AOA-backed ‘DOC Access Act’ targets health and vision plan abuses
A new bill now under consideration in the U.S. House aims to level the playing field for patients and their doctors by targeting anti-patient and anti-competitive health insurance and vision plan abuses.
DOC Access Act ensures doctors and patients are again at the center of important care decisions.
Introduced by Rep. Buddy Carter (R-Georgia) on July 29, H.R. 3323—the Dental and Optometric Care Access Act, or 'DOC' Access Act—seeks to ensure fairness in contracts between doctors and insurers, eliminate anti-competitive practices in health care, and improve overall quality of patient care.
The DOC Access Act, receiving joint support from the AOA and American Dental Association (ADA), would, among other safeguards, prohibit health insurers and vision and dental plans from:
- orcing discounts on noncovered services.
- Forcing doctors to participate in a vision or dental plan as a condition for participation in a medical plan.
- Restricting a doctor's choice of a lab.
AOA President Steven A. Loomis, O.D., applauded Rep. Carter's determination to expand access to doctors of optometry, and make insurers and plans more accountable.
"The DOC Access Act—which the AOA is proud to support—was written to ensure that doctors and patients, not insurance and plan executives, are again at the center of important, personal and personalized health care decisions," Dr. Loomis said.
Rep. Carter stated in a news release that this legislation is necessary to provide doctors with greater flexibility in meeting the needs of their patients.
"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. This legislation is a strong and necessary step in bringing free market principles back into health care by removing anti-competitive business practices," Carter said.
"The American Optometric Association and the Georgia Optometric Association provided invaluable input as the DOC Access Act was being drafted," Rep. Carter added. "With the bill now introduced and our efforts to build new support underway, I'll be staying in close touch with Dr. Loomis and other AOA and GOA leaders in the push to make HR 3323 the patient access priority it needs to be on Capitol Hill."
ADA President Maxine Feinberg, D.D.S., who was quoted along with Dr. Loomis in Rep. Carter's news release announcing introduction of the DOC Access Act, said, "I speak on behalf of the ADA's 158,000 members in thanking Rep. Carter for introducing this legislation, which would prohibit dental insurance companies from interfering in the doctor-patient relationship by dictating prices for services they don't even cover. State after state have passed similar laws, but federal action is necessary in order to apply the prohibition to all health care coverage products."
The DOC Access Act specifically targets plans, such as those organized under the Employment Retirement Income Security Act, that are regulated on a federal level and often are beyond the reach of state law. As such, the AOA is continuing to urge states to advance state-level fixes to plans regulated on the state-level.
"The DOC Access Act is great news and a huge step forward toward fighting back on the national level against abusive practices of health and vision plans," says Deanna Alexander, O.D., chair of the State Government Relations Committee (SGRC). "But, we want to make absolutely clear to state affiliates that they must continue to push for legislation addressing these abuses among plans regulated at the state-level."
"SGRC and the entire AOA structure stand ready to help even more states advance much-needed fixes to ongoing abuses at the state level," Dr. Alexander adds.
'Friend of optometry'
This legislation comes as a result of the dedicated work the GOA put into building a strong relationship with the congressman when he served in the Georgia State House and later in the Georgia Senate, advocating for free-market principles in health care.
John Whitlow, O.D., GOA Legislative Committee chair, says he's proud that Rep. Carter has decided to take the lead on such an important piece of legislation.
"Congressman Carter has been a great friend of optometry since his days in the Georgia State House and Senate," Dr. Whitlow says. "It's exciting to see how our friendships on the local level can flourish and have an impact nationally."
"Former U.S. House Speaker Tip O'Neill said, 'All politics are local,' and we are continually reminded of how important it is to have these local relationships," added Dr. Whitlow. "We are so pleased to have Congressman Carter on our optometric team."
AOA members can help build support for the DOC Access Act and other key AOA-backed legislation by urging their U.S. Senators and House members to take action.
Visit the AOA's Online Legislative Action Center to learn more about AOA's priority issues and to weigh-in with your lawmakers. Also, consider taking your involvement one step further by investing in AOA-PAC and working to build a stronger connection with your elected officials as an AOA Keyperson.
Mirroring some of the AOA’s longstanding agitation over vision plans’ abuses, the Sept. 26 lawsuit by Total Vision LLC (and Total Vision, P.C.) alleges unfair competition, monopolization, tying and intentional interference with prospective business relations. Total Vision LLC supports 59 independent practices in California.
The AOA and affiliates in Illinois and Georgia score wins against vision plan abuses in a year in which doctors of optometry are making inroads across the country. When all else failed, including talks with the plans and appeals to one state’s insurance commissioner, affiliates did the hard work of helping push through bills in their legislatures that address the abuses.