summary
Introduced
11/12/2020
11/12/2020
In Committee
11/12/2020
11/12/2020
Crossed Over
Passed
Dead
12/31/2020
12/31/2020
Introduced Session
116th Congress
Bill Summary
A bill to amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. 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 establishes a private right of action for a person adversely affected by a violation of this bill. The bill does not supersede state laws regarding health insurers and dental or vision benefit plans.
AI Summary
This bill, the Dental and Optometric Care Access Act of 2019 or the DOC Access Act of 2019, aims to improve health care coverage under vision and dental plans. The key provisions are:
1. It prohibits private health insurance plans from setting rates for items and services (except for dental cleanings) provided by doctors of optometry, dental surgery, or dental medicine, unless the plan pays a substantial amount for those services.
2. It allows agreements between these doctors and plans offering limited-scope dental or vision benefits to be extended for longer than 2 years, but only with the prior acceptance of the doctor for each extension.
3. It prohibits plans from restricting these doctors' choice of laboratories or suppliers.
4. It establishes a private right of action for people adversely affected by violations of the bill, allowing them to seek injunctive relief and monetary damages.
The bill does not supersede state laws regarding health insurers and dental or vision benefit plans.
Committee Categories
Health and Social Services
Sponsors (2)
Last Action
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (on 11/12/2020)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.congress.gov/bill/116th-congress/senate-bill/4894/all-info |
| BillText | https://www.congress.gov/116/bills/s4894/BILLS-116s4894is.pdf |
| Bill | https://www.congress.gov/116/bills/s4894/BILLS-116s4894is.pdf.pdf |
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