bill letting optometrists apply online to vision plan networks

The text as introduced · 459 words

89R7752 SCF-F

By: Middleton
S.B. No. 2573

A BILL TO BE ENTITLED

AN ACT

relating to the participation of optometrists and therapeutic

optometrists in managed care plans providing vision benefits.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter D, Chapter 1451, Insurance Code, is

amended by adding Section 1451.1545 to read as follows:

Sec. 1451.1545. PARTICIPATION IN VISION CARE PLAN; EFFECT

ON OTHER PLANS. (a) In this section, "vision care plan" has the

meaning assigned by Section 1451.157(a).

(b) A vision care plan issuer must include on the issuer's

Internet website a method for a licensed optometrist or therapeutic

optometrist to submit an application for inclusion as a

participating provider in the plan. The application:

(1) may only require an applicant to provide:

(A) standardized information prescribed by rules

adopted under Section 1452.052 that is applicable to an optometrist

or therapeutic optometrist; or

(B) information available from the Council for

Affordable Quality Healthcare; and

(2) must impose the same requirements on each

optometrist and therapeutic optometrist.

(c) A vision care plan issuer shall:

(1) not later than the fifth day after the date the

issuer receives an application described by Subsection (b) that

meets the plan's credentialing requirements, electronically

deliver to the applicant a participating provider contract,

including applicable reimbursement fee schedules, provider

handbooks, and provider manuals; and

(2) not later than the 20th business day after the date

the applicant accepts the contract, include the applicant as a

participating provider in the plan.

(d) A vision care plan issuer must allow an optometrist or

therapeutic optometrist to be a participating provider to the full

extent of the optometrist's or therapeutic optometrist's license on

all of the issuer's:

(1) vision care plans and other managed care plans

with vision benefits that have enrollees located in this state; and

(2) vision panels, as defined by Section 1451.154.

SECTION 2. Section 1451.157(a)(2), Insurance Code, is

amended to read as follows:

(2) "Vision care plan" means a managed care plan that:

(A) is offered in the form of a limited-scope

policy, agreement, contract, or evidence of coverage ; and

(B) [ that ] provides coverage for eye care

expenses but does not provide comprehensive medical coverage.

SECTION 3. The changes in law made by this Act apply only to

a contract between a vision care plan issuer and an optometrist or

therapeutic optometrist entered into or renewed on or after the

effective date of this Act.

SECTION 4. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.