,i #aaf? ,,congress #a/ ,session ,h4 ,r4 #cgfb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,july #ae1 #bjai,mr4 ,loebsack 7= himself1 ,mr4 ,c>t] ( ,georgia1 ,mr4 ,gos>1 ,mr4 ,van ,drew1 ,mr4 ,simpson1 ,ms4 ,cl>ke ( ,new ,york1 ,mr4 ,f]guson1 & ,mr4 ,pocan7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to am5d title ,,xxvii ( ! ,public ,heal? ,s]vice ,act to improve heal? c>e cov]age "u vision & d5tal plans1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,d5tal & ,optometric ,c>e ,access ,act ( #bjai or ! ,,doc ,access ,act ( #bjai4 #b4 ,improv+ heal? c>e cov]age "u vision & d5tal plans 7a7 ,9 g5]al ,title ,,xxvii ( ! ,public ,heal? ,s]vice ,act is am5d$ by ins]t+ aft] section #bgai;,a 7#db ,u4,s4,c4 #cjj;gg-#ai;a7 ! foll[+ new section3 #bgai;,b4 ,improv+ cov]age "u vision & d5tal plans 7a7 ,9 g5]al ,"u a gr\p heal? plan or individual or gr\p heal? insurance cov]age 7includ+ su* a plan or cov]age (f]+ limit$ scope d5tal or vision b5efits71 ! foll[+ %all apply3 7#a7 ,paym5t am\nts f cov]$ p]sons 7,a7 ,9 g5]al ,! plan or cov]age %all provide1 ) respect to a doctor ( optometry1 doctor ( d5tal surg]y1 or doctor ( d5tal m$ic9e t has an agreem5t to p>ticipate 9 ! plan or cov]age & t furni%es items or s]vices t are n cov]$ by ! plan or cov]age to a p]son enroll$ "u su* plan or cov]age t ! doctor may *>ge ! enrollee = su* items or s]vices any am\nt det]m9$ by ! doctor t is equal to1 or less ?an1 ! usual & cu/om>y am\nt t ! doctor *>ges individuals :o are n s enroll$ = su* items or s]vices4 7,b7 ,items & s]vices consid]$ cov]$ by a plan ,= purposes ( subp>agraph 7,a71 an item or s]vice %all be consid]$1 ) respect to a plan or cov]age1 to be cov]$ by ! plan or cov]age only if ! item or s]vice is an item or s]vice ) respect to :i* ! plan or cov]age is obligat$ to pay an am\nt t is reasonable & is n nom9al or de m9imis4 7#b7 ,duration ( limit$ scope vision & d5tal plans ,9 ! case ( an agreem5t betwe5 su* a doctor & su* a plan or cov]age t (f]s limit$ scope d5tal or vision b5efits1 ! agreem5t may only ext5d = a t]m beyond two ye>s ) ! prior acceptance ( ! doctor = ea* t]m ext5sion4 7#c7 ,no re/rictions on *oice ( laboratories ,! plan or cov]age may n1 directly or indirectly1 re/rict or limit1 su* a doctor's *oice ( laboratories or *oice ( s\rce & suppli]s ( s]vices or mat]ials provid$ by ! doctor to an individual :o is enroll$ "u ! plan or cov]age4 7b7 ,private "r ( action ,9 addition to any o!r rem$ies "u ,/ate or ,f$]al law1 a p]son adv]sely affect$ by a violation ( ?is subsection may br+ action = injunctive relief aga9/ a plan describ$ 9 subsection 7a7 &1 ^u prevail+1 9 addition to su* injunctive relief %all recov] monet>y damages ( no m ?an #a1jjj = ea* day f\nd to be 9 violation plus attorney's fees & co/s4 ,! di/rict c\rts ( ! ,unit$ ,/ates %all h exclusive jurisdiction ( civil actions br\ght "u ?is subsection4 7c7 ,relation%ip to exception = limit$1 except$ b5efits ,section #bgbb7;c77#a7 %all n apply ) respect to ! requirem5ts ( ?is section4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms doctor ( d5tal surg]y & doctor ( d5tal m$ic9e mean a doctor ( d5tal surg]y or ( d5tal m$ic9e1 z applicable1 :o is legally au?oriz$ to practice d5ti/ry by ! ,/ate 9 :i* ! doctor p]=ms su* function & :o is act+ )9 ! scope ( ! lic5se ( ! doctor :5 p]=m+ su* functions4 7#b7 ,! t]m doctor ( optometry means a doctor ( optometry :o is legally au?oriz$ to practice optometry by ! ,/ate 9 :i* ! doctor s practices4 4 7b7 ,con=m+ am5dm5t ,section #bgbb7;c77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ba7;c77#a77 is am5d$ by /rik+ ,! requirem5ts & ins]t+ ,subject to section #bgai;,b1 ! requirem5ts4 7c7 ,exclusive applicability ( ,/ate law ,not)/&+ any provision ( ?is ,act1 ,/ate law1 :i* directly affects any /&>d or requirem5t relat+ to heal? insurance issu]s & d5tal or vision b5efit plans1 %all h exclusive application & ! provisions ( ?is ,act %all n apply4 ,! ,/ate %all reta9 exclusive jurisdiction ov] heal? insurance issu]s & limit$ scope d5tal or vision b5efit plans t are directly gov]n$ by su* ,/ate4