Bill > HR1521

This bill, known as the Dental and Optometric Care Access Act of 2025 (DOC Access Act), aims to improve health care coverage under vision and dental plans by introducing several key provisions. The legislation establishes new rules for group health plans and insurance coverage, allowing doctors of optometry, dental surgery, and dental medicine to charge patients for non-covered services at their usual and customary rates, with a specific exception for dental cleanings where providers can only charge the contracted network fee. The bill mandates that health plans cannot restrict providers' choice of laboratories or service suppliers and allows for plan agreements with these medical professionals to be extended for terms longer than two years only with the prior acceptance of the doctor or entity. The legislation also provides a mechanism for providers to elect to be excluded from certain requirements and requires the Secretary of Health to annually notify states of their authority to enforce these provisions. Additionally, the bill includes a clause ensuring that state laws directly affecting health insurance issuers and dental or vision benefit plans will have exclusive jurisdiction, meaning that if state law conflicts with the bill's amendments, the state law will prevail. The overall intent is to provide more flexibility and transparency for healthcare providers and patients in vision and dental care coverage.

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https://www.congress.gov/bill/119th-congress/house-bill/1521/all-info