Two Congressmen Reintroduce Legislation Related to Patient Access and Managed Care

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WASHINGTON—Rep. Dave Loebsack (D-Iowa) and Rep. Earl L. “Buddy” Carter (R-Ga.) have introduced the Dental and Optometric Care Access (DOC Access) Act, which they said would “ensure patients have access to high-quality dental and optometric care by providing fairness in contracts between doctors and dental and vision insurers,” according to an announcement on Loebsack’s website last week. The bill, formally known as H.R. 3762, would amend Title XXVII of the Public Health Service Act. It was introduced July 15, but the full text of the bill has not yet been posted on the House website. The two congressmen also introduced similar legislation in early 2017, as VMAIL reported

The proposed 2019 legislation would allow for dentists, optometrists and ophthalmologists “to charge an amount that is usual and customary for the services that are not covered under an insurance plan rather than the insurer’s mandated fee schedule,” Loebsack’s announcement noted. Loebsack and Carter both serve on the House’s Committee on Energy and Commerce.

“It is imperative that dentists, optometrists and ophthalmologists are able to provide their patients with high-quality care,” Loebsack said in the announcement. “The DOC Access Act will give dentists, optometrists and ophthalmologists the freedom to charge a reasonable rate for the care their patient need.”

The American Optometric Association (AOA) and the American Dental Association (ADA) are supporting the proposed legislation, according to an AOA announcement. AOA said the bill is needed to “counter abusive practices in the federally regulated vision and dental coverage markets, and ensure patients and doctors—as opposed to insurance and plan executives—are at the center of important health care decision-making.”

“The DOC Access Act seeks to completely ban, at the federal level, anti-doctor and anti-patient policies of vision plans,” AOA president Barbara L. Horn, OD, said in the announcement. “The AOA is proud to join with the American Dental Association in supporting this legislation and in thanking Reps. Loebsack, Carter and all of the other original co-sponsors for their decisive leadership.”

The National Association of Vision Care Plans (NAVCP), however, said it believes the proposed legislation actually is “anti-consumer” and would lead to higher costs for patients.

“Managed vision care benefits are now offered by more than 80 percent of all U.S. employers to their employees,” said Julian Roberts, NAVCP’s executive director. “Those benefits greatly expand patient access to affordable, high-quality vision treatment and vision correction, and are fundamental to building and maintaining eyecare professional practices across the country.”

Roberts said NAVCP is “still awaiting to review the bill’s language,” but that if it is similar to the predecessor bill, it will be “anti-consumer, prevent cost transparency on services and materials, and significantly increase the cost of patient vision care.”

He added, “Further, it will remove the rights of individual eyecare professionals to decide how and if they want to contract with managed vision care plans to best serve their patients and their practice.”

Roberts said the association looks forward to working with the bill’s sponsors “to ensure that vision health is achievable for all Americans.”