04/08/2013

CDA keeps pressing Delta for information on fee cuts


Dear Colleague,

I am writing you today to provide the latest information CDA has about the Delta Dental Premier Plan reimbursement fee cuts – an expected average reduction of 8 to 12 percent sometime later this year.

In a letter to Delta President and Chief Executive Officer Gary Radine on March 1, CDA urged Delta to communicate its intentions to providers and answer questions about the impact and timing of these drastic cuts. Although Mr. Radine did not respond, Vice President of Network Development Dr. Dan Croley wrote on March 11, without details, that Delta is taking the steps it must follow and would notify dentists in its provider network when specifics are known. Unfortunately, it is clear from the letter that Delta does not intend to provide CDA with the requested information, which prompted our response to Delta.

CDA recently met with officials at the Department of Managed Health Care (DMHC), on our members' behalf, and was informed that, because CDA is not a party to these contracts, only the individual providers can demand information from Delta. DMHC also confirmed that contracted providers have a right to directly contact Delta with questions and concerns, and Delta has a responsibility and obligation to provide an adequate response. That response is separate and distinct from the 45-day notice requirement for contract policy changes enacted through CDA's 2012 sponsored bill, AB 2252.

You can find contact information for Delta in your contract, but if you experience difficulty reaching someone, you may also wish to contact Mr. Radine or Dr. Croley at Delta's executive office at 415.972.8300. CDA has informed Delta that it may hear from providers who feel that they are being left in the dark about the material changes to their contracts, demanding the details of and reasoning for these fee cuts. If Delta is unresponsive to your inquiries, DMHC also informed CDA that providers may file a complaint with DMHC. However, your contract may require you to file a grievance with Delta first.

We fully understand the importance of this issue to you and will continue to do everything we can to protect and assist you during this process, including continuing to offer Compass resources and guidance that can assist you in evaluating the complement of plans you accept in your office.

CDA will keep you informed of any new developments on cda.org and in the CDA Update. For additional support, you may contact our Dental Benefits Analyst Ann Milar at ann.milar@cda.org or 916.554.4994, or our hotline at 916.554.5858.

Sincerely,

Lindsey Robinson, DDS
Lindsey Robinson, DDS
President



Topics: Delta Dental