ADA, Foundation officials invite dentists to ‘donate their share’
The agreement expected to settle the ADA’s federal lawsuit against Aetna Inc. centers on actions the insurer will take to improve the fairness and speed of claims processing, to reduce the administrative burden on dental offices and, ultimately, to enhance patient care.
Most practitioners are likely to view the settlement’s financial elements as "a secondary benefit behind the change in business practices," said Dr. T. Howard Jones, ADA president.
"The ADA did not file this lawsuit for financial gain for itself or individual members," he said. "Our purpose was to eliminate the unfair business practices that Aetna and other insurance companies have engaged in for years, and we’ve done that through this settlement."
Individual dentists who have treated Aetna patients within the "class period" specified in the agreement—Aug. 15, 1995, to the present—may be eligible for a small one-time payment from the settlement. A key beneficiary of the settlement will be the Association’s charitable arm, the ADA Foundation—and through it, the entire dental profession and the patients it serves.
The agreement, which awaits court approval, calls for Aetna to establish a settlement fund containing $5 million, including $1 million to be paid directly to the Foundation. The remaining $4 million will be available for payments to class-member dentists.
But ADA and ADAF officials are encouraging class members to donate their share of the settlement to the Foundation, which will use it for dental health education, research and access-to-care and other charitable programs.
"Class-member dentists who opt to donate their share can enhance the work of the Foundation," said Dr. Arthur A. Dugoni, newly elected president of the ADAF Board of Directors. Such donations, he said, will help the Foundation "make even greater strides in improving health and making lives better, one person at a time."
Through the Foundation, the ADA is providing "a way for dentists, if they want to, to direct these settlement dollars toward a good cause," said Dr. James B. Bramson, ADA executive director.
Payments to individual class members are expected to be small, just as they were in Aetna’s recently settled suit with physicians. In an article published Aug. 19, The New York Times estimated that the total class membership in dentistry’s suit will number 40,000 to 50,000 dentists—those who have treated Aetna patients either under contract to the insurer or as "out-of-network" providers. If that estimate is correct, class members would receive $80 to $100 each, their share of the $4 million settlement fund.
ADA Chief Legal Counsel Peter M. Sfikas said the settlement agreement soon would be submitted to Judge Federico A. Moreno of South Florida’s U.S. District Court in Miami.
Mr. Sfikas said it is "very likely" that the judge will grant preliminary approval of the settlement. After that, Aetna will be given 30 days to release a Proof of Claim form that dentists can use to show that they qualify as class members. The form, which must be notarized for submission, will be printed in the ADA News, made available by fax and be posted online at ADA.org, the Association’s Web site.
"We’re urging Aetna to release the Proof of Claim form ahead of the 30-day deadline," said Mr. Sfikas, but, he added, "these things unfortunately take time."
Dentists who choose to donate their portion of the settlement to the ADA Foundation have two options. The first and simplest option is to do nothing—that is, do not file a Proof of Claim form, in which case the settlement share to which the dentist may be entitled automatically would be donated to the Foundation. The second option, which may yield a tax deduction for the donor, is to fill out the Proof of Claim form and indicate, by checking a box on the form, that payment is to be made directly to ADAF.
(ADA legal staff says dentists may wish to consult their personal tax advisers on which option is best for them.)
Either way, say ADA and ADAF officials, dentists will be making a contribution that far exceeds the dollar amounts involved—they will be helping their profession and its patients.
