Analysis of Dental and Vision Plan Non-Covered Services and Materials Mandates and the Projected Role of the DOC Access Act in the Vision and Dental Markets: An Update
In 2016, we conducted a survey-based study of optometry and dentistry in North Carolina and Texas to determine the impact on fees charged in states with laws prohibiting insurers from setting fees for non-covered services. The study found that allowing insurers to set the fees doctors can charge for non-covered services led to higher costs for dental and vision patients in the U.S.
In this study, we update the 2016 study relying on the same survey design to maintain comparability. We also expand the number of targeted states to 10. The survey questions aimed to assess how dental and optometry providers changed their behavior based on state-level non-covered services laws. There were 496 responses to the dental survey and 102 responses to the optometry survey that were included in the analysis. Consistent with the 2016 research, our findings clearly suggest that dentists and doctors of optometry are not charging unreasonable prices for non-covered services after state-level laws are passed prohibiting insurers from setting fees on non-covered services. Allowing federally regulated dental and vision plans to set fees for non-covered services and require materials be provided by specific laboratories results in cost-shifting and worse outcomes for patients.