House introduces bill to limit noncovered services provisions in dental plans
A bill was reintroduced in the U.S. House of Representatives to curb the practice allowing dental plans to set fees for services in which the plans have no financial liability.
Introduced Feb. 24, the Dental and Optometric Care Access Act would limit noncovered services provisions in dental and vision plans, which the ADA has supported for years. The Association said in a Feb. 25 letter that the current landscape negatively 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 often pay for their care coverage out of their own pockets or see out-of-network dentists. The legislation would stop dental plans from setting the fees network doctors may charge for services not covered by the insurers.
“This legislation is crucial to bring needed balance to contract negotiations between providers, who are often small business owners, and large dental insurance companies," according to the letter.
The Dental and Optometric Care Access Act complements laws that have passed in 43 states that limit interference with the doctor-patient relationship when the doctor delivers services insurers do not cover.
The bill aims to move toward lower dental and vision costs, increase transparency, and ultimately improve health care coverage for patients and providers. ADA President Brett Kessler, D.D.S., and Interim Executive Director Elizabeth Shapiro, D.D.S., thanked Reps. Earl “Buddy” Carter, R-Ga., and Yvette Clarke, D-N.Y., for introducing the bipartisan legislation that they said will "balance the scales and bring equity to insurer/provider contracting at the federal level."
“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.
“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,” Dr. Kessler said.
For more information about the Dental and Optometric Care Access Act, visit this webpage.
