WASHINGTON, D.C. – Reps. Earl L. “Buddy” Carter (R-GA), Yvette Clarke (D-NY), and Pete Sessions (R-TX) this week introduced the bipartisan Dental and Optometric Care Access (DOC Access) Act to provide fairness in contracts between health care providers and vision and dental insurers, thereby increasing the quality of care for patients and eliminating anti-competitive practices.
Current mandates in insurance provider agreements require doctors to charge patients unpredictable and unusual rates for services that are not covered under their vision or dental plans. The practice is especially troublesome in communities where a limited number of insurance plans control the market share and a provider has no choice but to accept an entire contract even if some terms harm their patients’ care and practice. The DOC Access Act allows dentists and optometrists to charge a fair and customary amount for the services that are not covered under an insurance plan rather than the insurer’s mandated fee schedule.
“Let’s be frank – health care is unreasonably expensive and bogged down by confusing red tape,” said Rep. Carter. “By prohibiting insurance providers from forcing doctors to participate in restrictive insurance plans or networks, doctors will be able to charge reasonable fees for the care Americans need. The DOC Access Act is a strong and necessary step in bringing free market principles back into health care and putting patients before profits.”
“Every year, millions of American families go to their local doctor of optometry for their vision and eye health care needs. Unfortunately, special legal treatment for and a lack of competition among vision plans has led to higher prices and less access to care for patients while doctors face the difficult choice of providing needed care to folks in their community or keeping their practices viable. The DOC Access Act aims to combat this issue by putting the power back in the hands of the patients and their doctors to control their own important healthcare decisions. I’m proud to join my colleagues across the aisle to help preserve access to care and help create a fairer market into our nation’s health care industry,” said Rep. Clarke.
“Millions of families in the United States visit their local optometrist and dentist for needed eye or dental care every year. Yet, in the current system, dental and vision insurance companies have too much control over important decisions patients and their doctors need to make. This has not only caused higher prices, but has also reduced access to care for patients. The DOC Access Act is aiming to fix this current problem by giving the power back to the patients and doctors, ensuring Americans have the access to the dental and vision care they need when and where they need it. I'm thrilled to join forces with my colleagues from both sides of the aisle, so that all Americans have a relationship with their doctor that is based on trust and transparency, which will inevitably be in the interest of the patient,” said Rep. Sessions.
Forty-five states – including Georgia – have enacted similar legislation addressing the coverage and fees for non-covered services. However, many insurance providers can sidestep these laws because the offered plans are regulated on the federal, not state, level.
“The DOC Access Act is not simply an important bill that releases the doctor-patient relationship from the constrictions of abusive vision and dental care policies, it is a critical step in fixing what we all agree is a broken health care system,” said American Optometric Association President Ronald L. Benner, O.D. “The profession of optometry – and the patients we serve in more than 10,000 communities across the country – share our collective gratitude for Reps. Buddy Carter, Yvette Clarke, and Pete Sessions for taking this important step toward ensuring more Americans have access to the eye and vision care and services that are best for their health.”
“We offer our strong support for this bipartisan legislation that would prohibit dental insurance companies from interfering in the doctor-patient relationship by dictating prices for services they don’t even cover. While a majority of states have passed similar laws, the DOC Access Act will ensure all patients in the country are protected, no matter how their dental plans are regulated. The American Dental Association thanks Representatives Carter, Clarke and Sessions on behalf of our members and patients for their efforts to balance the scales and bring equity to insurer-provider contracting at the federal level,” said George R. Shepley, D.D.S., president American Dental Association (ADA).
Read the full bill text here.
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