A San Francisco Superior Court judge has granted final approval of the $65 million amended settlement agreement between Delta Dental of California and the plaintiff class of Premier Dentists. The comprehensive settlement is the result of a lengthy legal battle that CDA initiated in 2013 after learning of Delta Dental’s plans to reduce Premier provider rates by 8 to 12 percent. CDA brought the litigation in order to protect the rights of its members and to require Delta Dental to honor the terms of its contracts.
“We told our members we would go to the mat for them and that’s exactly what we did,” said CDA President Natasha Lee, DDS. “This litigation demonstrates the great lengths CDA is willing to go to protect our members especially since individual dentists feel it would have been impossible to fight a company like Delta Dental on their own.”
During litigation, CDA discovered that Delta Dental had been imposing limitations on provider annual fee filings. As part of the settlement, Premier dentists who had their fees reduced by Delta Dental’s “inflationary adjustment percentage” are eligible to receive proportionate reimbursements based on the amount their fees were limited. Those not receiving settlement reimbursements were not affected.
Specific terms of the settlement include:
- Delta Dental will pay up to $65,029,299 to Premier dentists whose requests for fee increases submitted to Delta Dental were limited by the INAP.
- While allocations vary significantly depending upon a dentist’s practice size and the degree to which requests for fee increases were limited by the INAP, more than 14,000 dentists have been allocated an amount ranging from $500 to many thousands of dollars, with the average allocation calculated at $4,480. A notice of allocation amounts will be sent to those involved — no claim form is required.
- Delta Dental will provide Premier dentists with 120 days’ notice of material changes to participating dentist agreements. Delta Dental also will provide, for each Premier dentist affected by any future maximum fee allowance reductions, an individualized illustration of how those reductions would potentially affect the dentist’s practice. This will give dentists additional time and information to evaluate the impact of any changes and will enable them to make informed decisions about their contract with Delta Dental.
- Delta Dental will provide CDA with 12 days’ advance notice of changes to participating dentist agreements to prepare for questions from its members.
- Delta Dental will separately pay $2.35 million for attorneys’ fees and expenses.
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.
CDA is committed to supporting members in many ways, including through advocacy, protection and practice support resources.
Members with questions about the terms or meaning of the settlement may contact CDA at 800.232.7645.