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Delta Dental Anti-Trust Lawsuit

Back in 2019, the American Dental Association (ADA) filed a class action lawsuit against Delta Dental alleging that they violated anti-trust laws.


delta dental anti-trust lawsuit magazine clipping

The complaints:

  • They reduced reimbursements to participating dentists through territorial restrictions.

  • They fixed prices for specific dental goods and services.

  • They restricted competition from other competitors.

If you don't have delta dental insurance, you may not care about what is going on.


However, if you do have delta dental insurance you may be wondering if there is any truth to this and how this may affect you.


Is Delta Dental violating anti-trust laws? My Opinion

Whether Delta Dental is violating anti-trust laws, it is not up to me to decide because I'm a dentist and not an attorney. The courts will make the decision but what I can tell are objective observations based on my personal experience.


Irrefutable truth: Our insurance reimbursements from Delta Dental have remained unchanged since 2019.


What that means:

  • The reimbursements remained unchanged since pre-covid.

  • Our dental practice have not had a raise in over 5 years.

  • Reimbursements definitively did not keep pace with regular inflation.


I don't blame dentists for being upset at Delta because this "financial partnership" is non-sustainable.


Costs have been continually rising year after year and we've had no assistance from them at all. I don't have to tell you how much more expensive things are after the hyperinflation from post-covid.


Rising costs:

  • Annual rent increases.

  • Products and services increases.

  • Annual raises for office staff.


If this sounds unsustainable to you, it's because it is unsustainable. For how long do you think this can continue?


 

How this may affect you

For you as a patient, the ongoing class action lawsuit does not affect you at all. You can continue to receive dental care as you've been doing all along. However, after the lawsuit has concluded, there may be changes depending on the outcome.


If Delta wins: There will be no changes at all to your dental care nor your dental plan. Your benefits and copays would all remain unchanged.


If Delta loses: Your routine check ups and cleanings will most likely be unaffected meaning the benefits stay the same and there shouldn't be a copay. However, most restorative, basic, and major work may have slightly increased copays.


You may feel like this is detrimental to you if Delta Dental loses because you may have increased copays but you need to see this from your dentist's perspective. They haven't had a raise in over 5 years.


Have you had any raises in that time frame?


Even the minimum wage increases periodically doesn't it?


 

Closing thoughts

With stagnant revenue but with increasing expenses, the financial health of our dental practice, 1311 Jackson Ave Dental, is trending towards the negative. To be quite honest, I'm not sure how long we'll still be around if the situation does not change.


As of the moment, I would peg our chances of surviving past the end of our lease in 3/31/2028 at about 50%. If we do manage to miraculously survive and extend our lease for another 5 years, we'll most likely get wiped out by the end of it due to rising costs and stagnant revenues.


Quite unfortunate but it is what it is... Perhaps, we may get some good news from this class action lawsuit but if you've ever followed along any of these legal cases, they can drag out for years on end.


Upon reflection, this situation is absolutely fascinating because this is my first job where I'm taking a pay cut every year. Never thought it would be possible but here it is! Although I could slow down our demise if I withhold raises for my staff but that's not who I want to be.


Ultimately... does it even make sense to participate with dental insurance?

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David Chen 200 x 200.jpg

About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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