Recently, we’ve heard from many of our members voicing concerns about the substantial increase in costs for each patient visit in the COVID-19 era. New challenges such as purchasing extra PPE, hiring more staff, and treating fewer patients during the course of a day all raise concern for dentists. Some of you have asked, “What is the IDA doing about this?”
Antitrust laws prohibit the IDA from being involved in pricing and reimbursement discussions. These laws provide that competitors, such as dentists, cannot get together and discuss pricing. An association like IDA is essentially a group of competitors, and as such the IDA cannot be involved in PPE pricing discussions with individual dentists or third party payers. IDA is also not allowed to negotiate reimbursement rates for the CDT code D1999, and cannot be involved in discussions on what dentists should charge patients for PPE, as this could potentially be a violation of antitrust statutes. Unfortunately this is not an area where we can support our members.
The IDA shares the ADA’s concern that “it is inappropriate for any third party benefit program to unfairly place the cost burden on dentists by disallowing or bundling charges for PPE on the pretext that the payment for additional required PPE is included in the payment for any other procedure billed for the visit.”