The DOC Access Act of 2023 changes how dental and vision insurance plans can work with dentists and eye doctors. Right now, if you go to a dentist or optometrist who's in your insurance network, they can only charge you what your insurance allows. This bill says that if a doctor wants to provide something your insurance doesn't cover—like cosmetic dental work or premium vision services—they can charge you their regular price, as long as it's the same amount they'd charge someone without insurance.

The bill also protects dentists in a couple of important ways. First, if you need a dental cleaning that goes beyond what your insurance covers in a year, the dentist can only charge you the network rate (the discounted price), not their full price. Second, dentists can't be told which labs or suppliers they have to use—they get to choose who they work with. For vision and dental plans that offer limited coverage, insurance companies can't force doctors to renew contracts for more than two years at a time without the doctor agreeing each time.

The law gives states the power to enforce these rules, and if a state doesn't want to enforce them, the federal government can step in. However, states can create their own dental and vision insurance rules that override this federal law if they choose to. Essentially, this bill gives dentists and eye doctors more flexibility in pricing uncovered services and more control over their business practices, while still keeping insurance plans in place for covered care.

DOC Access Act of 2023

Manchin, Joe, III

Dentist and Optometric Care Access Act of 2023 or the DOC Access Act of 2023 This bill prohibits private health insurance plans from setting rates for items and services, except for dental cleanings, provided by a doctor of optometry, of dental surgery, or of dental medicine for which the plan does not pay a substantial amount. Additionally, an agreement between a plan and such a doctor for limited scope dental or vision benefits may last longer than two years only with the prior acceptance of the doctor for each term extension. Plans also may not restrict such a doctor's choice of laboratories or suppliers. Such doctors may elect to waive the application of the payment amount and choice of laboratories provisions of this bill. The bill does not supersede state laws regarding health insurers and dental or vision benefit plans.