Monday, Sep 24, 2018

Eligible Premier providers to be mailed Delta Dental settlement notices

Reprinted with permission from California Dental Association

Dentists eligible for payments under CDA’s settlement agreement with Delta Dental should have received allocation notices in the mail. The class action settlement administrator mailed letters to approximately 14,000 Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.” Dentists who did not have their fees reduced improperly by the inflationary adjustment percentage will not receive notices or payments under the settlement.

CDA advises Premier providers to watch for the letters, which are expected to provide information regarding payments and next steps. Those receiving payments, which range from $500 to many thousands of dollars, do not need to file a claim in order to receive a portion of the $65 million settlement agreement. Awards will be based on Delta Dental’s record of requests for fee increases submitted to Delta, any application of the inflationary adjustment percentage to those requested fee increases and claims history for services performed during the period of Jan. 1, 2011, through Sept. 14, 2017.

Besides the settlement amount, CDA secured additional protection for dentists, including those not receiving payments. Under the settlement agreement, Delta Dental must provide:

• 120 days’ written notice of material changes to participating dentist agreements to all contracted providers.
• Each Premier provider affected by any attempt to reduce reimbursement rates with an individualized illustration of how those reductions would potentially affect the dentist’s practice.
• CDA with 12 days’ advance notice of changes to participating dentist agreements to prepare for questions from members.

Although this agreement does not prevent future rate reductions, CDA successfully blocked Delta Dental’s attempt to reduce Premier provider reimbursement rates during the five-year litigation, saving dentists — even those not receiving settlement payments — more than $600 million in Premier plan fee reductions.

For settlement details, visit DeltaDentalofCaliforniaSettlement.com. Members with questions about the terms or meaning of the settlement may contact CDA at 800.232.7645.

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