Court grants preliminary approval of amended settlement between Delta Dental of California and California Dental Association

December 28, 2017

On December 27, the Superior Court of the State of California granted preliminary approval of a proposed class action settlement of litigation brought against Delta Dental of California by the California Dental Association (CDA) and Delta Dental Premier® dentists regarding Premier dentist contract terms and fee limitations.

CDA filed a lawsuit in 2014 challenging Delta Dental’s 2013 actions to amend its Participating Dentist Agreement (PDA) with Premier dentists to remove a restriction on lowering “maximum amounts allowed” for Premier provider contracted fees. Delta Dental maintained that the PDA expressly permitted the proposed amendments and that they were in accordance with California’s Knox-Keene Act governing health care service plans. Also at issue was an inflation adjustment percentage (INAP) that Delta Dental established and applied to Premier dentists’ requests for higher fees. Delta Dental maintained that use of the INAP did not breach the terms of the PDA.

Earlier this year, the court granted preliminary approval of a proposed class action settlement that included, among other provisions, payments to some California dentists for limits placed on requests to increase Premier fees since January 1, 2011. During the payment validation process, Delta Dental discovered a miscalculation that affected the proposed settlement. Delta Dental informed plaintiffs’ counsel and the parties jointly asked the court for additional time to review and develop a revised estimate of the alleged INAP impact and to confirm the number and identity of all class members. The parties subsequently agreed on a revised settlement amount, and plaintiffs filed a motion seeking preliminary approval of the amended settlement, which the court granted on December 27, 2017. A final approval hearing is scheduled for April 25, 2018.

The proposed class in the amended settlement consists of all California dentists who have been Premier dentists at any time from January 1, 2011 through December 27, 2017.

The payments provided in the proposed settlement are for requested fee increases that were limited in whole or in part by use of the INAP; they are not related to fee reductions. At no time did Delta Dental reduce Premier fees or announce a reduction in such fees.

Delta Dental maintains that, at all times, it has followed its PDAs with Premier dentists and complied with both the letter and spirit of California’s Knox-Keene Act. Delta Dental’s agreement to settle this lawsuit is not an admission of liability or wrongdoing. Nonetheless, Delta Dental is satisfied to resolve this issue and remains committed to all its participating dentists.

More information on the proposed settlement may be found at www.DeltaDentalOfCaliforniaSettlement.com.

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