The California Dental Association has taken legal action against Delta Dental of California challenging the insurer's adjustments to its Premier and PPO provider agreements that went into effect Jan. 1, according to a Jan. 3 article on the CDA website.
Four things to know:
1. Delta Dental of California's adjustments to its Premier and PPO provider agreements include significant fee reductions for several providers, increased administrative burdens and reduced value of benefit plans, according to the CDA.
2. The CDA alleges that the Delta Dental of California board of directors violated its duties by failing to analyze the need for and effect of the contract changes to Delta's provider network and patients.
3. One of the changes to the provider agreement includes 20 percent to 40 percent rate reductions for most periodontists, endodontists and oral surgeons, according to the CDA.
4. According to the CDA, the organization previously sought clarification from Delta Dental of California on the methodologies used to explain the contractual amendments and reimbursement changes, but the insurer said it would not provide any additional information, stating that it is confidential and proprietary.