DOC Access Act of 2025
Sponsored By: Representative Carter, Earl L. "Buddy" [R-GA-1]
Introduced
Summary
Protects dental and vision patients from surprise charges and strengthens provider control over contracts. It creates a new federal rule that defines covered services, limits what providers can bill enrollees for noncovered items, requires provider consent for contract extensions after two years, and stops plans from forcing providers to use specific labs.
Show full summary
- Families and patients: Providers can bill enrollees for noncovered items only up to the usual amount charged to non-enrollees. For dental cleanings a participating dentist may bill only the contracted network fee even if the cleaning exceeds an annual maximum.
- Providers: Optometrists and dentists must agree to any limited-scope plan extension beyond two years. They may elect for a plan year to be excluded from many of these requirements but not from the two-year contract rule.
- Plans and insurers: Must treat services as covered when the plan is obligated to pay a reasonable and not nominal amount and cannot limit the laboratory or source of materials that a provider chooses.
- States and enforcement: The federal secretary will ask each State whether it will enforce these rules. If a State declines or does not respond within 90 days the State will be treated as not substantially enforcing them.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 0 benefits, 0 costs, 2 mixed.
New rules for dental and vision bills
This bill would set new rules for dental and vision plans and in-network dentists and eye doctors. If a service is not covered, a participating provider could bill you no more than their usual price. For any dental cleaning, you would pay only the in-network fee, even if you pass your annual maximum. Plans could not control which labs or suppliers your dentist or eye doctor uses. A service would count as covered even when plan rules like deductibles, copays, waiting periods, or frequency limits limit payment. These rules would also apply to stand-alone or limited plans; providers could opt out of the billing and lab rules for a plan year, and extensions beyond two years would need the provider’s OK each time.
State enforcement of dental and vision rules
Each year, the Secretary would ask every State if it will enforce these dental and vision rules. If a State says no, or does not answer in 90 days, the federal government would treat it as not enforcing and step in. Where a State’s insurance law conflicts, the State’s rules would control for issuers and limited dental or vision plans it governs. Protections could vary by State.
Sponsors & CoSponsors
Sponsor
Carter, Earl L. "Buddy" [R-GA-1]
GA • R
Cosponsors
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 2/24/2025
Rep. Malliotakis, Nicole [R-NY-11]
NY • R
Sponsored 3/3/2025
Rep. Brownley, Julia [D-CA-26]
CA • D
Sponsored 3/5/2025
Rep. Wagner, Ann [R-MO-2]
MO • R
Sponsored 3/10/2025
Cherfilus-McCormick
FL • D
Sponsored 3/10/2025
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 3/10/2025
Rep. Foster, Bill [D-IL-11]
IL • D
Sponsored 3/14/2025
Rep. Krishnamoorthi, Raja [D-IL-8]
IL • D
Sponsored 3/18/2025
Rep. Ramirez, Delia C. [D-IL-3]
IL • D
Sponsored 3/18/2025
Rep. Valadao, David G. [R-CA-22]
CA • R
Sponsored 3/21/2025
Bost
IL • R
Sponsored 3/21/2025
Rep. Rouzer, David [R-NC-7]
NC • R
Sponsored 3/21/2025
Van Drew
NJ • R
Sponsored 3/21/2025
Sessions
TX • R
Sponsored 3/21/2025
Rep. Pettersen, Brittany [D-CO-7]
CO • D
Sponsored 3/25/2025
Reschenthaler
PA • R
Sponsored 3/25/2025
Mrvan
IN • D
Sponsored 3/31/2025
LaHood
IL • R
Sponsored 3/31/2025
Rep. Perez, Marie Gluesenkamp [D-WA-3]
WA • D
Sponsored 3/31/2025
Simpson
ID • R
Sponsored 3/31/2025
Rep. Davids, Sharice [D-KS-3]
KS • D
Sponsored 3/31/2025
Bishop
GA • D
Sponsored 4/1/2025
Rep. Schneider, Bradley Scott [D-IL-10]
IL • D
Sponsored 4/1/2025
Jackson (IL)
IL • D
Sponsored 4/1/2025
Rep. Torres, Ritchie [D-NY-15]
NY • D
Sponsored 4/1/2025
Rep. Meng, Grace [D-NY-6]
NY • D
Sponsored 4/3/2025
Rep. Castor, Kathy [D-FL-14]
FL • D
Sponsored 4/3/2025
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 4/7/2025
Johnson (GA)
GA • D
Sponsored 4/7/2025
Womack
AR • R
Sponsored 4/7/2025
Rep. Smith, Christopher H. [R-NJ-4]
NJ • R
Sponsored 4/7/2025
Estes
KS • R
Sponsored 4/10/2025
Rep. Weber, Randy K. Sr. [R-TX-14]
TX • R
Sponsored 4/10/2025
Rep. Sorensen, Eric [D-IL-17]
IL • D
Sponsored 4/24/2025
Rutherford
FL • R
Sponsored 4/29/2025
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 5/5/2025
Rep. Harder, Josh [D-CA-9]
CA • D
Sponsored 5/6/2025
Rep. Latimer, George [D-NY-16]
NY • D
Sponsored 5/8/2025
Rep. Quigley, Mike [D-IL-5]
IL • D
Sponsored 6/5/2025
Babin
TX • R
Sponsored 6/6/2025
Rep. Suozzi, Thomas R. [D-NY-3]
NY • D
Sponsored 6/9/2025
Rogers (KY)
KY • R
Sponsored 6/9/2025
Davis (NC)
NC • D
Sponsored 6/10/2025
Budzinski
IL • D
Sponsored 6/17/2025
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 6/20/2025
Soto
FL • D
Sponsored 7/2/2025
Rep. Miller, Carol D. [R-WV-1]
WV • R
Sponsored 7/17/2025
Sewell
AL • D
Sponsored 7/17/2025
Rep. Harshbarger, Diana [R-TN-1]
TN • R
Sponsored 7/21/2025
Rep. Correa, J. Luis [D-CA-46]
CA • D
Sponsored 7/23/2025
Kelly (MS)
MS • R
Sponsored 8/29/2025
Rep. Stefanik, Elise M. [R-NY-21]
NY • R
Sponsored 8/29/2025
Gonzalez, V.
TX • D
Sponsored 9/4/2025
Norcross
NJ • D
Sponsored 9/9/2025
Rep. Lee, Susie [D-NV-3]
NV • D
Sponsored 9/23/2025
Rep. Pappas, Chris [D-NH-1]
NH • D
Sponsored 9/30/2025
Rep. Fields, Cleo [D-LA-6]
LA • D
Sponsored 10/3/2025
Rep. Murphy, Gregory F. [R-NC-3]
NC • R
Sponsored 10/3/2025
Rep. Titus, Dina [D-NV-1]
NV • D
Sponsored 10/3/2025
Mannion
NY • D
Sponsored 10/3/2025
Schmidt
KS • R
Sponsored 10/3/2025
Rep. Ezell, Mike [R-MS-4]
MS • R
Sponsored 10/3/2025
Rep. Wilson, Joe [R-SC-2]
SC • R
Sponsored 10/8/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 10/8/2025
Rep. Owens, Burgess [R-UT-4]
UT • R
Sponsored 10/8/2025
Rep. Mann, Tracey [R-KS-1]
KS • R
Sponsored 10/8/2025
Rep. Vindman, Eugene Simon [D-VA-7]
VA • D
Sponsored 10/8/2025
McBride
DE • D
Sponsored 10/10/2025
Rep. Baumgartner, Michael [R-WA-5]
WA • R
Sponsored 10/10/2025
Rep. Beatty, Joyce [D-OH-3]
OH • D
Sponsored 10/14/2025
Rep. Barrett, Tom [R-MI-7]
MI • R
Sponsored 10/17/2025
Mullin
CA • D
Sponsored 10/17/2025
Davis (IL)
IL • D
Sponsored 10/21/2025
Rep. Bergman, Jack [R-MI-1]
MI • R
Sponsored 10/21/2025
Swalwell
CA • D
Sponsored 10/21/2025
Rep. Panetta, Jimmy [D-CA-19]
CA • D
Sponsored 10/28/2025
Rep. Neguse, Joe [D-CO-2]
CO • D
Sponsored 10/28/2025
Rep. Vasquez, Gabe [D-NM-2]
NM • D
Sponsored 11/4/2025
Pingree
ME • D
Sponsored 11/4/2025
Rep. Hoyle, Val T. [D-OR-4]
OR • D
Sponsored 11/7/2025
Rep. Mackenzie, Ryan [R-PA-7]
PA • R
Sponsored 11/12/2025
Craig
MN • D
Sponsored 11/17/2025
Goldman (TX)
TX • R
Sponsored 11/20/2025
Rep. Williams, Roger [R-TX-25]
TX • R
Sponsored 12/1/2025
Norman
SC • R
Sponsored 12/2/2025
Rep. Miller, Mary E. [R-IL-15]
IL • R
Sponsored 12/3/2025
Simon
CA • D
Sponsored 12/5/2025
Rep. Ansari, Yassamin [D-AZ-3]
AZ • D
Sponsored 12/11/2025
Rep. Bynum, Janelle S. [D-OR-5]
OR • D
Sponsored 12/12/2025
Rep. Gillen, Laura [D-NY-4]
NY • D
Sponsored 12/15/2025
Rescom. Hernández, Pablo Jose [D-PR-At Large]
PR • D
Sponsored 12/17/2025
Evans (CO)
CO • R
Sponsored 12/17/2025
Rep. Fry, Russell [R-SC-7]
SC • R
Sponsored 12/18/2025
Randall
WA • D
Sponsored 1/12/2026
Rep. Ross, Deborah K. [D-NC-2]
NC • D
Sponsored 1/14/2026
Rep. Westerman, Bruce [R-AR-4]
AR • R
Sponsored 1/21/2026
Moore (WV)
WV • R
Sponsored 2/3/2026
Langworthy
NY • R
Sponsored 2/5/2026
Rep. McDonald Rivet, Kristen [D-MI-8]
MI • D
Sponsored 2/10/2026
Rep. Walkinshaw, James R. [D-VA-11]
VA • D
Sponsored 3/12/2026
DelBene
WA • D
Sponsored 3/17/2026
Rep. Amo, Gabe [D-RI-1]
RI • D
Sponsored 3/18/2026
Stansbury
NM • D
Sponsored 3/19/2026
Biggs (SC)
SC • R
Sponsored 3/24/2026
Rep. Whitesides, George [D-CA-27]
CA • D
Sponsored 3/25/2026
Lofgren
CA • D
Sponsored 3/25/2026
Rep. Gooden, Lance [R-TX-5]
TX • R
Sponsored 4/6/2026
Rep. Larsen, Rick [D-WA-2]
WA • D
Sponsored 4/6/2026
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 4/6/2026
Tiffany
WI • R
Sponsored 4/9/2026
Hageman
WY • R
Sponsored 4/13/2026
McGuire
VA • R
Sponsored 4/15/2026
Kelly (PA)
PA • R
Sponsored 4/15/2026
Rep. Garcia, Sylvia R. [D-TX-29]
TX • D
Sponsored 4/16/2026
Rep. Scholten, Hillary J. [D-MI-3]
MI • D
Sponsored 4/16/2026
Rep. Van Orden, Derrick [R-WI-3]
WI • R
Sponsored 4/21/2026
Rep. Guest, Michael [R-MS-3]
MS • R
Sponsored 4/27/2026
Van Epps
TN • R
Sponsored 5/4/2026
Rep. García, Jesús G. "Chuy" [D-IL-4]
IL • D
Sponsored 5/12/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov