WASHINGTON, D.C. – Reps. Earl L. “Buddy” Carter (R-GA) and Yvette Clarke (D-NY) introduced the bipartisan Dental and Optometric Care Access (DOC Access) Act to help lower dental and vision care costs and put control of important health care decisions back into the hands of patients and their doctors.
The legislation addresses the increased consolidation and vertical integration among dental and vision insurance providers, which is leading to higher prices, fewer options for patients and providers, and diminished community access to needed care.
“It is important that we continue to work towards affordable, accessible, and high-quality health care for all Americans. The DOC Access Act moves us in the right direction by ensuring dentists and optometrists can make decisions that are best for them and their patients, not the insurance company,” said Rep. Carter.
"Every year, countless Americans are forced to confront inordinate roadblocks to the vision and eye care they need due to unnecessary restraints on their optometrists. People should always be empowered to make their own healthcare decisions, just as good doctors should always be available to carry them out. I’m proud to support this bipartisan legislation that puts power back in the hands of the patients, preserves their access to care, and creates a more equitable, more sustainable healthcare industry," said Congresswoman Yvette D. Clarke.
"Patients Rising is so thankful that Reps. Carter and Clarke are leading the charge on such an important issue to patients across the country," said Terry Wilcox, CEO and Chief Mission Officer for Patients Rising. "Like we see with pharmacy benefit managers, dental and vision benefit managers are out of control - and patients are literally paying the price. With only a handful of insurers dominating the market, their middlemen are hard at work setting prices and rigging a system that benefits only them at the expense of patients and our communities. The last place your insurer should be is in the exam room with you and your doctor. That's why we're thankful for this effort and we're committed to continue working hard to expose and put an end to the costly, controlling, and care-limiting schemes of insurers and their benefit managers."
“The AOA, doctors of optometry, and patients across the country applaud the introduction of the bipartisan DOC Access Act, introduced by Reps. Carter and Clarke and supported by hundreds of visionary House and Senate health policy leaders,” said Steven Reed, O.D., AOA President. "This legislation provides a clear, patient-focused solution to put a stop to abusive practices by Vision Benefit Managers (VBMs), including price fixing for items and services not covered by the plan and steering patients and doctors to VBM-owned labs, which too often results in higher costs, inferior products, and unacceptable wait times. From statehouses across the country to the U.S. Capitol, legislators are taking commonsense action to address the increasingly harmful effects of growing VBM market concentration and vertical integration, and this bill is a pivotal step in continuing that momentum.”
“I would like to thank Representatives Carter and Clarke for their leadership to bring more balance to contract negotiations to address abusive practices of large dental insurance companies and the impact on small business owners and their patients,” said Brett H. Kessler, D.D.S., president of the American Dental Association. “Our patients are being negatively impacted when dental insurance companies interfere with care delivery by dictating how much a doctor may charge a plan enrollee, even though they choose not to cover those services in the plan. The DOC Access Act will play a crucial part in curbing the anti-patient and anti-competitive practices of dental insurance plans.”
Read full bill text here.
Background
Both the dental and vision insurance markets are highly concentrated and increasingly vertically integrated. With one or two plans dominating most markets in which they operate, vision and dental insurers force doctors to sign agreements which include costly and controlling provisions, on the threat of being otherwise relegated to out-of-network status for their own communities. These agreements often set prices on goods and services, even those not covered by the plan, and require patients and doctors to patronize other subsidiary businesses, including optical laboratories owned by vision plans.
Similar to laws passed in nearly every state, the DOC Access Act seeks to apply safeguards to federal regulated plans in an effort to help states progress toward lower costs, greater transparency, and better options for patients and providers.
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