ADA expresses support for legislation that would prohibit noncovered services provisions in dental, vision plans

Dental and Optometric Care Access Act of 2023 ‘crucial to bring needed balance to contract negotiations’

The ADA sent a letter to the U.S. House sponsors of federal non-covered services legislation on March 30, expressing the Association’s “strong support for this bipartisan legislation that would prohibit noncovered services provisions in dental and vision plans.”

HR 1385, the Dental and Optometric Care Access Act of 2023, will provide greater access to high-quality care by helping to curb anti-patient and anti-competitive practices of dental insurance plans, wrote ADA President George R. Shepley, D.D.S., and ADA Executive Director Raymond A. Cohlmia, D.D.S.

“This legislation is crucial to bring needed balance to contract negotiations between providers, who are often small business owners, and large dental insurance companies,” wrote Drs. Shepley and Cohlmia. “Passage of HR 1385 would balance the scales and bring equity to insurer/provider contracting at the federal level.”

Drs. Shepley and Cohlmia said it is unreasonable for dental plans to set fees for services in which the plans have no financial liability.

According to the letter, 45 states have enacted laws that limit interference with the doctor-patient relationship when the doctor delivers services insurers do not cover.

“However, a federal effort is needed as many dental plans are regulated on the federal rather than state level,” they wrote. “The current landscape adversely impacts competition in the dental plan market, which is dominated by only a few national carriers in many states, and shifts costs to patients who are paying for their coverage out of their own pockets or are seeing a dentist out-of-network.”

Follow all of the ADA’s advocacy efforts at ADA.org/advocacy.