June 21, 2017

Dentists petition AG Healey to review Delta Dental practices

Attorney General Maura Healey.

(Updated on June 22) Calling Delta Dental's decision late last year to create a new for-profit plan discriminatory against dentists and confusing for consumers, the Mass Dentists Alliance for Quality Care (MDAQC) on Wednesday said it has petitioned Attorney General Maura Healey to review insurer's practices.

Delta Dental, the state's largest insurer, gave dentists until the end of February to sign onto its new PPO plan, a preferred provider organization plan that limits members to care within a network of providers. Many dentists have opted out, saying their reimbursements will be up to 30-percent lower under the new plan and consumer choice is limited.

The new PPO plan blends elements of the company's existing Delta Dental Premier and Delta Dental PPO plans under a new, for-profit subsidiary.The MDAQC alleges dentists were coerced into joining the new PPO, which Delta Dental says is designed to lower costs for consumers and employers.

On Thursday, Delta Dental spokeswoman Kristin LaRoche responded to the MDAQC's claims, saying it's "unfortunate" that a group of dentists is opposing Delta's efforts to lower costs.

"We can all agree that the rising costs of dental care are squeezing the budgets of families and small businesses across the state, threatening access to care for thousands of people. Our move to establish a PPO is a necessary step to increase consumer choice by immediately making a more affordable option available," LaRoche said in a statement.

According to Delta Dental, more than 4,000 dentists have signed onto the new PPO plan, which would make it the largest PPO network in the state.

MDAQC noted Delta Dental is using the same trademarks for the nonprofit and for-profit plans, which it said is confusing to consumers, and suggested that the company's complicated corporate structure will make it difficult for Healey's office and the Massachusetts Division of Insurance to properly supervise the use of the charitable public assets provided to Delta Dental.

According to James Donnelly, an attorney at Worcester-based Mirick O'Connell who is representing the dentists, the dentists who have opted out of the the new PPO plan are being discriminated against because they're difficult to find when searching Delta Dental's website, and he said that Delta's market power in Massachusetts has coerced dentists to join.

A Delta Dental spokesman speaking on background said the claim that dentists are harder to find on the site if they haven't joined the new PPO plan "completely unfounded," and added that the new product won't be added to the search tool until it is approved by regulators.

The attorney general's office is reviewing the petition, as well as concerns submitted by other dentists about the new plan, according to a Healey spokeswoman.

Note: This story was updated on June 22 to clarify the timeline for signing up for the PPO plan and to include responses from Delta Dental.

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