On behalf of members, CDA has filed a legal action against Delta Dental of California in San Francisco Superior Court. The action challenges Delta Dental’s adjustments to Premier and PPO provider agreements effective Jan. 1, 2023.
The Department of Managed Health Care asked Delta Dental to report any rate changes affecting over 10% of its provider network to the department. Additionally, DMHC is monitoring its help desk for calls from consumers.
In Tuesday’s election, Massachusetts voters overwhelmingly supported a ballot measure that will require Massachusetts dental plans to spend at least 83% of premium dollars on patient care rather than administrative overhead costs and executive compensation.
The Biden administration this week expanded coverage for medically necessary dental procedures in Medicare. Coverage of some services — specifically, elimination of infection preceding an organ transplant and certain cardiac procedures — will begin in 2023, while coverage of dental services linked to head and neck cancers will start in 2024.
Update 11/9/22: The CDA-endorsed ballot measure in Massachusetts – Question 2 – passed in Tuesday's election and will require dental insurance companies to spend at least 83% of premium dollars collected on dental services as opposed to using the money for administrative costs and executive compensation.
A proposed rule from the Center for Medicare & Medicaid Services would cover medically necessary dental services as part of the existing medical services benefit in Medicare. CDA last week submitted specific recommendations on coverage of services.
Reports from CDA members during the last week on contract change notification letters sent by Delta Dental of California raise additional concerns for CDA about the proposed changes.
Delta Dental of California is revising its Delta Dental of California Participating Provider Agreement effective June 1, 2022. Although described as an “enhancement,” the contract amendment alters reimbursement for Premier or PPO contracted dentists who treat DeltaCare® enrollees as out-of-network providers.
Do you have a question about a dental benefit issue? You can receive timely assistance from a CDA Practice Support expert. Simply submit your question online using the dental submission form available within your cda.org account.
CDA Practice Support continues to hear from member dentists impacted by Delta Dental of California’s contractual change under Participating Dentist Rule 2, Basis of Fees that took effect September 15, 2018. Dental practices can take action annually to avoid negative impacts.
Understand how a dental practice can bill properly by registering all treating dentists in the practice with the dental plan or plans.
Delta Dental of California’s proposed reductions to the “maximum allowable fees” for approximately 2,200 endodontists, periodontists and oral surgeons in California will not take effect July 1, as previously scheduled. Instead, Delta Dental has decided to indefinitely postpone the previously announced fee reductions.
