Legal Advocacy & Litigation
The ADA stands up for dentistry, defending sound science and fair dealings on behalf of patients and the profession. The Association frequently explores possible participation in lawsuits that may be of national significance to dentistry. The ADA has filed several class action lawsuits and racketeering charges against insurance companies that allegedly conspired to deny, reduce or delay lawful payments to contracted dentists.
We also support dentists and states facing legal challenges by way of friend of the court (amicus curiae) briefs. The following lawsuits are pending and may affect your rights as a dentist:
- In Met Life et al. v. Glenn, ADA’s amicus brief to the U.S. Supreme Court focused on the illegitimacy of the insurer’s position that an ERISA plan administrator’s dual function as evaluator of eligibility and payer of benefits only present a potential conflict of interest. ADA also advocated that a plan administrator should have minimal, if any, interference with the doctor’s assessment of the patient given the fiduciary-type nature of their relationship.
- In Sharpe v. Arizona Health Care Cost Containment System Administration, et al., ADA and the Arizona Dental Association argued to the state appellate court that the state’s legislature mandated coverage for dentures when it is determined by a patient’s doctors to be medically necessary and that a state agency cannot rely on an irrebuttable presumption that the inability to properly chew can never constitute a medical necessity and had no reasonable basis for overriding the conclusions of the patient’s doctors.
- In Rutt v. Anthem Health Plan and Connecticut State Dental Association v. Anthem Health Plan, ADA’s amicus brief to a federal appeals court took the position that ERISA does not preempt state law claims of dentists and other health care providers that arise from their contracts with managed care plans but rather that ERISA preemption applies only against plan participants and beneficiary.
- In Taylor v. Sturgell, ADA’s amicus brief argued that the U.S. Supreme Court should affirmatively state that the virtual representation doctrine (privity) will not be applied simply because litigants in the second case are members of the same organization as a litigant in the first case. Specifically, an ADA member would not waive his or her day in court based on action by another member based only on joint professional association membership
The ADA answers member dentists’ inquiries on a wide variety of issues. Answers are supplied on an informational basis and do not constitute legal advice.
ADA Division of Legal Affairs
211 E. Chicago Ave.
Chicago, IL 60611