# I Can't Smile, California, an independent watch on Medi-Cal dental > An independent watchdog on Medi-Cal dental managed care in Sacramento and Los Angeles counties: who runs the plans, their specialists, the rules and the fines. - Canonical page: https://icantsmilecalifornia.org/ - Site: [I Can't Smile, California](https://icantsmilecalifornia.org/), described for agents in [llms.txt](https://icantsmilecalifornia.org/llms.txt) - Published 2026-09-15, last updated 2026-10-18 - Notice: Independent watchdog, commentary and satire project on Medi-Cal dental managed care. Not the State of California, the Department of Health Care Services, Medi-Cal Dental or the Smile, California campaign, and not connected to any of them. Not a dental plan. Not legal, medical or dental advice. This markdown copy is generated from the page for software agents; the page itself is the version of record. A parody presentation ## Meet Bartle McShill He says he works for billionaires, and he would like you to know that he is the good guy. Two minutes, eleven slides, one corporate shield and a round of applause, with the words on screen as he says them. Not about any real person. About anyone who operates like this. [Watch the presentation](https://icantsmilecalifornia.org/bartle-mcshill.html) [Who is Bartle](https://icantsmilecalifornia.org/bartle-mcshill.html#who) [Open Corporate Shield, Bartle McShill's two minute parody presentation](https://icantsmilecalifornia.org/bartle-mcshill.html) Two minutes, out loud ## Two minutes on 2027 From 1 January 2027 your plan must show you your own prior authorization, on your phone, in the health app you choose. We turned that page of All Plan Letter 26-006 into a track you can read along with. Press play. [Play the track](https://icantsmilecalifornia.org/plan-letters.html#listen) [Read the plan letter](https://icantsmilecalifornia.org/plan-letters.html#what-is) [**Prior Authorization Tracking** Read along, 1:47](https://icantsmilecalifornia.org/plan-letters.html#listen) Medi-Cal Dental ## Fee for service The original Medi-Cal dental program, and still how most of California gets dental care. You pick any dentist who takes Medi-Cal Dental and you go. Dental managed care exists in only two of the 58 counties. A third, San Mateo, folds dental into the medical plan instead. If you are here for your own benefits rather than our commentary, the two links below leave this site and land on the State's own pages, which are the ones you want. [The State's site: dental.dhcs.ca.gov](https://dental.dhcs.ca.gov/) [The State's site: smilecalifornia.org](https://smilecalifornia.org) ### Where it applies | | | | --- | --- | | 55 counties | Fee for service only | | Los Angeles | Unless you opt in | | Sacramento | Only by exception | | Your dentist | Any that takes Medi-Cal | Dental managed care ## GMC and PHP In two counties the State can hand your dental benefit to a plan instead. Sacramento runs Geographic Managed Care, where joining is mandatory and almost every member is in a plan. Los Angeles runs a Prepaid Health Plan, where it is voluntary and roughly nine in ten members stay in fee-for-service. The covered benefits are the same either way. The network and the rules are not, and that is what this site is here to explain. [How managed care works](https://icantsmilecalifornia.org/dental-managed-care.html) [The rules by county](https://icantsmilecalifornia.org/dental-managed-care.html#counties) ### Two counties, two rules | | | | --- | --- | | Sacramento | GMC, mandatory | | Los Angeles | PHP, voluntary | | San Mateo | Dental inside the medical plan | | Covered benefits | Same as fee for service | About this site ## No budget, no sponsor We are not the State of California, not the Department of Health Care Services, not Medi-Cal Dental, and not the Smile, California campaign. Nobody sponsors us and nobody pays us. This site is built and run on free and low cost tools, so the information on it stays free for the people of California. Nothing here is legal or medical advice. [About this project](https://icantsmilecalifornia.org/about.html) [Things we are not](https://icantsmilecalifornia.org/about.html#notus) ### The short version | | | | --- | --- | | Part of the State | No | | Sponsored by | Nobody | | Costs you | Nothing | | Legal or medical advice | No | Not a government website **Looking for your actual dental benefits?** This is a commentary site and cannot help with your coverage. For official Medi-Cal Dental information, visit [smilecalifornia.org](https://smilecalifornia.org) or call the Telephone Service Center at 1-800-322-6384. ## Latest and Loudest New Parody Game ### [Phone Tag: you have reached Member Services](https://icantsmilecalifornia.org/phone-tag.html) Your screen turns into a phone, and every key does something. Bartle McShill puts you on hold and leaves you a voicemail about overcoming your sadness. Bonnie from Peasant Relations explains why she stamps someone else's name on every letter. Newest on key 8: Bartle opens the CAC Meeting, which in his world stands for Community Attack Clan, from an empty mansion in a velvet jacket and a crown. There is an excuse slot machine, a game where you try to stay on the line, and a few wrong numbers. Not about any real person. About anyone who operates like this. New Parody Game ### [Dental Managed Cartels, Incorporated: The Plan](https://icantsmilecalifornia.org/dental-managed-cartels.html) A comic book in nine short chapters, with a game at the front where you play the villain. An invented company tries to take every low-income smile in California, loses most of the state, and holds on to one county with both hands. Sound effects, toys to poke, and the real record in boxes along the way. Not about any real person. About anyone who operates like this. New Parody ### [We Can't Smile, California: a cartoon band plays the Capitol lawn](https://icantsmilecalifornia.org/assets/audio/we-cant-smile-california.mp3) Our first animated music video. The Root Canals set up in front of a cartoon Capitol, the crowd brings signs, a robot takes the last verse, and Bartle, Caroline and Esmeralda sneak around the speaker stack trying to stop the show. A minute and a half, with the words landing on the big screen as they are sung. Not about any real person. About anyone who operates like this. New Article ### [DSO vs. FQHC: How Dental Fraud Can Happen in Each](https://icantsmilecalifornia.org/dso-vs-fqhc.html) A dental chain is paid for each procedure. A community health center is paid for each visit. Each rule rewards a different shortcut, and both have been caught. How the two models work, how the money moves, and the cases prosecutors and courts have actually proven, with every case labeled by how far it got. New Parody ### [Charity Boy: a charity worker, a claims denier and a very quiet sister go to dinner](https://icantsmilecalifornia.org/charity-boy.html) Our second parody and our first cartoon. Frederick helps people for a living. Caroline denies dental claims for one. Todd's sister set up the dinner, then remembered her oven. Three and a half minutes, drawn and sung, with the words on screen as they are said. Not about any real person. About anyone who operates like this. New Article ### [The Employment Penalty of a Broken Smile](https://icantsmilecalifornia.org/employment-penalty-of-a-broken-smile.html) Missing teeth cost people jobs. The research says so, the State knows it, and Medi-Cal pays three plans a flat monthly fee, per member, to fix it. What the evidence shows, what California pays, and what happens between the payment and the chair, with the numbers drawn out. The first piece on the library's new articles shelf. Parody ### [Meet Bartle McShill: he says he works for billionaires, and he is here to help](https://icantsmilecalifornia.org/bartle-mcshill.html) Our parody character takes the lectern for two minutes. Eleven slides, a corporate shield, a round of applause, and the words on screen as he says them. Not about any real person. About anyone who operates like this, in any way. New ### [Your dental records, without an app: the 30 day rule and who has to answer](https://icantsmilecalifornia.org/your-dental-records.html) You do not need a health app to see what your plan holds about you. Federal law lets you ask in writing, and the plan has 30 days. Which law binds the plan, which binds your dentist and which binds the State, what each of the three plans tells its members, why the company running your plan cannot hold your file hostage, and where to go when nobody answers. New ### [All Plan Letter 26-006: your prior authorization, on your phone, from 2027](https://icantsmilecalifornia.org/plan-letters.html) The State has told all three dental managed care plans that from 1 January 2027 a member must be able to watch a prior authorization move, in an app of their choosing, within one business day. Approved or denied, which items, when it expires, the reason for a no, and the file your dentist sent in. With a short track to listen to while you read. Explainer ### [Utilization management: how a plan decides what it will pay for](https://icantsmilecalifornia.org/utilization-management.html) Every plan runs a process for reviewing what your dentist asks for. Who reviews it, what they are allowed to weigh, what has to be put in writing, and where the rules come from. Explainer ### [Prior authorization: how long your plan has to answer your dentist](https://icantsmilecalifornia.org/utilization-management.html#prior-authorization) The State's instructions to every Medi-Cal dental plan: 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. Miss the deadline and it counts as a denial. Explainer ### [Beneficiary Dental Exception: the formal way out of a plan](https://icantsmilecalifornia.org/beneficiary-dental-exception.html) In Sacramento County, joining a dental managed care plan is mandatory. A Beneficiary Dental Exception, or BDE, is the one legal route out, for members who cannot get an appointment. Who qualifies, the form, the deadlines, and what twelve months of the State's own reports show. ## Now showing [Phone: Phone Tag](https://icantsmilecalifornia.org/phone-tag.html) Your screen becomes a phone. Press any key and see what happens. (parody) [Comic and game: Dental Managed Cartels, Incorporated](https://icantsmilecalifornia.org/dental-managed-cartels.html) Play the villain, then read the comic (parody) [Music video: We Can't Smile, California](https://icantsmilecalifornia.org/assets/audio/we-cant-smile-california.mp3) A minute and a half, drawn and sung (parody) [Cartoon: Charity Boy](https://icantsmilecalifornia.org/charity-boy.html) Three and a half minutes, drawn and sung (parody) [Presentation: Bartle McShill](https://icantsmilecalifornia.org/bartle-mcshill.html) Two minutes, with slides (parody) Parody. Not about any real person. About anyone who operates like this. ## Find your way ### [Find a Director](https://icantsmilecalifornia.org/dental-directors.html) Who answers for your plan's decisions ### [For Dentists](https://icantsmilecalifornia.org/for-dentists.html) What the plan owes you and your patient ### [Your Dental Records](https://icantsmilecalifornia.org/your-dental-records.html) Ask in writing and the plan has 30 days ### [Dental Awards](https://icantsmilecalifornia.org/dental-awards.html) The plans that list the most specialists ### [Beneficiary Dental Exception](https://icantsmilecalifornia.org/beneficiary-dental-exception.html) The one way out of a plan in Sacramento ### [The Employment Penalty of a Broken Smile](https://icantsmilecalifornia.org/employment-penalty-of-a-broken-smile.html) New article. Follow the money to the chair. ### [Library](https://icantsmilecalifornia.org/library.html) Five shelves of articles, fines and documents What we track ## Four things we are watching Medi-Cal dental managed care in Sacramento County, where joining a plan is mandatory, and in Los Angeles County, where it is optional. ### Network adequacy Whether the dentists and specialists a plan lists are really there for its members, and whether a member can actually get an appointment. [See the awards](https://icantsmilecalifornia.org/dental-awards.html) ### Deadlines How fast a plan must answer your dentist, what it must tell you in writing, and what to do when it says no. [See the deadlines](https://icantsmilecalifornia.org/utilization-management.html#prior-authorization) ### Enforcement The fines California's regulator has issued against Liberty and California Dental Network (DentaQuest), what each was for, and the documents behind them. [Open the library](https://icantsmilecalifornia.org/library.html) ### Ownership Who owns the companies behind the three plans, and who runs each plan day to day. [See who runs your plan](https://icantsmilecalifornia.org/who-runs-your-plan.html) ## Got a story, a bill or a denial letter? Tell us what happened with your plan, your dentist or a Notice of Action. This site cannot help with your coverage. For that, call the Medi-Cal Dental member line on 1-800-322-6384. [Send a tip](https://icantsmilecalifornia.org/contact.html)