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ADA thanks federal legislators for sponsoring bill to prohibit noncovered services in dental, vision plans

Dental and Optometric Care Access Act reintroduced

May 26, 2021

By David Burger

The ADA is supporting a bill in both the Senate and House that would prohibit noncovered service contract provisions in dental and vision plans.

In a May 24 letter to Sens. Joe Manchin, D-W.V., and Kevin Cramer, R-N.D., the ADA thanked the lawmakers for sponsoring S 1793, the Dental and Optometric Care Access Act. The ADA, in a separate letter, thanked Reps. Yvette Clarke, D-N.Y, Buddy Carter, R-Ga., Darren Soto, D-Fla., and David B. McKinley, R-W.V., for introducing the House version of the bill, HR 3461.

“We offer our strong support for this bipartisan legislation as we believe that patients are adversely affected by provisions in dental insurance plans that dictate what a doctor may charge a plan enrollee for services not covered by the plan,” wrote ADA President Daniel J. Klemmedson, D.D.S., M.D., and Executive Director Kathleen T. O’Loughlin, D.M.D., in the letters.

“It is unreasonable for dental plans to set fees for services in which the plans have no financial liability, and that is why 41 states, including West Virginia and North Dakota, have enacted laws that limit interference with the doctor-patient relationship when the doctor delivers services insurers do not cover,” Drs. Klemmedson and O’Loughlin wrote. “However, a federal effort is needed as many dental plans are regulated on the federal rather than state level.”

Drs. Klemmedson and O’Loughlin said that 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.”

They also said the act will “provide greater access to high-quality care by helping to curb anti-patient and anti-competitive practices” of dental insurance plans.

“This legislation is crucial to bring needed balance to contract negotiations between providers, who are often small business owners, and large dental insurance companies,” Drs. Klemmedson and O’Loughlin wrote.

The act would “balance the scales and bring equity to insurer/provider contracting at the federal level," the letter concluded.

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