SB 738 - This act requires any health care plan that provides eye care to assure direct access to primary eye care providers without any referral. The primary eye care providers need not be on the list of preferred providers, although the health care plan may charge a "reasonable" higher copayment for out-of-plan care (under regulations issued by the Dept. of Insurance). Several other protections for the patient and eye care providers are included. Both opthalmologists and optometrists are included as eye care providers.
CHERYL GRAZIER

SCA 1 - TECHNICAL AMENDMENT CORRECTING GRAMMAR.

SA 1 - DEFINITION OF HEALTH MAINTENANCE ORGANIZATION SHALL NOT INCLUDE AN HMO IF SUBSTANTIALLY ALL OF ITS PRIMARY HEALTH CARE SERVICES ARE PROVIDED TO MEMBERS AT ITS OWN FACILITIES BY HEALTH CARE PROFESSIONALS WHO PROVIDE HEALTH CARE SERVICES ON BEHALF OF THE ORGANIZATION. SA 2 - ALLOWS A PERSON TO SEEK EYE CARE BY A PROVIDER OUTSIDE OF PROVIDER NETWORK IF THE PLAN IS OUT OF PLAN REIMBURSE- MENT. AND ALLOWS HEALTH CARE PLANS TO ESTABLISH A PROTOCOL FOR ADMINISTRATION AND DELIVERY OF PRIMARY EYE CARE SERVICES.