 (the combined workbook, dental tab), 2023, submitted 28 June 2024, 2024, submitted 1 October 2025, and 2025, submitted 30 June 2026. 2024 Dental Managed Care Annual Network Certification Executive Summary, 29 August 2025. All are linked from the DHCS Network Adequacy page. The reports are spreadsheets; the answers are in the plan compliance tabs.
4
Plans DHCS told Washington complied with every standard in 2025
0
Numbers in the 2025 report behind those answers. The boxes for dentist counts, travel times and ratios were optional, and every one is blank.
7
Kinds of dentist the 2025 report lists beside its standards, prosthodontists included
When someone outside DHCS checked
When someone outside DHCS checked
For calendar year 2023, the State's external quality reviewer, Health Services Advisory Group, checked the dental plans' network numbers and published its findings in April 2025. It ran the distance test twice, once for general practices and once for specialty practices, ZIP code by ZIP code. It found that “at the county level, Dental MC plans did not meet the required time or distance standards”.
In Sacramento, every plan fell short for specialists in some of the small towns in the south of the county: Isleton, Walnut Grove, Courtland, Herald and Wilton among them. Exceptions DHCS had approved covered most of those gaps. Not all: in Courtland (95615), neither Health Net, for its child members, nor Liberty met the distance standard or the requirements for an exception. The reviewer adds that it “did not audit DHCS’ AAS methodology or results.”
For the same year, DHCS told Washington that each Sacramento plan complied “based on all analyses”. In the line for exceptions, which the form says to fill in with “None” if there are none, it wrote “None.”
DHCS, Medi-Cal Dental Managed Care External Quality Review Technical Report, Contract Year 2023 to 24, Volume 2, Validation of Network Adequacy, prepared by Health Services Advisory Group, April 2025: Tables 11, 15 and 19 for Sacramento by ZIP code, Table 21 and page 44 for the county results. 2023 Network Adequacy and Access Assurances Report, dental tab, items II.C.2.a and II.C.2.f.
What we still do not know
- How many specialists of each kind any Sacramento plan has had since May 2021. The counts DHCS used to print came from the plans' own Provider Network Reports, which the published contract template requires every month. We have not found them published. They can be requested under the California Public Records Act.
- Why the dentist totals in the 2023 outside review are five to eight times the ones DHCS certified for 2021, and whether they count dentists outside Sacramento County. Neither document explains it.
- Whether DHCS ever measures the distance to one kind of specialist, a prosthodontist for example, rather than to specialists as a group. For medical plans, the State's 2025 list of approved exceptions names one specialty on every row, such as cardiology, nephrology or psychiatry. It has no dental rows.
- What the secret shopper calls found. DHCS says it makes them and that the plans complied. It has not published the results.
- Why the 2023 and 2024 reports to Washington list no exceptions for the Sacramento plans, when the reviewer's 2023 tables and DHCS's own 2024 summary both show exceptions approved.
When the network comes up short, the plan still owes you the care. If no dentist in the network can provide a covered service, the rules say the plan must cover it outside the network, on time, at no extra cost to you. How that works, and how to push for it, is in the next section.
Recount the votes
Run the search yourself
Directories change, sometimes weekly. Here is exactly what we searched on 14 September 2026, so you can check whether the winners have been busy recruiting.
- SearchEach plan's own directory, with the settings below.
- VerifyEvery name against the federal provider registry.
- RecordA dated row on the record. Old rows never leave.
We check again at random, and whenever someone reports a change. Each open envelope keeps its own record: prosthodontics and periodontics. The prosthodontics search settings are in the scoreboard.
| Plan | Where to search | Settings we used |
|---|---|---|
| Health Net | Health Net Medi-Cal dental | Medi-Cal adult directory, dentists by specialty, periodontics, near Sacramento, CA. Then Dr Kohnen by name in El Dorado, Placer, San Joaquin and Solano counties. |
| California Dental Network (DentaQuest) | DentaQuest Find a Dentist | Medi-Cal DMC adult, periodontics, within 50 miles of ZIP 95819 |
| Liberty Dental Plan | Liberty Medi-Cal dentist search | Medi-Cal GMC/PHP network, periodontist, within 45 miles of Sacramento |
Got a different result? Or called one of these offices and could not get in to see a periodontist? Tell us. For how provider directories go wrong more generally, NoSuchProvider.org tracks ghost networks.
Show your work
Sources
Everything stated as fact on this page traces to one of these. If you find an error, tell us and we will correct it.
- Health Net, California Dental Network (DentaQuest) and Liberty Dental Plan, Medi-Cal provider directories for the Sacramento area, prosthodontics, searched 14 September 2026. Search settings are listed in the scoreboard.
- California Dental Network (DentaQuest), downloadable provider directory files, which it calls machine-readable directories. California Medi-Cal DMC adult file, every row dated 1 July 2026, counted by ZIP code and primary specialty.
- Centers for Medicare and Medicaid Services, NPI Registry, the National Plan and Provider Enumeration System. Used to check the specialty declared by dentists the directories list as prosthodontists.
- American Dental Association, National Commission on Recognition of Dental Specialties and Certifying Boards, Recognized Certifying Boards. Definitions of board certified, board eligible and educationally qualified; the American Board of Prosthodontics as the certifying board for prosthodontics.
- American Board of Prosthodontics, Importance of Board Certification and Examination Guidelines. Sections A to D of the certifying examination; Diplomates.
- American College of Prosthodontists, position statement on what a prosthodontist is, and Why see a prosthodontist. Three years of residency after dental school, one more for maxillofacial prosthetics, and what prosthodontists treat.
- ADA News, Five things to know about the American College of Prosthodontists, January 2025.
- California Business and Professions Code 1625. The practice of dentistry includes constructing, altering, repairing or selling a bridge, crown, denture or other prosthetic appliance.
- Smile, California, covered services for adults. Partial and full dentures, denture relines and crowns as Medi-Cal dental benefits.
- DHCS, Dental Managed Care boilerplate contract, 2025. Exhibit A8, sections 5 (specialists) and 9 (out-of-network coverage when the network cannot provide a service); Exhibit A11, sections 1 (out-of-network case agreements under an alternate access standard), 3.2 (specialist appointments within 30 business days), 3.4 (provider shortage) and 10 (out-of-network providers).
- Code of Federal Regulations, title 42, section 438.206(b)(4) and (5). Out-of-network coverage when a Medicaid managed care network cannot provide a covered service, at no greater cost to the member.
- Health Net, California Dental Network (DentaQuest) and Liberty Dental Plan, Medi-Cal provider directories for the Sacramento area, periodontics, searched 14 September 2026. Search settings are listed in the Periodontics awards.
- California Department of Health Care Services, Medi-Cal Dental Managed Care (DMC) Methodology Overview, 29 August 2025. Required provider types, ratio and distance standards, secret shopper surveys, directory language reporting.
- California Department of Health Care Services, Dental Managed Care Network Adequacy Certification, September 2021. Definition of each plan's specialist network.
- California Department of Health Care Services, Dental Managed Care Network Adequacy Certifications of June 2018, June 2019 and August 2020. Specialist and dentist counts for each Sacramento plan, the six-specialty footnote, the statement that no ratio exists for dental specialties, and the 2018 and 2019 corrective action plans.
- California Department of Health Care Services, corrective action plan closure letters (timely access) to Health Net and Liberty Dental Plan, 17 September 2018.
- California Department of Health Care Services, Network Adequacy and Access Assurances Reports for dental managed care, 2022, 2023, 2024 and 2025, spreadsheets on the federal form. Standards and the provider types listed against them, analysis methods, each plan's compliance answer, and the exceptions listed. In the 2025 report, tab II, the row Specialty details lists “Primary Care Dentist, Endodontists, Oral and Maxillofacial Surgeons, Orthodontists, Pedodontists, Periodontists, and Prosthodontists” beside the travel, emergency and dentist ratio standards, and the six specialties beside the two specialist appointment standards; the 2024 report does the same.
- California Department of Health Care Services, 2024 Dental Managed Care Annual Network Certification Executive Summary, 29 August 2025. The four standards reviewed, the pass result, approved alternative access standards by ZIP code, and secret shopper results left out of the federal report.
- California Department of Health Care Services, 2025 Annual Network Certification Alternative Access Standards Requests. Approved exceptions for medical plans, one specialty per row; no dental plans appear.
- California Department of Health Care Services, Network Adequacy page, where every report above is listed.
- California Department of Health Care Services, Medi-Cal Dental Managed Care External Quality Review Technical Report, Contract Year 2023 to 24, Volume 2, Validation of Network Adequacy, prepared by Health Services Advisory Group, April 2025. Dentist totals, time or distance results by ZIP code for general and specialty practices, and the county results for calendar year 2023.
- Code of Federal Regulations, title 42, section 438.68 and section 438.207. Network adequacy standards, specialists as designated by the State, plan documentation and the State's yearly assurance to the federal government.
- California Welfare and Institutions Code 14197. The dental time and distance standard, dental appointment deadlines, alternative access standards and the medical specialist list.
- California Department of Health Care Services, Medi-Cal Dental Managed Care. The two counties where dental managed care operates, mandatory enrollment in Sacramento County and opt-in enrollment in Los Angeles County.
- American Dental Association, National Commission on Recognition of Dental Specialties and Certifying Boards, Recognized Dental Specialties. The twelve recognized specialties and their definitions, including periodontics and prosthodontics.
- California Health and Safety Code 1367.27. Provider directory publication, weekly updates and inaccuracy reporting.
- California Code of Regulations, title 28, section 1300.67.2.2. Timely access standards for dental plans.
- Code of Federal Regulations, title 42, section 438.10(h). Medicaid managed care provider directory contents.
- California Dental Network (DentaQuest), Sacramento County Community Advisory Committee minutes, 12 March 2026. Sacramento County member base, dental visit and preventive care rates.
- California Health and Human Services Open Data Portal, Medi-Cal Managed Care Enrollment Report, August 2026 count. Enrollment by dental plan in Sacramento County, filtered to the three rows used on this page.
- Centers for Disease Control and Prevention, About Periodontal (Gum) Disease, reviewed 15 May 2024. Prevalence of periodontitis, risk groups, tooth loss, referral to a periodontist.
- Eke PI and others, Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009 to 2014, Journal of the American Dental Association, 2018. 42% of adults 30 or older with periodontitis, 7.8% severe, 60% among adults below the poverty level.
- American Academy of Periodontology, What is a Periodontist? Training and referral from general dentists.
Questions members ask
Who is actually in the chair?
Real questions about getting to a specialist on a Medi-Cal dental plan, answered plainly. Where a rule applies, we link to the page on this site that quotes it.
How do I get to see a specialist on a Medi-Cal dental managed care plan?
Through a referral. Your primary care dentist, the one the plan assigned you, refers you. The plan authorizes it. Then the plan has to get you the appointment: for an adult, within 30 business days of the authorized referral; for a child, within 30 calendar days.
The decision on the referral runs on its own clock: 5 business days for a routine request, 72 hours for an urgent one, and a letter to you within 2 business days of the decision. A missed deadline counts as a denial you can appeal. The clocks, with the rules behind them.
The directory says my plan has a periodontist. Does that mean a periodontist will treat me?
Not by itself. A directory listing says the plan has signed up that dentist at that office. It does not say who will be in the room on the day of your appointment.
In Sacramento, the three plans' directories list two periodontists between them, at fifteen offices, and the same two names appear at address after address. See the map. Treat a listing as a lead, not a promise, and get the name of the person you are booked with.
I called the office, they said the specialist works there, and I booked. Can I still end up with a general dentist?
Yes. It happens. A specialist may visit an office only some days a month. A front desk may book you with whoever is in that day. A general dentist may do the work while the specialist “oversees” it from somewhere else, or not at all.
A general dentist is allowed to do many of the same procedures, dentures included, so nothing in the office stops it. What stops it is you: a referral and an authorization that say specialist, and a name on paper that you check against the person who walks in.
What should I get in writing before the appointment?
Three things: the specialist's name, the specialist's NPI number, and the office where you will be seen. Ask the plan for its authorization letter with the specialist named on it, or ask the clinic to confirm it by email, text, portal message or on the appointment card.
One sentence does the job: “Please confirm in writing the name and NPI of the specialist I am scheduled to be treated by on that date.” If nobody will put a name on paper, that tells you something. Keep the confirmation with your referral.
What is an NPI, and how do I check one?
An NPI is the ten digit National Provider Identifier that every dentist who bills a health plan has. The federal NPI Registry is free and public: type the name, and it shows the dentist's listed practice location and the specialty the dentist declared, called a taxonomy, such as Periodontics, Prosthodontics or General Practice.
It is what the dentist told the government, not a license check, but it is the quickest way to see whether the person named is a specialist at all. It is how this page checked the prosthodontist listings.
How do I know the person treating me is the specialist on my paper?
Ask, before anything starts. “Are you Dr Smith?” and “Are you the periodontist?” are normal questions, and a real specialist will not mind them; they spent three extra years earning the title. Read the badge, or the name on the door. If the answer is no, you can stop, say you were authorized to see a specialist, and reschedule.
Afterward, two records name the dentist who treated you: your treatment record, which the treating dentist signs, and the claim the office sends your plan, which carries the treating dentist's name and NPI. You have a right to both. How to ask, and how long they have.
I was treated by a general dentist after a specialist referral. What now?
Write down the date, the office, and the names of everyone who treated you or told you who would. Then, in this order:
- Ask for your treatment record for that day. The plan has 30 days.
- File a grievance with the plan, in writing, and send a copy to the plan's dental director, the one person California law makes answerable for dental decisions.
- If the plan does not fix it, take it to the State's regulator.
- Tell us. Patterns across members are what enforcement is built from.
The specialist care the plan authorized is still owed to you. Being seen by someone else does not use it up.
My plan says a general dentist can handle it instead. Is that allowed?
A plan can change or deny a request, but it has to do it in writing, with the reason, the rule it relied on and how to appeal, and a dentist has to stand behind the decision. “The general dentist can do it” is a decision, and you can appeal it. Who decides, and what has to be in writing.
If the real reason is that the plan has nobody of that specialty, see the next question. It cannot send you back to the general dentist because its network is short.
What if my plan has no specialist of the kind I need?
Then the plan must send you outside its network and pay for it, on time, at no extra cost to you. Its contract with the State says so, and so do federal Medicaid rules. The contract even spells out the mechanics: an agreement with an outside specialist at the Medi-Cal fee-for-service rate, within the same time and distance standards, or a ride to get there.
That is the moment things tend to get strange, so read the part where we get real before you make the call.
Can I just go to a specialist on my own and have Medi-Cal pay?
Not while you are in a managed care plan. Outside the plan's network, without an authorization, the plan will not pay. There are two doors: ask the plan for an out-of-network authorization, as above, or, in Sacramento County, ask the State for a Beneficiary Dental Exception if you cannot get the appointments you need. In Los Angeles County, joining a plan is optional in the first place. How the two counties differ.
Not legal, medical or dental advice. The rules above are quoted and linked on the pages this section points to. Before you act, talk to a professional advisor, the Health Consumer Alliance, or the State departments.
Tried to see a prosthodontist? Or a periodontist?
If you were referred to a specialist your plan could not provide, or a directory sent you to an office that could not see you, we want to hear about it.