Ohio’s optometrists, as well as insurance providers, are celebrating the passage of an over-arching bill designed to give optometrists more autonomy in dealings with insurers. After a near-unanimous vote—91-2 in the state’s House and 31-0 in its Senate—the new legislation was signed into law by Ohio’s Governor John Kasich in late December. In a joint announcement, the Ohio Optometric Association and the National Association of Vision Care Plans (NAVCP) applauded the measure, saying it “will provide consumers with an enhanced ability to make informed choices about their vision care.” The two groups worked closely with legislators to develop the bill.
The new guidelines essentially features three components, explains Michael Earley, OD, Ohio Optometrist Association president and associate dean of academic affairs at Ohio State University’s College of Optometry.
First, it allows optometrists to use any lab they want—a change from previous requirements to use the insurance companies lab. The insurance company can still adjust its level of coverage, but can’t deny coverage to any lab completely. Additionally, both the doctor and the insurer must be transparent to the patient about the lab they use.
Second, it stymies any attempt by insurance companies to force optometrists to accept vision discount plan. In the past, insurers have mandated optometrists accept these plans—often at a loss—if they want to be on a medical plan, too.
Some optometrists are actually losing money on this and that caused them to drop the medical plan, lowering the number of ODs that a patient could see in the area, explained Dr. Earley. Ophthalmologists aren’t treated like this and now, optometrists won’t be either. “This removes that restriction that was only on optometrists,” he adds.
Third, it restructures what Dr. Earley calls “uncovered benefits,” in a way that gives optometrists dominion over what discounts they accept.
“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],” an NAVCP spokesman explained to Vision Monday. Optometrists were not reimbursed by the discounts. “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.
Additionally, It allows doctors to offer their own benefits such as “faithful patient discounts.”
|NAVCP. Ohio Optometric Association and NAVCP Applaud Governor Kasich for Signing “Consensus-driven” Vision Health Legislation. netforum.avectra.com/eWeb/DynamicPage.aspx?Site=NAVCP&WebCode=ArticleDetail&faq_key=6471f946-c7b0-4ad4-a55a-39b1045c8b4d. December 20, 2018. Accessed December 21, 2018.|