01/06/2022

House Bill 156, Effective March 20, 2019 by Lia Rankins

by Lia Rankins

A new state law went into effect on March 20th to provide consumers with a greater ability to make decisions regarding their vision care.  Formerly House Bill 156, sponsored by Representative Kirk Schuring (R-Canton), the new law will permit vision care providers, defined as optometrists and physicians, to utilize any supplier for vision care materials such as lenses, lens treatments and coating, and contact lenses.  The insurance company can still adjust its level of coverage based on the selected supplier but it cannot deny coverage altogether.

Many vision plans negotiate discounts on behalf of their members so that they can get lower priced eyewear with their providers once their benefit runs out, such as for additional pairs of glasses or sunglasses.  The new law still allows vision care providers to participate in the discount plans but they are not required to do so.  Consumers can use the suppliers of their choice and can make an informed decision based on information given by both the vision provider and the insurer.  The insurer has disclosure requirements ensuring that consumers know that if they choose to receive vision care services or materials that are not covered benefits under the plan, a participating vision care provider can charge them his or her normal fee for such services or materials. The consumers must understand that they may incur out-of-pocket expenses as a result of purchasing vision care services or materials that are not covered vision care services. 

If the vision care provider recommends an out-of-network source for the vision care materials, the provider must notify the consumer in writing that the source is out- of-network, inform the consumer of the cost of the materials and disclose any business interest the provider has in the recommended source.The new law ensures that patients will be able to utilize the suppliers of their choice when ordering eyewear.It also benefits providers as it prohibits forced pricing on the sale of vision services and materials that are not covered services under a benefit plan.Concerns had been raised by providers that specific vision care material suppliers or manufacturers were required to be used for the purchase of vision products and these mandated suppliers were not always timely in producing eyewear, leading to a delay in patient treatment. 

The new law is supported by both providers and insurers and will promote transparency for patients in the purchase of eyewear and other related products.

We will continue to communicate more information on this new law as it becomes available in an effort to keep you up to date.