Eye care coverage; requirement for carrier practices. (HB368)

Introduced By

Del. Chris Head (R-Roanoke)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Eye care coverage; carrier practices. Establishes requirements upon carriers, including indemnity insurers, health maintenance organizations, issuers of accident and sickness subscription contracts, and corporations operating optometric or vision care services plans, regarding the operation of health benefit plans that provide coverage for vision care services, optometric services, or health care services and materials related to the care of the eye and related structures. The measure prohibits a carrier providing a health benefit plan that includes coverage for eye care from (i) setting professional fees or reimbursement for the same eye care services in a discriminatory manner; (ii) precluding a covered person who seeks eye care from obtaining such service directly from a licensed provider on the health benefit plan provider panel; (iii) promoting or recommending any class of eye care providers to the detriment of any other class of eye care providers for the same eye care service; or (iv) requiring an eye care provider to hold hospital privileges or impose any other condition or restriction for initial admittance to a provider panel not necessary for the delivery of eye care upon such providers which would have the effect of excluding an individual eye care provider or class of eye care providers from participation on the health benefit plan provider panel. The measure also requires such a carrier to (a) ensure that all eye care providers on a health benefit plan provider panel are included on any publicly accessible list of participating eye care providers for the health benefit plan; (b) allow each eye care provider on a health benefit plan provider panel, without discrimination between classes of eye care providers, to furnish covered eye care services to covered persons to the extent permitted by such provider's licensure; and (c) include opticians, optometrists, and ophthalmologists on the health benefit plan provider panel in a manner that ensures covered persons timely access and geographic access to eye care. Violators are subject to injunctive relief and damages of not more than $100 and reasonable attorney fees and court costs. Read the Bill »


Bill Has Failed


01/03/2014Prefiled and ordered printed; offered 01/08/14 14100136D
01/03/2014Referred to Committee on Commerce and Labor
01/15/2014Assigned C & L sub: Subcommittee #2
01/23/2014Subcommittee recommends continuing to 2015
01/28/2014Continued to 2015 in Commerce and Labor
12/04/2014Left in Commerce and Labor