Ohio Optometric Group and NAVCP Say State’s New Vision-Plan Legislation Is ‘Consensus-Driven’

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WORTHINGTON, Ohio—The Ohio Optometric Association (OOA) and National Association of Vision Care Plans (NAVCP) have commended Ohio Gov. John Kasich for signing legislation this week that the organizations say will improve consumer protections and “support flexibilities for both providers and the vision plans providing care in the state,” according to a joint announcement. The legislation, House Bill 156, was approved by a 31-0 vote in the Oho Senate late last week. It had earlier passed the House, by a 92-2 vote. OOA and NAVCP have worked with legislators for many months to put together this legislation, which both groups say is consensus-driven and patient-centered.

According to the bill’s language, it will “seek to prevent” vision benefit plans from establishing fee limitations on vision care services and materials “that are not covered vision services for enrollees under an insurance plan.” In addition, strategies by vision benefit plans that “adopt or impose a deductible, copayment, coinsurance, or any other requirement in such a way as to provide de minimis reimbursement …. [are] contrary to the spirit and intent” of the new law.

Another provision of the bill relates to a declaration by providers on whether to accept or not accept as payment an amount set by the contracting entity for vision care services and materials that are not covered. The bill states that “the publication of such declaration to enrollees” by vision benefit plans should treat providers equally “regardless of the declaration made and should be communicated in such a manner as not to imply that the vision care provider is favored or disfavored based on the declaration.”

A spokesman for NAVCP told VMAIL the association believes the new legislation “allows consumers to access affordable benefits through their vision plan while providing flexibility to providers to offer access to out of network suppliers and eyewear to patients that may benefit from them.” He added, “The consumer’s needs are paramount here. We were pleased to support additional cost and source transparency requirements in the bill. We need to make sure that [consumers] have access to eyewear that meets their means, but they always need to know what all of their options are, and what they cost.

“Many vision plans negotiate discounts on behalf of their members so that they can get lower priced eyewear with their providers once their benefit runs out, for additional pairs, sunglasses, [and such]. This bill still allows vision care providers to participate in these discount plans if they want to, but assure that they aren’t mandatory,” the spokesman said.

In the joint announcement, OOA’s executive director Keith Kerns said the new legislation will provide consumers with an enhanced ability to make informed choices about their vision care.” He added, "This law will enable consumers to use the suppliers of their choice, preserve a robust marketplace for services and provide more choice between plans.” (OOA represents approximately 70 percent of optometrists practicing in the state, the association said.)

OOA and NAVCP worked for several months with legislators to develop the consensus-driven legislation, the joint announcement noted, and the resulting bill is “truly reflective of what can be achieved through good-faith negotiation and mutual cooperation.” Ohio Rep. Kirk Schuring (R-Canton) is listed as the main sponsor of the bill.

Lukas Ruecker, president of Mason, Ohio-based EyeMed Vision Care and chairman of NAVCP's board of directors, said he believes legislation will help consumers continue to make the best choices. “It can serve as a model for consumer vision care protections in all states,” he added, in the announcement.

NAVCP member companies operate extensive networks of vision care providers in all 50 states. Approximately 170 million (53 percent) Americans are covered by these networks.