The new administrative rules slated to begin Jan. The effect of the rate reductions and new administrative rules on patients’ coverage and benefits.The ability of Delta Dental to meet California’s time and distance standards if the rate reductions take effect.Whether the financial condition of Delta Dental requires such dramatic rate reductions.The impact of the proposed reductions on Delta Dental’s existing provider network.The soundness of the proposed reductions given the increasing costs of providing oral health care.The letter specifically requests that DMHC review: “CDA is deeply concerned that a significant provider rate reduction, such as the one being implemented by Delta, will have a deleterious effect on patient access to care because we anticipate it will result in a significant number of providers leaving the Delta Dental network,” CDA states in a letter sent Nov. Now, CDA has asked the Department of Managed Health Care, which has regulatory oversight of Delta Dental, to step in on this “urgent pending issue” to protect provider network standards and timely access to care. CDA asks state regulator to review ‘the soundness of the proposed reductions’ 1 announcing several significant contractual amendments and reimbursement changes, including 20-40% rate reductions for most periodontists, endodontists and oral surgeons, as CDA detailed in an email and other communications to members.ĬDA has sought clarification from Delta Dental on the methodologies used to justify these changes however, Delta has stated it will not provide any additional information, claiming the information is confidential and proprietary. 1 for participating Premier and PPO providers.ĭelta Dental sent notices to participating providers on Sept. 6, 2022: CDA is asking the California Department of Managed Health Care to review the soundness of Delta Dental of California’s proposed rate reductions due to take effect Jan. 3.Īffected members who have not already done so can log in to read CDA’s FAQ about Delta Dental’s 2023 contractual changes or use a dental plan evaluation checklist to help them understand the potential effects of the contractual changes on their practice.ĭec. Additionally, DMHC is monitoring its help desk for calls from consumers.ĬDA has since filed a legal action against Delta Dental challenging Delta’s adjustments to the Premier and PP provider agreements, as CDA reported Jan. 1.ĬDA requested the meeting after first sending a letter asking the state regulator to review the soundness of Delta Dental’s proposed reductions given the increasing costs of providing oral health care and the impact of the proposed reductions on Delta Dental’s existing provider network, among other concerns CDA reported below.Īs a result of that meeting, DMHC has asked Delta Dental to report any rate changes affecting over 10% of its provider network to the department. 24, 2023: CDA in December met with the California Department of Managed Health Care, which has regulatory oversight of Delta Dental of California, to discuss Delta Dental’s proposed rate reductions for participating Premier and PPO providers, which took effect Jan. Search this website Submit search Click to toggle Menu
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