CDA is pursuing litigation to require Delta Dental to honor its contractual obligations inherent in the Participating Dentist Agreement between Delta and its participating providers. CDA is also challenging whether the Delta Dental board of directors has violated its legal responsibilities, referred to as fiduciary duties.
You can read the filed amended complaint for details of the allegations.
CDA filed against Delta Dental in December 2022. The case has taken place over many months of hearings, discovery and amended complaints with additional facts for consideration.
In May 2024, the Superior Court ruled in favor of Delta Dental and the individual directors and officers, resulting in the case being dismissed.
The Court ruled that the directors do not owe fiduciary duties to dentists who participate in the Delta network and that Delta has unfettered discretion to set reimbursement rates.
While it’s unfortunate that the case has reached this stage, CDA’s pursuit of meaningful reform will not be stopped. As of June 2024, CDA’s leaders, legal team and outside counsel have evaluated the next steps and decided to appeal the decision. The deadline to file a Notice of Appeal is in early July.
CDA fundamentally disagrees with the court’s ruling and leadership and feels it’s unwise to let it stand. Failing to appeal leaves Delta Dental and its board of directors with the impression that they can change contractual terms, regardless of how those changes affect dentists and patients.
CDA’s decision to appeal was not made lightly. We cannot and will not stop in pursuit of increased transparency and fair dealings by Delta Dental on behalf of our members.
Filing the action did not by itself suspend the contract changes that Delta Dental announced. While the lawsuit we filed challenges those actions, their validity necessarily depends upon the ruling of the court. The litigation does challenge the validity of the fee reductions that Delta Dental seeks to impose.
If you are not a Delta Dental provider, you may still benefit from CDA’s actions since other dental benefit plans will take note of the action we’ve taken on behalf of our members and those plans may reconsider potential actions in the future which could be detrimental to CDA member-dentists.
Litigation takes time and is costly. While the process is unpredictable, it is typically measured in years rather than weeks or months. In fact, when we previously filed litigation against Delta Dental, it took nearly 5 years to resolve. There are many factors that can impact the duration of the process, including CDA’s appeal of the decision of the Superior Court.
The appeal process will likely take 14 to 18 months from the date of filing.
You should simply inform them that how this turns out is dependent on the legal process that can span several months (or longer) and that there is no way to reliably predict how this, or any other litigation will turn out. It would be wise to refrain from predictions, and also wise to avoid negative or disparaging comments about Delta Dental, which could even violate the participating provider agreement. If the patient has concerns, they have the right to reach out to the Department of Managed Health Care’s consumer hotline to register a complaint at (888) 466-2219.
While there may be periods of time without new information regarding the appeal, be sure to opt in to receive CDA emails so that you are connected to all our updates on dental plan reform and resources for members. You may also follow the latest news in the Dental Plan Action Center.
CDA is fighting for reform on multiple fronts, including results-driven legislative advocacy. Keep connected to the latest news and updates through emails from CDA, the Dental Plan Action Center and our newsroom.