; and (IV) other network adequacy standards to ensure that care through these plans is accessible to diverse communities, including those who are limited-English proficient; and (iii) provide coverage for services for enrollees through out-of-network providers at no additional cost to the enrollees in cases where in-network providers are unable to comply with the standards established under clause subclause (III) or (IV) of clause (ii) for such services and the out-of-network providers can deliver such services in compliance with such standards. (b) Effective date The amendments made by subsection (a) shall apply to plan years beginning more than 1 year after the date of the enactment of this Act. . 431. Improving access to dental care (a) Reports to congress (1) GAO report on dental therapist programs Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the Alaska Dental Health Aide Therapists Program and the Dental Therapist and Advanced Dental Therapist programs in Minnesota, to assess dental therapists’ effectiveness in— (A) improving access to timely dental care among communities of color; (B) providing high quality care; and (C) providing culturally competent care. (2) GAO report of expanding scope of certain practices The GAO shall also report on state variations in use of dental hygienists and assess the effectiveness of expanding the scope of practice for hygienists in— (A) improving access to timely dental care among communities of color; (B) providing high quality care