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Carter Introduces Legislation to Ensure Access to Quality Dental and Optometric Care

Congressman Earl L. “Buddy” Carter (GA-01) has introduced the Dental and Optometric Care Access (DOC Access) Act, to provide fairness in contracts between doctors and insurers to increase the quality of care for patients and eliminate anti-competitive practices.

Current mandates in insurance provider agreements require doctors to charge patients for services that are not covered under vision or dental plans at unpredictable and unusual rates. 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.

“This legislation is necessary to provide doctors with greater flexibility in meeting the needs of their patients,” Carter said. “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. This legislation is a strong and necessary step in bringing free market principles back into healthcare by removing anti-competitive business practices.”

Thirty-five states – including Georgia – have enacted similar legislation addressing the coverage and fees for non-covered services. However, many insurance providers are able to sidestep these laws because the offered plans are regulated on the federal level instead of on the state level.

“I am thrilled,” said Maxine Feinberg, D.D.S., president of the American Dental Association. “And I speak on behalf of the ADA’s 158,000 members in thanking Rep. Carter for introducing this legislation, which would prohibit dental insurance companies from interfering in the doctor-patient relationship by dictating prices for services they don’t even cover. State after state have passed similar laws, but federal action is necessary in order to apply the prohibition to all health care coverage products.”

“Rep. Buddy Carter’s leadership in Congress and his determination to expand access to the essential eye health and vision care doctors of optometry provide will make patients healthier and insurers and plans more accountable,” said American Optometric Association President Steven A. Loomis, O.D.  "The DOC Access Act —which the AOA is proud to support – was written to ensure that doctors and patients, not insurance and plan executives, are again at the center of important, personal and personalized health care decisions.”

The only pharmacist in Congress, Carter owned and operated community pharmacies for more than thirty years. He previously served in the Georgia General Assembly and as Mayor of Pooler, Georgia where he used his business and health care experience to advocate for returning free market principles back into healthcare.