ADA News

San Francisco—A Kansas dentist has put his name on a class action lawsuit against the company that manufactures and sells the Invisalign brand for instituting a case quota, allegedly failing to reimburse dentists for thousands of dollars in training fees and reportedly decertifying doctors who don’t comply with the company's rules.

The lawsuit, filed May 10 in federal court in northern California, claims Align Technology Inc., which manufactures and sells Invisalign, violated California public policy by requiring doctors to prescribe at least 10 cases each year in order to make money. Jason Hartley, attorney with Stueve Siegel Hanson LLP, the Kansas City law firm representing the putative class, said he believes tens of thousands of dentists have been decertified as a result of Align’s practices.

The lawsuit alleges Align was not concerned about patient welfare but about its own bottom line. It describes Align's practices as unfair and fraudulent.

"The necessary and intended effect of Align's actions was to coerce doctors, under the threat of decertification, into prescribing Invisalign even where it was not necessary and/or where it was not the safest or most effective course of treatment," the lawsuit states. "In effect, Align offered doctors an all or nothing deal: prescribe Invisalign to at least 10 patients a year, regardless of whether it was necessary, safe or the most effective treatment or do not prescribe Invisalign at all."

The class action complaint asks Align to refund dentists the fee they paid to be certified to prescribe Invisalign and says as a result of the practices, the class suffered injury in fact and lost money or property.

"These quota requirements were not disclosed to the doctors when they signed up to take the training course," Mr. Hartley said. "If they're going to take away their ability to prescribe Invisalign, they need to refund the money for the training."

An Align spokeswoman wouldn't comment on the case because it's pending litigation, but the company did issue a news release announcing they were being sued.

"Align has reviewed the complaint and will vigorously defend against the litigation," the release states.

Align required doctors to pay about $2,000 for a training course to be certified to prescribe Invisalign. In June 2009, the company announced doctors would have to start at least 10 cases each year in order to retain their certification.

This was met with protest from numerous groups. The American Dental Association communicated with the company a number of times and in April, Align announced it was dropping the requirement. Dentists are still required to complete 10 Invisalign continuing education hours per year. Those who don’t will have their accounts temporarily suspended until they complete the credits, according to Align's news release.

Dentists whose accounts were deactivated after not meeting the case quotas can reactivate their accounts by completing more training courses and meeting the 10 CE requirements, the news release states.

Dr. Christopher Leiszler, who practices in Brown City, Kan., is the only named plaintiff in the case. Dr. Leiszler, who referred all questions to his attorney, paid for and completed Invisalign's training in 2008 and was a certified provider, starting one new patient case but failing to meet the 10-case requirement, the lawsuit states.

Dr. Leiszler's account was suspended, and he was told he would have to pay another $2,000 to retake the Invisalign training course in order to prescribe the product again.

Dr. Leiszler is not the only dentist who has taken issue with Align.

Dr. Mark Burbey, who practices in Appleton, Wis., also had his Invisalign certification deactivated after failing to prescribe 10 cases. After Align announced it was dropping the quota, Dr. Burbey was ready to be reinstated as a provider but was told he would have to pay an additional $2,000 to be recertified.

"This policy reflects the need for doctors to stay current with Invisalign developments in order to be successful with the product," according to a letter Align sent to doctors regarding the issue. "Doctors who have never started an Invisalign case will probably find today's Invisalign system to be a very different product than the one they learned about in their first Invisalign training course."

Dr. Fred Olsen, a general dentist in Phoenix, had a similar experience and complained to Align, the ADA and the Arizona Dental Association to get his point across. He also paid about $2,000 to be trained in December 2008 and only completed two cases before having his certification dropped by the company.

After Dr. Olsen heard about the case requirements being dropped, he was interested in bringing Invisalign back into his practice but, like Dr. Burbey, was told he'd have to pay another approximately $2,000 to be retrained.

Dr. Olsen said he had a number of clinical questions for the local liaison, and all he could talk about was marketing and promotions.

Prescribing a lot of Invisalign cases doesn't make someone a good dentist, Dr. Olsen said. You can do two crowns and be a fantastic dentist or do 1,000 crowns and not be very good, he said. Quantity doesn't equal quality, he added.