IS THE ADA’S COLLECTING INFORMATION THAT COULD BE USED AS THE BASIS FOR A CLASS-ACTION LAWSUIT AGAINST MANAGED CARE ORGANIZATIONS AND OTHER INSURANCE COMPANIES A POSITIVE MOVE?
In May, the ADA’s Division of Legal Affairs began seeking information from members about their experiences with managed care organizations, or MCOs, and other insurance carriers. These data, said ADA officials, possibly could be used as the basis of a class-action lawsuit for, among other things, alleged intrusions on dental practice decision making and the dentist/patient relationship.
ADA President Dr. Richard F. Mascola describes the ADA’s initiative as a signal to the profession that "the Association is becoming more aggressive, picking up speed, in responding to the alleged heavy-handedness" of insurance companies and MCOs when they interfere with the patient’s ability to get the benefits of their contract.
ADA General Counsel Peter M. Sfikas has noted that a growing responsiveness in the courts to public concerns about the health care system has opened the door to more aggressive action on behalf of patients and professionals. "Whether we’ll eventually find anything of ultimate value behind that door, only time will tell," he said, adding that the legal division would assess whether enough evidence had been discovered to warrant a lawsuit.
When JADA asked readers in July what they thought about this course of action, 87 percent said it is a good idea. "This is the best thing the ADA might ever do," said one reader.
Ten percent of these respondents simply said, "It’s about time." A few others added, "Go for it," and one said, "Sic ’em."
"This action may return the decision-making questions back to the patient and the dentist," said a reader.
"We need to attack this problem as an industry or we will lose control of our profession," echoed another.
Just 11 percent of respondents said they think this is a bad idea.
"No one makes us participate in these plans," said a reader. ""If you are suspicious, don’t enroll in or accept the plan."
A few mentioned the time and cost involved in such an initiative. "It is not something the general membership should get involved in either timewise or financially," said one. "Let those who have ‘bedded’ down with these companies assume responsibility for their problems."
Two percent of the respondents said they "don’t know" if the ADA’s action is a good or bad idea.
