How Arkansas’ major VBM law delivers on calls to promote fairness, doctor-patient relationships

Arkansas optometrists achieve sweeping vision benefit manager (VBM) reforms that restore patient choice and access, and support independent practices, as advocates challenge plans’ outsized influence. 

Signed into law on Feb. 25 by Gov. Sarah Huckabee Sanders, Act 142 of 2025, formerly H.B. 1353, ensures VBMs offer contract terms that are fair for providers and benefits that are appealing for consumers via provisions that seek to rebalance the relationship among plans, patients and their doctors. Such reforms come at a pivotal time for optometry’s advocates as the AOA and affiliates’ full-court press against anti-competitive, anti-patient VBM policies spans boardrooms to legal chambers, and statehouses to the U.S. Capitol. 

What does Act 142 accomplish in Arkansas? 

Effective in August 2025, 90 days after conclusion of the legislative session, Act 142 would ensure the following for Arkansas’ doctors of optometry: 

• Fair Reimbursements. Requires reimbursement rates to be at least that of Medicare for covered services and materials.
• Coordination of Benefits. Allows patients to combine and coordinate vision and medical benefits to maximize their coverage.
• Bans Unfair Audits. Prohibits the use of “batch” or “extrapolation” audits of participating providers; any additional payments due must be based on the actual over/under payment. 
• Payment Protection. Prohibits VBMs from restricting cash payments to providers when it’s the lowest-cost option for patients. 
• Reimbursement Certainty. Prohibits VBMs from reimbursing at a different amount based on providers’ choice of optical lab, health record software or equipment doctors choose. 
• Eliminates Virtual Credit Card Requirements. Prohibits VBMs from requiring providers to accept forms of payment where a processing fee is assessed in order to get reimbursed. 
• Transparent Provider and Service Listings. Prohibits VBMs from misleading enrollees about what services are fully covered, as well as prevents "steering” of enrollees and “tiering” of providers based on noncovered service discounts or brands of products carried. Also prevents “steering” of enrollees to one provider over another; to any retail establishment affiliated with the VBM; or to any internet or virtual provider affiliated with the VBM. 
• Increased Oversight. Expands the Insurance Department’s regulatory authority by adding VBMs to the definition of a health benefit plan. 

Introduced in January, H.B. 1353 (Act 142) resonated with legislators, passing the House 96-0 and Senate 28-1, in part because lawmakers were struck by the imbalanced paradigm between plans and providers; namely, decades of stagnant reimbursement rates coupled with headline inflation on practice costs and expenses, as well as unfair mandates that made such contracts untenable for doctors and frustrating for patients.  

That message overwhelmingly resonated as optometry’s advocates testified in committee hearings to the anti-competitive nature of VBM policies. Now, Arkansas optometrists have delivered two significant legislative victories—including a 2019 scope win—in slightly more than a handful of years. 

“We are thrilled with how our elected leaders agreed that VBM reform was necessary,” says Matt Jones, O.D., Arkansas Optometric Association (ArOA) Legislative co-chair. “In 2019, we passed scope of practice legislation, and now in 2025 we are able to pass sweeping VBM legislation. Both advocacy efforts serve a similar purpose, which is to give patients access to high-quality eye care across the state. Act 142 is a huge victory for all eye care providers and our patients.” 

Adds Joseph Sugg, O.D., ArOA Legislative co-chair: "This law removes influence from insurance companies on where patients receive their eye care. It promotes competition in the vision care market, increases patient choice and access to care by the doctors they prefer to see, and allows patients to use their benefits in combination with their medical insurance. It also strengthens contract terms between doctors and VBMs, and this should only help to further increase patient choice and access." 

AOA, affiliates’ VBM advocacy for optometry achieving results 

The ArOA secured a critical win for Arkansas’ optometrists, but the AOA and affiliates’ work isn’t done. Tens of millions of Americans rely on their local doctors of optometry for their comprehensive eye health and vision needs, and even despite historic advancements in optometry’s scope and level of care provided, plans haven’t sufficiently advanced alongside the profession. Toward that end, the AOA and affiliates continue a multi-pronged approach to achieving reimbursement and coverage fairness.  

📺WATCH: Patients Rising video on stopping VBM abuses.  

Even now, Texas doctors continue to fight for their own VBM law—groundbreaking legislation in its own right.

In 2023, Texas broke new ground when H.B. 1696 became law, addressing grievous VBM policies, such as patient steering and doctor tiering, as well as eliminating chargebacks, noncovered services, audit extrapolation and more. While VBMs immediately challenged the law in court, a legal battle that is still ongoing, Texas recently introduced 2025 legislation to bolster patient access to vision care and counteract VBMs’ aim to limit doctors’ participation as in-network providers. 

In addition to supporting states’ advocacy, the AOA continues to advocate at a federal level, as well as directly with plans on behalf of members. In fact, this direct advocacy is already having an effect: over $2.9 million has been driven back into optometry practices. 

Here’s how else the AOA is championing VBM reforms: 

• Federal legislation. The recently reintroduced Dental and Optometric Care Access Act, a bipartisan effort by Reps. Buddy Carter, R-Ga., and Yvette Clarke, D-N.Y., would lower vision costs and put decision-making power back into the hands of patients and their doctors by targeting ERISA plans. 
  

• Federal investigations. Three Congressional investigations into VBMs, their policies and market actions, are currently ongoing by the U.S. House Oversight Committee, House Energy & Commerce Committee and U.S. Senate Appropriations Committee. 
  

• Direct plan advocacy. Doctors can email stopplanabuses@aoa.org with a health or vision plan challenge and the AOA will help fight on their behalf. Additionally, the AOA offers resources to empower doctors in these issues, including responding to automatic downcoding programs. 

Additionally, the AOA continues to review and monitor such plan mandates and challenges alongside anti-trust experts, as well as provide enhanced transparency behind these actions with the AOA’s Health and Vision Plan Action Report. This daily accounting of the AOA’s actions regarding health and vision plans can be found in members’ First Look emails, Monday through Friday. 

Save the date: AOA on Capitol Hill 2025 

Are you ready to join optometry’s advocates? The foundation of AOA’s federal advocacy efforts, AOA on Capitol Hill, is the AOA’s single-largest federal advocacy event, connecting our profession’s leaders to the nation’s policy leaders to advocate and support optometric eye health and vision care. 

Join hundreds of optometry’s advocates as they champion the profession’s federal policy priorities, including VBM reform, with House and Senate leaders. 

What: AOA on Capitol Hill 2025 
When: Sept. 28-30, 2025 
Where: Washington, D.C. 

Follow the AOA’s event page for more information about registration and housing in the coming months.