AGD Supports Legislation Reintroduced to Address Noncovered Services Issue
The Dental and Optometric Care (DOC) Access Act (H.R.3461/S.1793) was reintroduced in the House on May 21 by Representatives Yvette Clarke (D-NY), Buddy Carter (R-GA), Darren Soto (D-FL), and David McKinley (R-WV), and in the Senate on May 24 by Senators Joe Manchin (D-WV) and Keven Cramer (R-ND). The bill would help ensure fairness in contracts between doctors and insurers by prohibiting noncovered service contract provisions in dental and vision plans.
AGD sent letters of support to the House and Senate sponsors of the DOC Access Act on May 26, thanking them for taking the lead on this critical piece of legislation.
The DOC Access Act would allow dentists to charge an amount that is usual and customary for services not covered under an insurance plan rather than the insurer’s mandated fee schedule. Additionally, it will limit plan contracts to two years unless a dentist chooses to extend the contract for another term. The bill also includes a private right of action provision that allows individual doctors to take offending plans directly to court.
Impact on General Dentistry: AGD is pleased the DOC Access Act has been reintroduced in this session of Congress and strongly supports the legislation. Historically, insurance providers have mandated through agreements that doctors must charge patients for services and materials that are not covered under vision or dental plans regardless of the usual and customary rate. These charges set by the insurance provider’s fee schedule often do not cover the service or operation’s total cost. This legislation will bring better practices and free-market principles back into the healthcare system and ensure fairness in dentists and insurers’ agreements.
AGD sent letters of support to the House and Senate sponsors of the DOC Access Act on May 26, thanking them for taking the lead on this critical piece of legislation.
The DOC Access Act would allow dentists to charge an amount that is usual and customary for services not covered under an insurance plan rather than the insurer’s mandated fee schedule. Additionally, it will limit plan contracts to two years unless a dentist chooses to extend the contract for another term. The bill also includes a private right of action provision that allows individual doctors to take offending plans directly to court.
Impact on General Dentistry: AGD is pleased the DOC Access Act has been reintroduced in this session of Congress and strongly supports the legislation. Historically, insurance providers have mandated through agreements that doctors must charge patients for services and materials that are not covered under vision or dental plans regardless of the usual and customary rate. These charges set by the insurance provider’s fee schedule often do not cover the service or operation’s total cost. This legislation will bring better practices and free-market principles back into the healthcare system and ensure fairness in dentists and insurers’ agreements.