SB2573 - Relating to the participation of optometrists and therapeutic optometrists in managed care plans providing vision benefits.

  89R7752 SCF-F     By: Middleton S.B. No. 2573       A BILL TO BE ENTITLED   AN ACT   relating to the participation of optometrists and therapeutic   optometrists in managed care plans providing vision benefits.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter D, Chapter 1451, Insurance Code, is   amended by adding Section 1451.1545 to read as follows:           Sec.   1451.1545.     PARTICIPATION IN VISION CARE PLAN; EFFECT   ON OTHER PLANS. (a)   In this section, "vision care plan" has the   meaning assigned by Section 1451.157(a).           (b)     A vision care plan issuer must include on the issuer's   Internet website a method for a licensed optometrist or therapeutic   optometrist to submit an application for inclusion as a   participating provider in the plan.   The application:                 (1)  may only require an applicant to provide:                       (A)     standardized information prescribed by rules   adopted under Section 1452.052 that is applicable to an optometrist   or therapeutic optometrist; or                       (B)     information available from the Council for   Affordable Quality Healthcare; and                 (2)     must impose the same requirements on each   optometrist and therapeutic optometrist.           (c)  A vision care plan issuer shall:                 (1)     not later than the fifth day after the date the   issuer receives an application described by Subsection (b) that   meets the plan's credentialing requirements, electronically   deliver to the applicant a participating provider contract,   including applicable reimbursement fee schedules, provider   handbooks, and provider manuals; and                 (2)     not later than the 20th business day after the date   the applicant accepts the contract, include the applicant as a   participating provider in the plan.           (d)     A vision care plan issuer must allow an optometrist or   therapeutic optometrist to be a participating provider to the full   extent of the optometrist's or therapeutic optometrist's license on   all of the issuer's:                 (1)     vision care plans and other managed care plans   with vision benefits that have enrollees located in this state; and                 (2)  vision panels, as defined by Section 1451.154.          SECTION 2.  Section 1451.157(a)(2), Insurance Code, is   amended to read as follows:                (2)  "Vision care plan" means a managed care plan that:                       (A)  is offered in the form of a limited-scope   policy, agreement, contract, or evidence of coverage ; and                       (B)   [ that ] provides coverage for eye care   expenses but does not provide comprehensive medical coverage.          SECTION 3.  The changes in law made by this Act apply only to   a contract between a vision care plan issuer and an optometrist or   therapeutic optometrist entered into or renewed on or after the   effective date of this Act.          SECTION 4.  This Act takes effect immediately if it receives   a vote of two-thirds of all the members elected to each house, as   provided by Section 39, Article III, Texas Constitution.  If this   Act does not receive the vote necessary for immediate effect, this   Act takes effect September 1, 2025.