DOC Access Act introduced amid growing patient calls for Congress to act

Through its partnership with bipartisan leaders in Congress, the American Dental Association and more than a dozen national patient advocacy groups, the AOA is making it a top priority to halt anti-doctor/anti-patient abuses by vision plans, including predatory contracting, forced discounts on noncovered services and materials, and restrictions on lab choice.

With more support than ever, the AOA-backed Dental and Optometric Care (DOC) Access Act (H.R.1385) was reintroduced on March 7 in the U.S. House by Reps. Buddy Carter, R-Ga., and Yvette Clarke, D-N.Y. AOA priority legislation, the DOC Access Act has made steady progress through Congress since its original introduction in 2015. Introduction of Senate companion legislation is expected soon as is further public support from patient advocacy groups calling on Congress to take action.

Each year, tens of millions of Americans rely on local doctors of optometry for their comprehensive vision and eye health care needs. Many patients are covered for this essential care through a combination of health plan and supplemental vision plan. Special legal treatment for and a lack of competition among vision plans has led to costly mandates being forced on patients and their doctors—higher prices and less access to care for patients while doctors face the tough choice of providing needed care to neighbors or keeping their practices viable.

The AOA has a multi-armed strategy to combat these abuses at the federal, state and local level. The reintroduction of this bill, along with its growing support, means optometry’s advocates are making significant headway.

“DOC Access is not simply an important bill that releases the doctor-patient relationship from the constrictions of abusive vision and dental care policies; it is a critical step in fixing what we all agree is a broken health care system,” says AOA President Ronald L. Benner, O.D. “The profession of optometry— and the patients we serve in more than 10,000 communities across the country—share our collective gratitude for Reps. Buddy Carter and Yvette Clarke for taking this important step to ensuring Americans have access to the eye and vision care services that are best for their health.”

Curbing vision, health plan policies that restrict care

The DOC Access Act complements state-level vision and dental plan laws enacted in 45 states by disallowing detrimental policies by ERISA and other federally regulated vision, dental and health plans. However, a federal effort is now needed as roughly one-third of patients in any given state now have a vision and/or dental plan that is federally regulated and not complying with these state laws.

The DOC Access Act would prohibit plans from: 

• Limiting patients’ and doctors’ choice of labs.
• Price fixing for noncovered services and materials.

Additionally, the bill would limit plan-doctor agreements to two years unless otherwise indicated by the doctor and includes a strong enforcement provision that encourages state and federal regulators to work together to put a stop to harmful plan abuses.

“Let’s be frank: health care is unreasonably expensive and bogged down by confusing red tape,” says Rep. Carter. “By prohibiting insurance providers from forcing doctors to participate in restrictive insurance plans or networks, doctors will be able to charge reasonable fees for the care Americans need. The DOC Access Act is a strong and necessary step in bringing free market principles back into health care and start putting patients before profits.”

Rep. Clarke adds, “Every year, millions of American families go to their local doctor of optometry for their vision and eye health care needs. Unfortunately, special legal treatment for and a lack of competition among vision plans has led to higher prices and less access to care for patients while doctors face the difficult choice of providing needed care to folks in their community or keeping their practices viable. The DOC Access Act aims to combat this issue by putting the power back in the hands of the patients and their doctors to control their own important health care decisions. I’m proud to join my colleagues across the aisle to help preserve access to care and help create a fairer market into our nation’s health care industry.”