House committee leaders request study of dental insurance industry

Comptroller general would examine effects of consolidation, vertical integration on consumers, providers

The House Committee on Energy and Commerce chair is asking the Government Accountability Office to study the state of consolidation and vertical integration in the dental and vision benefits industries.

The request is the result of ongoing advocacy by the American Dental Association related to dental insurance reform, including the DOC Access Act, which would prohibit dental and vision plans from setting the fees network doctors can charge for services not covered by the insurers.

Committee Chair Cathy McMorris Rodgers, R-Wash., and Subcommittee on Health Chair Brett Guthrie, R-Ky., are asking for the study to evaluate the impacts of consolidation and vertical integration on consumers, including the prices they pay, as well as health care providers, according to the letter to Comptroller General Gene Dodaro.

“[C]onsolidation and vertical integration concerns exist in the dental benefits market,” the chairs said in the letter. “We are interested in understanding the effects of consolidation and vertical integration in health care and how incentives change when the entity responsible for paying for care financially aligns itself with the entity responsible for providing such care.”

The requested study would look at the extent to which providers of dental and vision benefits are vertically integrated with payers and whether these arrangements create an opportunity to evade existing laws and regulations. It would also assess whether there is sufficient enforcement authority and capacity to address these concerns.

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