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New York bill takes aim at quotas

Albany, N.Y.—New York appears to be the first state to make it illegal for dental manufacturers to establish quotas for dentists to use their products.

The bill’s passage in the New York State Legislature comes after aggressive lobbying by the New York State Dental Association. The association’s campaign began after asking Align Technology Inc. to rescind its requirement that dentists begin a minimum of 10 cases of Invisalign annually in order to participate in the company’s program. Invisalign is the tooth alignment system manufactured by Align.

The NYSDA sent Align a letter in September 2009 stating that if the company did not rescind its quota policy, the state association would seek legislation. After extensive discussions between the two parties, Align decided not to make any changes, so the NYSDA pushed forward, said Sandy DiNoto, spokeswoman for the NYSDA.

Last April, Align announced it was dropping the case requirement, but Dr. Mark Feldman, NYSDA executive director, believed it was still necessary to pursue legislation that would make it illegal to establish a quota in New York.

“You never know what other companies are going to establish a proficiency quota on their own as a marketing technique as opposed to relying on scientific evidence,” Dr. Feldman said.

Dentists opposed to patient quotas argue that companies imposing them are more worried about selling more of their product than they are about patient welfare.

“It is our duty to protect patients from corporate interference in the dentist/patient relationship,” said Dr. Robert J. Doherty, NYSDA president.

Dr. Feldman said it wasn’t difficult to find a legislator to sponsor the bill, which passed unanimously among those who voted in both houses. It was signed into law by Gov. David A. Paterson on Sept. 19 and took effect immediately.

The American Dental Association’s Council on Government Affairs reports no other states are considering this type of legislation. It’s Dr. Feldman’s hope that New York’s bill won’t require any other states to seek legislation—that companies will heed the warning on their own and stop requiring quotas.

“Corporations don’t practice dentistry, dentists do,” Dr. Feldman said.

Align is currently facing a class action lawsuit, filed May 10 in federal court in northern California, by dentists who allege the company instituted a case quota, failed to reimburse dentists for thousands of dollars in training fees and reportedly decertified doctors who didn’t comply with the company’s rules. The case is active and ongoing, said Jason Hartley, attorney with Stueve Siegel Hanson LLP, the Kansas City law firm representing the putative class.