SS/SB 692 - This act prohibits contracts between insurers and providers of optometric and ophthalmic services from limiting fees for noncovered services or materials provided to insureds by optometrists subject to the contracts and prohibits providers from charging more than the usual and customary rates for noncovered services or materials. This act also requires that the contracted fees not be less than what the insurers would pay unless reduced by contractual limitations of enrollees' deductibles, co-pays, or coinsurance and that those contracted fees are reasonable and not de minimus reimbursement to avoid the prohibition on fee limits for noncovered services. This act includes an exception to the applicability of the section for plans or any provider contracts for optometric services or ophthalmic services underwritten by a health benefit plan or health carrier subject to Chapter 354 or Chapter 376 as of January 1, 2014. This act is similar to HB 750 (2013) and SCS HCS HB 1134 (2012).
MICHELA BIRK