ST. LOUIS—The American Optometric Association (AOA) reported Friday that leaders of a second congressional committee have launched an inquiry into reports provided by doctors of optometry, dentists and patient advocates of alleged abusive marketplace tactics on the part of vision and dental benefit specialty coverage plans. In a Jan. 30 letter to the Government Accountability Office (GAO), Congress’ investigative arm, Reps. Cathy McMorris Rodgers, R-Wash., and Brett Guthrie, R-Ky., detailed concerns and questions related to “the effects of consolidation and vertical integration in health care” specific to vision and dental benefits.

The two lawmakers chair the Committee on Energy and Commerce and the Subcommittee on Health, respectively.

At the request of the two lawmakers, the GAO is being asked to examine “how vision and dental benefit manager consolidation, market concentration, and acquisitions of small and other independent health care practices may impact consumers—including through the prices paid by consumers, and health care providers,” according to the letter.

This action by Reps. Rodgers and Guthrie follows an earlier vision care market investigation, initiated in August 2023 and requested by Rep. James Comer, R-Ky., chair of the U.S. House Committee on Oversight and Accountability.

According to the AOA, Rep. Rodgers expressed concerns recently in opening remarks to a Jan. 31 House Energy and Commerce Health Subcommittee hearing on the growing cost of health care, noting ballooning health care costs incurred by American families “through ever-increasing insurance premiums,” tax dollars and the effect on wages due to employers’ health care expenses. In citing examples of elevated costs for patients and employers, Rep. Rodgers directly called out vision plans.

“One such example is with vision insurance, an area that has seen significant consolidation and vertical integration over the past decade,” Rep. Rodgers said. “This has led to the same companies controlling the production of frames and lenses, owning and operating nearly all the laboratories, employing the doctors and owning the independent practices. The result is less transparency and higher cost of treatment.”

Ronald L. Benner, OD, AOA president, noted that within the policy advocacy arena, the AOA is pushing back against plan policies that the organization believes work against doctors and patients, and feels that optometry is seeing growing support in both the House and Senate.

“We’ve committed our relentless advocacy network, our full grassroots capability, our AOA-PAC clout, our always-on communications platforms and our organizational strength to the job of securing policy change and needed relief for our doctors,” Dr. Benner said.

Prior to this federal investigation, the bipartisan, bicameral Dentist and Optometric Care (DOC) Access Act, H.R. 1385/S. 1424 was introduced in early 2023 to prohibit rate-setting by private health insurance plans for specified vision and dental care services and prohibit restrictions on doctors’ choice of laboratories, as well as other measures. The bill was referred for committee review in the Senate and subcommittee review in the House.

According to the AOA, nearly one-third of patients in any given state have a vision or dental plan that is federally regulated, and the association asserts that the DOC Access Act would represent a significant step toward curbing these plan policies. Additional advocacy initiatives are planned, with the association’s Capitol Hill mobilization scheduled for April, where colleagues are invited to join fellow doctors and students in Washington, D.C. to continue advocacy efforts.  

Click here for more information on advocacy initiatives by the AOA.