Dentists have filed class-action lawsuits against Delta Dental in four states, alleging that the organization engaged in conduct that suppressed reimbursement rates and limited competition in the insurance market.
Four notes:
1. The lawsuits — filed April 30 in California, Wisconsin, Michigan and Massachusetts — follow developments in a federal antitrust lawsuit filed in 2019, according to a May 13 news release from the American Dental Association.
2. The federal case alleges that Delta Dental engaged in several anticompetitive practices within its state subsidiaries, including suppressing reimbursement rates and fixing prices for dental services, costing dental providers $13 billion. The plaintiffs sought class certification for all dental providers who had been reimbursed by Delta Dental since Oct. 11, 2015, but that request was denied by an Illinois federal judge in September. The U.S. Court of Appeals for the Seventh Circuit also declined to immediately review that decision in December.
Plaintiffs also sought to amend the federal complaint to add state-based class claims, but that request was denied in January, leading them to move forward with the case only with the federal claims.
3. Dental providers are now seeking class certification statewide for each lawsuit filed because the national request for class certification in the federal case was denied. The allegations made in the state cases are similar to those of the federal case, including claims that the Delta Dental entities operating in those states engaged in anticompetitive conduct and that their policies led to reduced reimbursement rates for providers. The cases also claim that Delta Dental’s market share in each state exceeds 50%, which allows each entity to influence reimbursement rates and network participation.
4. The state lawsuits seek injunctive relief and monetary damages, along with remedial actions to restore competition.
Becker’s has contacted Delta Dental and its state affiliates for comment and will update this article if more information becomes available.
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