Understanding the impact of Total Vision vs. VSP settlement for optometrists

Optometry practice owner Total Vision is on the verge of reaching settlement in its antitrust lawsuit, which accused eye care insurance giant Vision Service Plan (VSP) of leveraging its market power to create competitive disadvantages for the company. 

Here’s what doctors of optometry need to know about the lawsuit. 

The lawsuit 

In a lawsuit filed in U.S. District Court in California in 2023, Total Vision accused VSP of using its market position to impose unfair business restrictions. According to the allegations, VSP required Total Vision to purchase large quantities of frames and lenses from VSP suppliers and mandated the use of VSP’s practice management software. These requirements allegedly prevented Total Vision from seeking competitive prices from other vendors. 

The lawsuit claimed Total Vision felt compelled to accept these terms due to VSP’s extensive patient coverage in California. Total Vision believed refusing the arrangements would risk losing access to VSP’s provider network, which could devastate Total Vision’s business. 

Total Vision also alleged that VSP attempted to pressure the company into accepting a below-market buyout offer or allowing VSP to make an investment at an unfavorable valuation. When Total Vision rejected these attempts, VSP allegedly removed the chain from its provider network. 

The settlement 

The case had progressed to the discovery phase and would likely have gone to trial in late 2025 or 2026. 

VSP filed a motion to dismiss the case, arguing that its arrangements with Total Vision were standard commercial agreements, not anticompetitive or unfair business practices. A judge denied the request to dismiss. 

A day later, Total Vision and VSP asked the court to pause the case, saying they were in discussions regarding a confidential agreement. Such settlements typically conclude the case with neither party admitting wrongdoing and may include both financial consideration and commitments to change behavior going forward. The court order issued on May 21, 2025, which paused the case pending settlement, states that the parties may resume litigation if they fail to finalize settlement terms within 60 days. However, litigants do not typically ask a court to pause proceedings unless the parties agree that a settlement of their dispute is desired by both parties and preferable to continued litigation.  

The takeaway 

While the specific facts of the case were unique to Total Vision and VSP, certain allegations were similar to complaints the AOA has received from members about VSP: 

• VSP’s refusal to deal with doctors except on its own terms. 
• Requiring doctors to use different VSP-tied products and services—many times unwanted—in order to be allowed to join or remain on the VSP provider panel. 
• Unfair competition with VSP-owned locations. 

Resources for holding vision plans accountable 

Interested in learning more about payer advocacy efforts or aware of discrimination or other harmful actions by policies or insurers? Help the AOA hold insurers accountable by taking the following steps: 

• Report plan abuses to the AOA at stopplanabuses@aoa.org. 
• Visit the AOA’s Action Center to learn more about federal legislation that could curb common and egregious plan abuses.
• Consider investing in AOA-PAC, the only federal political action committee dedicated to fighting and winning for optometry. 

Have questions? Contact the AOA’s Third Party Center by email.