On behalf of its members, the California Dental Association (CDA) -- along with several individual dentist providers -- has taken legal action against Delta Dental of California by filing a demand for binding arbitration in response to Delta Dental's notice dated August 1, informing providers of changes to key provisions in their agreements.
According to the CDA, Delta Dental is unilaterally attempting to change two significant provisions of providers' agreements: The first restricts dentists' ability to use arbitration to challenge Delta Dental's actions, and the second eliminates the current requirement that Delta Dental provide justification for changing its reimbursement fees. Both are key provisions that have been in participating dentist agreements for many years.
Delta Dental has provided no explanation for its attempt to delete them now, although it appears to precede the anticipated action by Delta Dental to reduce fees without justification by the end of this year, according to the CDA.
"CDA is committed to supporting our members in their practices and the patients they serve. "Delta's unilateral attempt to change key provisions of its contracts would allow Delta to abandon its responsibility for justifying its payments to contracted providers," said CDA President Lindsey Robinson, DDS, in a news release. "This move toward nontransparency appears to be motivated by Delta's desire for financial gain, not to improve patient coverage or care. It leaves us with no choice but to seek a legal remedy."
CDA is taking this legal action to ensure that Delta Dental will honor its current contracts with dentists and continue to be required to justify reducing fees in the future.
Due to the 2012 CDA-sponsored law requiring dental plans to provide 45 business days' notice of any provider agreement changes, Delta Dental's recently proposed changes cannot take effect until October 4 at the earliest, allowing time for dentists to review how these changes will affect their practices, the CDA noted.
