The Washington State Dental Association (WSDA) and three member dentists filed a legal action against Washington Dental Service (doing business as Delta Dental of Washington) in King County Superior Court on February 20, 2019.
The complaint alleges that directors at Delta Dental acted independently and with disregard to twice-approved member bylaw amendments designed to improve company transparency and make services more patient-focused. The legal action also alleges that Delta Dental violated company bylaws and state statutes by declining to hold annual meetings for the past two years.
“Delta has repeatedly raised antitrust concerns as a scare tactic that is not supported by the facts,” said Bracken Killpack, WSDA executive director. “Instead, Delta should view this as an opportunity to bring the company back into legal compliance and, at the same time, establish a stronger working relationship with their members. It’s regrettable that their unwillingness to take that approach has forced today’s filing.”
Delta Dental of Washington was created in 1954 as a nonprofit 501c company by member dentists, along with financial support from the WSDA. Yet the WSDA now notes that Delta’s directors have continually vetoed bylaw amendments approved by more than 90% of its membership.
Delta’s board has announced that its Independent Directors (not elected by membership) were vetoing most of the approved bylaw amendments, including provisions for independent claims review, expense disclosures, and the requirement to commit a specific percentage of premium revenue in patient claims (medical loss ratios).
“Delta’s continued efforts to repeatedly block member proposals reflect a corporate culture that consistently puts its own profits ahead of legitimate concerns about how it could better support patient care and treatment decisions. Over the past two years, Delta has repeatedly and unlawfully blocked proposals by member dentists aimed to improve patient care in Washington,” said Denny Bradshaw, DDS, one of the member dentists who filed the action.
“The continued unwillingness of Delta’s board to work with its members has left us no choice but to take this action,” Bradshaw continued. “Delta’s board says that it wants to work with the members, but those words ring hollow when the board fails to respond to the legitimate concerns of their members and fails to hold required meetings that are designed to foster member input into its operations.”
Delta members also point to Delta claims personnel who are not licensed dentists challenging their diagnoses and treatment plans. This involves alleged unlicensed and unlawful practice of dentistry by Delta employees, as well as intrusion into the doctor-patient relationship.
“To Delta members, the doctor-patient relationship is the key to optimal dental care,” explained Todd Irwin, DMD, another one of the members who filed the action. “Delta should be a strategic partner in strengthening that relationship and improving oral health in Washington. Instead, their actions show a desire to weaken that relationship by inserting themselves between the doctor and the patient.”
“Going forward, the only way to constructively address these problems is to create avenues for meaningful membership input into which member dentists serve on the Board of Directors,” said Nathan Russell, DDS, MBA, the third dentist filing the action. “The Delta board’s apparent desire for one-way communication where it talks, and member dentists only listen, is completely unacceptable and a significant deviation from the organization’s history.”
In the legal action’s Prayer for Relief, the plaintiffs aren’t very focused on relief via monetary damages. The thrust of the legal action is to regain control of this nonprofit company by membership and serve the public interest, which contrasts with an earlier settlement between the California Dental Association and Delta Dental of California.
The outcome of the California case centered on financial damages to member dentists and notice to member dentists on fee schedule changes. The current action in Washington targets the return of the control of a nonprofit insurance company from an unelected elite group with seven-figure salaries to its membership.
“Washington Dental Service has received the complaint from the WSDA, and it is currently being reviewed. We have no additional comment at this time,” said Kristi Ellefson, public relations senior manager for Delta Dental of Washington.
Dr. Davis practices general dentistry in Santa Fe, NM. He assists as an expert witness in dental fraud and malpractice legal cases. He currently chairs the Santa Fe District Dental Society Peer-Review Committee and serves as a state dental association member to its house of delegates. He extensively writes and lectures on related matters. He may be reached at mwdavisdds@comcast.net or smilesofsantafe.com.
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