To Regulate A Vision Benefit Manager; To Amend The Vision Care Plan Act Of 2015; And To Amend The Healthcare Contracting Simplification Act.
Impact
If enacted, the bill will impact existing regulations by preventing insurers and benefit managers from reducing reimbursements based on conditions like the choice of optical laboratory or brand of materials selected by the vision care provider. Additionally, the bill prohibits insurers from steering enrollees towards specific providers or rewarding choices that may limit patient autonomy. These reforms aim to foster an environment of fair competition among vision care providers while ensuring that patient interests remain a priority in the delivery of care.
Summary
House Bill 1351 aims to enhance regulations surrounding vision benefit managers and amend the Vision Care Plan Act of 2015 as well as the Healthcare Contracting Simplification Act. The bill primarily seeks to establish clearer guidelines about the relationship between vision benefit managers and vision care providers. It sets forth provisions to ensure that vision care providers are not unfairly incentivized or restricted in their practices due to contracts with insurers or vision benefit managers. This move is intended to protect consumer rights by ensuring that patients have adequate access to their preferred vision care providers without undue influence from their insurers.
Contention
While the bill is recognized for its potential to improve transparency and fairness in the vision care marketplace, some legislative discussions highlight concerns about whether these regulations could discourage innovative care delivery models. Supporters argue that such measures are essential to protect patients and ensure equitable access to vision care providers. Meanwhile, opponents warn that too much regulation could stifle flexibility in care delivery and adaptation to evolving healthcare needs, emphasizing the need to find a balance between regulation and provider autonomy.
To Require Consent To The Assignment Of Benefits To A Healthcare Provider; And To Mandate Notice To An Enrollee Of The Assignment Of Benefits To A Healthcare Provider.
To Require Consent To The Assignment Of Benefits To A Healthcare Provider; And To Mandate Notice To An Enrollee Of The Assignment Of Benefits To A Healthcare Provider.
To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.
To Establish The Transportation Benefit Manager Act; To Regulate Contracts Of Certain Ambulance Providers; And To Regulate Claims And Prior Authorization Procedures For Certain Ambulance Services.
To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.
To Regulate Electronic Medical Records; And To Prohibit A Healthcare Payor That Has Electronic Access To Medical Records From Requesting Medical Records In A Different Format From A Healthcare Provider.
Expanding limitations to third-party access to provider network contracts and discounts unless certain criteria are met and prohibitions on payment method restrictions and limitations on certain transaction fees from dental services to all healthcare services.