The DOC Access Act and Georgia Dentistry
Of the current collection of legislation before congress, the Dental and Optometric Care (DOC) Access Act stands out as being of interest to dentists. The DOC Access Act was initially introduced in the House in 2015, and several senators and representatives have been seeking to pass some version of it ever since. Passing the DOC Access Act would amend the Public Health Service Act to prohibit dental insurance plans from limiting charges on services that are not covered. It would also limit network agreements to 2 years unless the doctor agrees to a longer contract extension, and no restrictions would be allowed on choice of laboratories or suppliers.
Doesn’t Georgia Already Have a Law Like This?
Georgia, along with 41 other states, passed a law governing noncovered dental services. Passed in 2011, it states that, “no contract between a dental insurer and a dentist shall require a dentist to accept an amount set by the dental insurer as payment for dental care services that are not covered dental services under the covered person’s dental benefit plan.” It goes on to prohibit insurers from even implying that dentists should discount services for noncovered benefits.
What Would the DOC Access Act Add?
Insurance plans may be regulated differently depending on their characteristics. The Employee Retirement Income Security Act of 1974 (ERISA) enables self-funded insurance plans to avoid certain state regulations. Currently, self-funded plans regulated by ERISA may still claim exemption from Georgia’s Non-covered Dental Services Act. Federal legislation like the DOC Access Act closes regulatory loopholes left by the gap between state and federal law. DOC Access would also add the aforementioned provisions governing contract length and protections of laboratory and supplier choice.
The American Dental Association supports the passage of the DOC Access Act, and it argues that the legislation will foster competition in the insurance industry, benefit consumers, and bring balance to contract negotiations. To support the passage of DOC Access, reach out to your Senators and Representative. Also, don’t forget to help support local legislative efforts by attending Law Day 2025 and participating in GDA’s Contact Dentist Program.
