American Dental Association Comments on California Settlement
March 10, 2017
CHICAGO — The California Dental Association (CDA) announced that they have reached a proposed settlement agreement with Delta Dental of California in its lawsuit against the insurer regarding CDA’s claims that Delta breached its contractual commitments.
“The ADA is pleased that the California Dental Association has reached a settlement with Delta Dental with terms very favorable to the dentists of California,” said Gary L. Roberts, D.D.S., ADA president. “We support CDA’s efforts on behalf of its members to challenge unilateral revisions of its provider contracts. Ultimately, the settlement benefits the patient, the provider and the profession."
“This effort should remind all dentists who have contracts with any third-party payers to review your contracts,” said Ronald D. Riggins, D.M.D., chair of the ADA Council on Dental Benefit Programs. “Dentists should request copies of their contract from the payer and explore whether future changes can be provided as redlined changes to the contract.”
The CDA filed the legal action in August 2013 in response to Delta Dental’s plans to reduce reimbursement rates for the Premier plan by 8 to 12 percent. The CDA claimed that Delta Dental’s attempt to amend the participating dentist agreement (PDAs) was a breach of contract and that Delta Dental had not adequately disclosed its plan to reduce reimbursement rates. During the course of litigation, the CDA also discovered that Delta Dental had been imposing additional limitations on provider annual fee filings for participation in the Premier network that were not authorized under the PDAs.
The CDA’s proposed settlement is on behalf of all California dentists who had a PDA for participation in the Delta Dental Premier network at any time between Jan. 1, 2011, and Dec. 31, 2016. The settlement agreement has been submitted to the Superior Court of California in San Francisco for the court’s consideration in a public hearing.
More information on the settlement can be found at cda.org/dental.
Editor’s Note: Reporters are invited to follow the ADA on Twitter @AmerDentalAssn
About the ADA
The not-for-profit ADA is the nation's largest dental association, representing 163,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit ADA.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website MouthHealthy.org