The Legal Aid Society, Willkie Farr & Gallagher LLP, and Freshfields Bruckhaus Deringer are pleased to announce the preliminary approval of a class action settlement in Ciaramella et al. v. James V. McDonald – a class action litigation filed on behalf of New York State Medicaid-eligible people over the age of 21 that challenged New York State’s limitations on Medicaid coverage for root canals, crowns, replacement dentures and dental implants.

For the complete proposed settlement document please click here.

Settlement Information

As part of the settlement, DOH will do the following:

• Expanded coverage. DOH will provide expanded NY Medicaid coverage for the Services to Class members for whom the Services are medically necessary, subject to certain requirements detailed in the Proposed Settlement.
• Policy and guidance. DOH will revise official DOH policy concerning the Services (the “Revisions”) and issue guidance concerning the Revisions (the “Guidance”). Furthermore, DOH will provide a notice and a webinar to Managed Care Organizations (“Plans”) that provide dental coverage to Medicaid recipients in the State of New York, as well as local social services districts and the Office of Temporary Disability Assistance, to educate these parties about the Revisions and the Guidance.
• No future changes. For four years, DOH will not change the Revisions in any way that could deny or limit any of the Services, without the agreement of Plaintiffs’ lawyers or a change of law requiring changes to the Revisions;
• Monitoring. DOH will provide various reports to Plaintiffs’ lawyers in order to facilitate the monitoring of DOH’s compliance with the Revisions. DOH will document noncompliance by Plans, and require corrective action, if needed.

Fairness Hearing

The Fairness Hearing will be held, September 25, 2023 at 2:00pm in Courtroom 18A, 500 Pearl Street, New York, NY 10007 before Magistrate Judge Sara L. Cave. Please email MedicaidDentalCase@legal-aid.org or call 212-298-3380, if you have any questions.

Class Notice in English
Class Notice in Spanish