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Dentist Group Organizes RICO Suit

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NU Online News Service, May 20, 2003, 1:10 p.m. EDT – The American Dental Association, Chicago, is trying to organize a legal action against dental managed care companies that would be similar to the litigation that lawyers for medical doctors have organized against major medical insurers.

The ADA says it and two member dentists have filed a suit in the U.S. District Court in Miami accusing several dental insurers of violating the Racketeer Influenced and Corrupt Organization Act.

The suit also accuses the insurers of violating state laws by “illegally paying their in-network dental providers less than their charges for provided dental services and with late payments in states with prompt-pay statutes,” the ADA says in a statement about the suit.

The ADA charges that the insurers have been changing procedure codes to less expensive codes; reducing payments by bundling codes for two or more procedures into a single code; and using their economic power to make dentists accept “abusive practices.”

The defendants named in the lawsuit are CIGNA Corp., Philadelphia, and its dental insurance unit; MetLife Inc., New York, and its dental insurance unit; Connecticut General Life Insurance Company, Hartford; and Mutual of Omaha Insurance Company, Omaha, Neb.