On Friday, May 21, Rep. Clarke (D-NY) introduced the “Dental and Optometric Care Access Act of 2021” (“DOC Access” Act) H.R. 3461. The bill was cosponsored by Reps. Carter (R-GA), Soto (D-FL), and McKinley (R-WV).

At the time of this posting bill text is not yet available, however the bill is expected to be identical to H.R. 3762, that was introduced in the 116th Congress by Rep. Loebsack (D-IA) and that was cosponsored by Reps. Clarke, and Carter. That bill would have:

  • Allowed a provider to charge the consumer for services that are not “covered” by the health, dental or vision plan as long as the provider does not charge more than s/he charges to individuals that are not on a plan.
  • Defined services that are “covered” by a plan as only those services for which the plan is obligated to pay an amount that is “reasonable” and is not “nominal or de minimis,” terms which are not defined.
  • Allowed that contracts to be extended for a term beyond two years with the “prior acceptance” of the extension by the provider. 
  • Prohibited restrictions on choices of laboratories or suppliers.
  • Created a private right of action in district courts for a violation of the Act with injunctive relief, monetary damages up to $1000 a day and attorney’s fees/costs.

The House version of DOC Access was followed quickly by the introduction of a companion bill (S. 1793) in the Senate by Sens. Manchin (D-WV) and Cramer (R-ND) on May 24. Last Congress, the Senate version of DOC Access (S. 4894) differed from the House version in its scope, and it included a definition of “covered services,” which was similar to some state laws.

NADP has been actively opposed to the House version of DOC Access for the past several years and recently advocated against the reintroduction of any federal non-covered services legislation during Advocacy in Action.

Please contact Director of Government and Regulatory Affairs Teresa Cagnolatti with questions.

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