ADA Backs DOC Access Act as House Subcommittee Weighs Dental Contracting Bill

Edited by Orthotown staff

The ADA submitted a statement for the record supporting the Dental and Optometric Care Access Act ahead of a Sept. 15 hearing of the House Energy and Commerce Committee’s Health Subcommittee, where the measure was one of 17 legislative proposals under discussion.

H.R. 1521 was introduced Feb. 24, 2025, by Rep. Buddy Carter, R-Ga., and Rep. Yvette Clarke, D-N.Y., and would amend the Public Health Service Act. The hearing was titled “Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity,” and no dental witness appeared on the panel.

Under the bill, a dentist participating in a plan’s network could generally charge up to their usual and customary fee for services the plan does not cover, rather than a fee the insurer sets. Dental cleanings are carved out of that provision: for any cleaning, including one that exceeds the patient’s annual maximum, the dentist could charge only the contracted network fee.

Two further provisions address contract terms. A contract could not be extended beyond two years unless the provider accepted the extension in advance, and a plan could not restrict a dentist’s choice of dental laboratories or suppliers.

ADA President Richard Rosato and Executive Director Nader Nadershahi argued that plans should not be setting fees for services they carry no financial liability for. They wrote that passage would “balance the scales and bring equity to carrier-provider contracting” at the federal level.

More than 40 states have enacted laws limiting insurer involvement in fees for services dental plans do not cover. The ADA said self-funded plans governed by the Employee Retirement Income Security Act can claim exemption from those state protections absent federal action.

The association also cited market concentration figures from a Government Accountability Office report issued in March. In 2024, the three largest dental insurers in each state held a median 66.8% of group-market enrollment, with their combined share ranging from about 38% to 98%. In 11 states, the top three held at least 80%.

Clarke said the bill seeks to lower prices and return control to patients and their doctors, and Carter raised health care consolidation during the hearing. The ADA urged the committee to mark up H.R. 1521, which would be the next step if lawmakers decide to proceed.

Sources:
U.S. House Committee on Energy and Commerce, Health Subcommittee hearing record, Sept. 15, 2026: docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=119549
H.R. 1521, Dental and Optometric Care Access Act, introduced Feb. 24, 2025: docs.house.gov/BILLS-119HR1521ih.pdf
U.S. Government Accountability Office, GAO-26-107787, “Dental Insurance: Information on Market Concentration,” March 9, 2026: gao.gov/products/gao-26-107787
ADA News, “House committee considers DOC Access Act,” Sept. 16, 2026: adanews.ada.org/2026/september/house-committee-considers-doc-access-act