Legislation prevents forced discounts for optometrists

Several state affiliates are promoting legislation to stop an unfair business practice used by vision plans. The practice forces optometrists to give discounts and charge varying prices on services and materials not covered by patients' vision plans.

"This law sets what most consider to be very reasonable and obvious limits."

The bills for optometrists are based on similar legislation pushed by dentists and passed in at least 30 states that prohibits forced discounts on services.

The optometric legislation was first passed by Kentucky in 2012 and then by both Maryland and Texas in 2014. The laws prohibit anti-competitive behavior by health and vision plans and allows providers and patients to reach reasonable fees for services and materials. 

Victories for two states-and the profession

Maryland Optometric Association (MOA) President John L. Burns, O.D., called the passage of House Bill 1160 a victory for optometry and for all vision care providers in Maryland. 

He noted that Maryland's bill goes a step beyond just preventing insurers from mandating discounts. It also provides protections against contract provisions that force optometrists to join a discount vision plan to participate with an insurer's major medical network.

"The MOA is thrilled to have passed this piece of legislation in just one year," Dr. Burns added. "There is a lot more to do, but this was a great start."

Thomas A. Lucas, Jr., O.D., legislative chair for the Texas Optometric Association, said, "We are happy that Texas could lead the way on this state-by-state initiative to restore a small amount of independent decision-making to our practices."

"This law sets what most consider to be very reasonable and obvious limits on what is out-of-bounds in a contracting situation that can be inherently unfair to the small business optometrist," Dr. Lucas added. "Allowing optometrists to be competitive and responsive to local marketplace conditions for products and services beyond the defined covered benefit is a good thing for optometrists, employers and patients."

Other states and optometrists should get involved

The AOA State Government Relations Center offers advice to other state leaders for speaking with legislators: Point out that this bill does not mandate a benefit on insurance companies or raise insurance costs for patients because it does not require health plans, vision plans or consumers to add any additional services. The bills also do not prohibit one business from forcing another business to reduce its charges for services when it does not pay any part of the purchase cost.

State leaders interested in the legislation should attend the 2013 State Legislative and Third Party National Conference Sept. 8-9 in Washington, D.C. Registration is available online. For more information, contact Daniel Carey at the AOA's State Government Relations Center at 703-837-1343 or dcarey@aoa.org.

August 12, 2013

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