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Vermont Prohibits Insurers from Forcing Eye Doctors to Limit Patient Choice

July 1, 2016

A new Vermont law protects vision care providers from retribution by insurance companies when providers recommend or sell products and services not covered by their patients’ insurance plans.

A new Vermont law protects vision care providers from retribution by insurance companies when providers recommend or sell products and services not covered by their patients’ insurance plans.

“A vision care plan or other health insurance plan shall not restrict or otherwise limit, directly or indirectly, an optometrist’s, ophthalmologist’s or independent optician’s choice of or relationship with sources and suppliers … more beneficial to the consumer,” Senate Bill 215 states.

The new provision adds to a section of existing state law prohibiting eye doctors from charging more than their “usual and customary rate” for services and materials not covered by a patient’s insurance plan.

Signed by Gov. Peter Shumlin (D) on June 2, the revised law took effect on July 1.

‘Bullying’ State’s Eye Doctors

State Sen. Kevin Mullin (R-Rutland County) says he sponsored the bill because vision care insurers were creating hardships for patients by forcing their eye doctors to use specific laboratories, services, and products.

“This was important to Vermont because the vision service plans were bullying Vermont eye doctors,” Mullin said. “We heard one story where the doctor had to wait three weeks for a legally blind teenage patient to receive her eyeglasses from a lab on the other side of the country that the plan required. The same glasses could have been provided the next day by a manufacturer here in Vermont for no additional cost.”

The benefits of freeing eye doctors to steer patients toward greater selection of products are easy to see, Mullin says.

“This new bill will provide the patient with better choice and quality of care without additional cost,” Mullin said.

As Seen in Kansas

Kansas Gov. Sam Brownback (R) signed the Vision Care Services Act in 2014, prohibiting insurers from setting the prices of products or services eye doctors provide patients, except when the insurers have agreed to reimburse doctors for those products or services. The same law forbids insurers from requiring vision care providers to participate in one vision care insurance or discount plan in order to be eligible to participate in others.

Similar to Vermont’s SB 215, the Kansas law prohibits insurance plans from having “the effect, directly or indirectly, of limiting the choice of sources and suppliers of materials by a patient of a vision care provider.”

Jenni White (jlwplusdmw@gmail.comwrites from Oklahoma City, Oklahoma.

Internet Info:

Michael Hamilton, “Give Vision Patients Protection, not ‘Eye of Newt,’” Consumer Power Report, The Heartland Institute, June 9, 2016: http://news.heartland.org/newspaper-article/2016/06/09/give-vision-patients-protection-not-eye-newt

Vermont Senate Bill 215: An Act Relating to the Regulation of Vision Insurance Plans, Vermont Senate, 2015: https://www.heartland.org/policy-documents/vermont-s-215-act-relating-regulation-vision-insurance-plans

Christina Thielst, “States Consider Blocking Do-It-Yourself Eye Exam Telemedicine,” Health Care News, The Heartland Institute, June 2016: http://news.heartland.org/newspaper-article/2016/05/24/states-consider-blocking-do-it-yourself-eye-exam-telemedicine

Image via Thinkstock

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FIRE Health Care
Author
Jenni White is cofounder of Restore Oklahoma Parent Empowerment and a former public school science teacher.
jlwplusdmw@gmail.com @@RopeOK

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