Delta Dental of Massachusetts
MDS Files Petition for Adoption of Emergency Regulations
On May 5, 2020, the MDS filed a petition before the Division of Insurance (DOI) seeking the adoption of emergency regulations to support and sustain dental providers during the COVID-19 outbreak. This petition seeks to require Delta Dental of Massachusetts to:
- provide meaningful advanced claims payment
- increase reimbursement levels to pre-October 2019 levels
- require financial support for increased PPE expenses by either increasing maximum allowable fees for all covered procedures or allowing a standard fee per date of service per patient
Please stay tuned for updates as these efforts progress.
Read the petition.
ADA Files Class Action Lawsuit Against Delta Dental
November 26, 2019
State Dental Society Leaders were informed that the American Dental Association (ADA) filed an antitrust class action lawsuit against Delta Dental Plans and the Delta Dental Plan Association. The lawsuit alleges that independent Delta Dental carriers across the country violated federal antitrust laws. MDS President Janis Moriarty is a named lead plaintiff on behalf of her own practice as well as on behalf of the class of all Massachusetts Delta Dental providers if the court certifies this case as a class action.
As described in the ADA statement:
ADA complaint alleges that Delta has engaged in anti- competitive conduct and violated federal antitrust laws by allocating territories of operation and dividing the national market in order to restrict competition and reduce reimbursement rates to dentists.
Delta's New Fee Methodology
The MDS Takes Aim at Delta Patient Letter
Information Regarding the Medicaid Fund Established by Delta
Over the summer, the MDS informed members about the new fee methodology for the Dental Service of Massachusetts, Inc. (DSM) Delta Dental Premier and Delta Dental PPO Networks that was approved by the Massachusetts Division of Insurance (DOI). Some members were concerned about the impact the new fees will have on dental offices that focus primarily on Medicaid patients. Delta Dental of Massachusetts is establishing a $1.2 million fund (the Delta Dental of Massachusetts Medicaid Fund) to provide additional reimbursement during the first year of the new fee schedule to dentists for whom Medicaid patients represent a substantial majority (75% or more) of their revenue.
The eligibility of dentists seeking reimbursement from the Delta Dental of Massachusetts Medicaid Fund will be reviewed by Delta Dental from October 1, 2019, through December 31, 2019. If you think you are eligible, you will need to send Delta Dental a copy of your 2018 MassHealth 1099 Form and your 2018 Federal tax return, along with the name and email address of one person in your practice that Delta can contact regarding questions about the documentation and to whom it can provide notice on eligibility. If there is other documentation you think that would help in Delta's review of your eligibility, please send that as well. Delta Dental is working with the U.S. Postal Service to establish a PO Box specifically for this initiative, and will post the PO Box number on the Delta Dental of Massachusetts provider web portal (www.deltadentalma.com) as soon as it is available.
Please send your eligibility documents ONLY to the designated Medicaid Eligibility PO Box. DO NOT mail them to any other Delta Dental PO Box or address as these documents will be reviewed by specialized staff, who will be making eligibility determinations.
That is all you need to do now.
If you meet eligibility requirements, you will hear from Delta again early in 2020. If Delta confirms that you are eligible for support from the fund, it will provide more information on how and when reimbursements will be made. Delta is working with the DOI to finalize the Delta Dental of Massachusetts Medicaid Fund disbursement procedure.