• Dentists Denied Class Certification In Delta Dental Antitrust Lawsuit

  10/15/2025

  On September 22, 2025, United States District Judge Elaine E. Bucklo of the Northern District of Illinois denied class certification to a putative class of approximately 240,000 dentists that alleged Delta Dental, a nationwide provider of commercial dental insurance, conspired to suppress provider reimbursement rates in violation of Section 1 of the Sherman Act.  In re Delta Dental Antitrust Litig., 1:19-cv-06734, MDL 2931 (N.D. Ill. Sept. 22, 2025).  The Court concluded that the putative class could not establish class-wide injury in a relevant antitrust market where the allegations failed to “correspond to the commercial realities of the industry.”  Because dental patients “choose providers close to where they live or work” plaintiffs could not fulfill Rule 23(b)(3)’s requirement that common legal or factual issues predominate the putative class representing dentists nationwide.  The Court further held that the proper standard for review for plaintiffs’ claims is rule of reason, requiring prospective plaintiffs to demonstrate harm in a specific market that outweighs potential procompetitive benefits to obtain relief under the antitrust laws.

  In 2019, plaintiffs representing a class of dentists filed suit against the Delta Dental Plan Association and its 39 member companies (collectively the “Delta System”).  Like most healthcare providers in the United States, these dentists are often compensated not by patients directly, but through reimbursements from the patients’ dental insurance carrier.  Reimbursement amounts are negotiated rates between the insurer and particular providers.  According to plaintiffs, defendants conspired to suppress reimbursement rates by: (1) creating “Exclusive Service Areas” (ESAs), designated territories in which its member companies operate; (2) fixing prices via multi-state claims-processing standards, information sharing, and “effective discount” requirements; and (3) restricting output by limiting terms under which member companies may operate non-Delta Dental (i.e., “second-brand”) business.

  The Delta System is a long-standing collaboration rooted in state-chartered dental service corporations and coordinated nationally since the 1960s that aims to deliver multi-state coverage to large, national employers who provide dental benefits to their employees nationwide.  The Court considered this historic context when concluding that the Delta System’s ESAs, pricing policies, and second-brand constraints should be assessed under the rule of reason, and not (as plaintiffs argued) as per se restraints of trade.  Specifically, Judge Bucklo cited evidence in the record reflecting plausible procompetitive benefits arising from defendants’ longstanding collaboration, including network expansion into rural areas, reduced free riding, and efficient multi-state claims administration.  The Court emphasized that when a restraint is plausibly ancillary to a legitimate joint endeavor and may enhance competition, the rule of reason presumptively applies.

  To the extent providers can pursue their Section 1 claims under the rule of reason, the Court’s Order forecloses their ability to do so as a class.  Specifically, the Court found plaintiffs failed to prove that questions of law or fact predominate over questions affecting individual members.  According to the Order, plaintiffs failed to show predominance because of the inherently local nature of the relevant market—while insurers may pay claims nationally, patients select dental providers locally. As such, whether Delta Dental possessed market power and caused injury turns on evidence of localized conditions and cannot be established through common, class-wide proof.

  Categories: Class Certification, Conspiracy, Horizontal Restraints, Price-Fixing, Rule of Reason, Sherman Act § 1
  

Links & Downloads

• In re Delta Dental Antitrust Litig.