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On behalf of members, CDA has filed a legal action against Delta Dental of California in San Francisco Superior Court. We will be sharing additional details with CDA members about the legal action in the weeks to come.
The action challenges Delta Dental’s adjustments to Premier and PPO provider agreements effective Jan. 1, 2023, which include significant fee reductions for many providers, increased administrative burdens and diminished value of benefit plans. CDA alleges that the board of directors of Delta Dental, a nonprofit, tax-exempt company, violated its fiduciary duties by, among other things, failing to conduct appropriate analysis of the need for and impact of the contract changes to Delta Dental’s provider network and patients. Anyone can read the filed complaint for details of the allegations.
"CDA is committed to supporting our members in their practices and ensuring the patients we serve can access dental care,” said CDA President John Blake, DDS. “As a dental benefit plan company, Delta Dental has a responsibility to be transparent about such significant changes that affect its provider networks and their patients. CDA believes that Delta Dental failed to adequately consider the basis for and impact of these changes and has failed to offer sufficient justification for these actions."
CDA previously sought clarification from Delta Dental on the methodologies used to justify the significant contractual amendments and reimbursement changes, including 20-40% rate reductions for most periodontists, endodontists and oral surgeons. Delta Dental, however, stated that it would not provide any additional information, claiming that it is confidential and proprietary. Based on our review and study of adjustments to Premier and PPO provider agreements that Delta Dental has announced, as well as reports from CDA members, it appears that the changes Delta Dental is making are intended to increase its own profits without adequately considering the interests of network dentists and their patients.
"Challenges with dental benefit plans are a top concern for CDA members as we are keenly aware that current dental benefit structures are not working for patients or dentists,” said Dr. Blake. “This litigation is a step toward increasing transparency and accountability. Significant work must be done to develop quality, standardized and meaningful dental benefit plan requirements that meet the oral health care needs of Californians."
Members can stay connected with the next steps
More details about the litigation claims and process will be provided in the coming weeks. CDA members can stay up to date for additional developments in the CDA newsroom.