Eligible Premier providers to receive settlement payments

Updated 12/7/18 to address new Delta Dental rule

Approximately 14,000 dentists are expected to receive payments by the end of October as part of CDA’s settlement agreement with Delta Dental. The agreement, which was approved by the court in May and followed by a 60-day appeal period, provides $65 million to Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.” Under the agreement, Delta Dental has 120 days from the end of the appeal period to distribute the payments to eligible providers. Dentists who did not have their fees reduced improperly by the inflationary adjustment percentage will not receive payments.

Among Premier providers receiving awards, individual settlement payments vary from $500 to many thousands of dollars and are 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 detailed and individualized claims history for services performed between Jan. 1, 2011, and Sept. 14, 2017.

CDA has received inquiries from Premier providers who did not receive settlement allocations or thought their award amounts should be higher. In many of those instances, Delta Dental records show those dentists did not file for fee increases or did not file at regular intervals. CDA Practice Support recommends that providers review the article “New Delta Dental rule can affect dentists’ fees” when revising their Delta Dental Premier fees.

In addition to the monetary settlement, 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, which saved 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.

Related Items

CDA Practice Support is hearing from members who have questions about the Delta Dental settlement, which CDA secured final court approval of in late April. Provided here are members’ top questions, compiled and answered by Practice Support. Questions include “What started the legal action that led to this settlement?” and “Are there any benefits beyond the $65 million payment?”

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.

Dentists seeking information regarding CDA’s amended settlement agreement with Delta Dental can find all related information posted at DeltaDentalofCaliforniaSettlement.com. Under the settlement agreement, Delta Dental must pay $65 million to Premier Providers whose rates were impacted by an inflationary guard. Not every Premier Provider had his or her fees reduced by this procedure, but those who did will receive some proportionate reimbursement.