Delta Dental Is Sued By Another Dentist, Following The Lead Of The ADA
A class-action suit has been filed by a Mississippi dentist against the Delta Dental Plans Association and Delta Dental plans. The largest dental insurer in the United States is accused of fixing prices as well as conspiring to lower the amount of money paid to clinicians.
This suit was filed by William Dickey III, DMD, from Big River Dental in Brandon, Mississippi on December 11, two weeks after a class-action suit was filed by the ADA against Delta Dental, which claims uncompetitive conduct. Dr. Dickey’s antitrust lawsuit was filed in the U.S. District Court for Mississippi’s Southern District. He is one of around a dozen people who are suing different Delta Dental brands, with similar allegation claims.
The suit claims that Dickey was deprived of the option of being able to accept dental patients under more insurance plans than he could have in a competitive market and that he was reimbursed less for the dental services and goods that he provided than he would have been if the anticompetitive conduct had not occurred.
Delta Dental Operates as a Conglomerate Rather than as Separate Entities
The suit states that Delta Dental is currently the leading dental care insurer in the United States and serves over 80 million Americans, with 1 in 3 Americans insured with Delta Dental, and 3 out of every 4 U.S. dentist is part of Delta Dental’s system.
For example, it is noted in the suit that the plans not only are Delta Dental Plans Association members but govern the association as well. Its member plans, which are all independent insurance companies or an affiliate of the companies, have total control of the association.
The board of directors of the associations is controlled by the plans, which are made up of CEOs and presidents of Delta Dental plans. However, the suit claims that the independent companies are promoted by the association as Delta Dental, a single provider.
Dr. Dickey alleges that since the plans appoint the officers and elect the board for the Delta Dental Plans Association, in addition to voting on any of the association’s major actions, that the plans control all of the major decisions.
Delta Dental has Engaged in Anticompetitive Conduct that Violated Federal Antitrust Laws
It is also claimed by the dentist that Delta Dental has engaged in anticompetitive conduct and is in violation of federal antitrust laws by territories of operation being allocated and the U.S. market divided in order to restrict competition and reduce reimbursement rates given to clinicians. He also alleges in his suit that the actions of Delta Dental harm patients and dentists.
The suit claims that the practices of Delta Dental will continue under compensating dental providers who belong to its network and this will result in patients being harmed. The ADA, Dr. Dickey, and the other dentists who are suing have requested that the proceedings be certified by the court as a class action.
Many people believe that no matter which party ends up winning that these lawsuits, as well as their effects, are going to have a significant impact on provider/carrier relationships.
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