DDMA Responds to MDS Petition for More Financial Support

Dentistry Today


After the Massachusetts Dental Society (MDS) filed a petition with the state’s Division of Insurance to adopt emergency regulations to support and sustain dental providers by compelling stakeholders to provide long-term relief to dentists, Delta Dental of Massachusetts (DDMA) announced a pair of programs to help dentists and employers stay afloat.

DDMA’s Programs

DDMA’s new programs include the Provider Advance Payment Program and the Employer Relief Credit.

The first of its magnitude in Massachusetts, DDMA said, the voluntary Provider Advance Payment Program will enable eligible practices in the DDMA network to receive a one-time payment of up to 50% of their 2019 average weekly claims for six weeks.

Amounts will vary by practice. DDMA will issue the interest-free advance payments in June and manage the reimbursement through deductions from weekly claims payments beginning in August. To date, DDMA said, it is the only dental insurer in the state to make this level of commitment to supporting Massachusetts dentists.

In its petition, the MDS asked for payment of 50% of a provider’s average weekly reimbursement payments received in 2019, multiplied by nine weeks, capped at $50,000 per practice.

“Every business and industry has been affected by COVID-19, and dentists have been hit particularly hard,” said DDMA president and CEO Dennis Leonard.

“The advance payment program will help providers in our network manage cashflow issues as restrictions are lifted and they work to return to more regular operations. This is one of a number of steps we are taking to support our dentists, and we urge our industry peers to do the same,” said Leonard.

The Delta Dental of Massachusetts Employer Relief Credit will provide Massachusetts businesses that offer fully insured dental coverage through DDMA with a 30% credit on insurance premiums paid to DDMA for April and May. The rebates will come in the form of credits that will reduce these clients’ June premiums.

“The Delta Dental team’s comprehensive response to meeting the needs of multiple stakeholders during this pandemic is impressive,” said John Regan, president and CEO of Associated Industries of Massachusetts. “The programs they’ve put in place address immediate business needs and provide much needed community support.

The Petition

With almost 2.2 million members, DDMA is the largest provider of dental benefits serves most of the patients receiving dental services in the state. According to the MDS, DDMA is still charging premiums even though it isn’t sending out claim reimbursements.

Flush with cash and reserves, the MDS said, DDMA is best situated to support the very network on which it and its members depend. Other Delta Dental companies have implemented programs to sustain their networks, the MDS continued, including reimbursement advance programs and assistance funds.

But despite weeks of outreach from the MDS, the organization said, DDMA has yet to adopt similar measures for its oral health providers. The MDS believes that DDMA is prioritizing its short-term goal of maximizing its cash holdings over the long-term health and stability of its provider network.

Most dental practices in the state need about $150,000 to $300,000 in financial relief to reopen their doors to non-emergency care, the MDS said. The $670 billion that the federal government has provided in short-term financial relief has assisted MDS members, the organization said, but these communities need long-term support to ensure access to care too.

In addition to costs being borne while closed, dental practices will face increased costs upon reopening due to stronger personal protective equipment (PPE) standards and associated procurement costs, the MDS said, underscoring the organization’s emphasis on the need for innovative long-term financial assistance initiatives.

It its DOI filing, the MDS is calling for actions that it said will provide comprehensive relief matching the scale of the pandemic’s impact on dental practices. In addition to the payment of 50% of a provider’s average weekly reimbursement payments received in 2019 multiplied by nine weeks, the MDS says:

  • Third-party benefit programs should either adjust the maximum allowable fees for all procedures or allow a standard fee per date of service per patient to accommodate the rising costs of PPE, which are provisions supported by the ADA;
  • The reimbursement methodology that immediately preceded Delta Dental of Massachusetts’ adoption of its new methodology, whose principal effect is to lower the rates paid to participating providers, should be reinstated.

Other DDMA and MDS Efforts

In April, DDMA contributed $2 million to the MDS Foundation COVID-19 Recovery Fund, established to support the continued viability of community dental offices and dentists in the state following the extended COVID-19 shutdown.

“The COVID-19 pandemic has caused many Massachusetts dental offices to close, except for emergency care,” said Leonard. “This not only limits patients’ access to non-urgent care, it creates significant financial and business challenges for dentists and other oral health providers.”

The MDS Foundation established its COVID-19 Recovery Fund with an internal commitment of $300,000 and a goal of raising $2 million from other parties. The DDMA contribution full funds the expressed fundraising target, and the MDS will identify and determine the most meaningful ways to distribute these funds.

“We are working with dentists in our network to understand the impact on their businesses and how we can best support them during the pandemic. Our investment in the MDS Fund is the first but not only step we plan to take,” said Leonard.

“Because we believe the need is even greater, we are working on additional plans to support the dentists in our network and urging our industry peers to also demonstrate their support for Massachusetts dentists and oral health providers,” said Leonard.

“I and all of the members of the MDS Foundation are deeply appreciative of the grant from DDMA to help our dentists in need during this pandemic,” said Robert Lewando, DDS, chair of the MDS Foundation.

“DDMA recognized the significant challenges our member dentists face and has risen to the challenge to help them survive at a time when many practices are in deep financial need, and I am extremely grateful to them for the action they have taken,” said Lewando.

Also in April, DDMA contributed $150,000 to the City of Boston’s Resiliency Fund, $25,000 to the Worcester Together; COVID-19 Response and Relief Fund, and $25,000 to the COVID-19 Response Fund for the Pioneer Valley.

“The losses and disruptions caused by this pandemic are widespread and ongoing,” said Leonard. “Delta Dental of Massachusetts is committed to providing more resources to support our patients, providers, and clients, and we’re continuing to evaluate other steps we can take in the coming weeks and months to secure and improve the oral health of all.”

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