Bill > HB1696

This bill relates to the relationship between managed care plans and optometrists and therapeutic optometrists. The key provisions include: - Defining "managed care plan" to include vision benefit plans and administrators, in addition to health maintenance organizations and preferred provider benefit plans. - Prohibiting managed care plans from discriminating against optometrists and therapeutic optometrists, restricting plan participants from using them, or excluding them as participating providers. - Requiring managed care plans to include optometrists and therapeutic optometrists as participating providers, give them equal prominence in provider listings, and provide them with certain information and payment options. - Placing restrictions on managed care plan contracts with optometrists and therapeutic optometrists, such as prohibiting chargebacks for covered products/services the plan does not provide, requiring 90-day notice of contract changes, and prohibiting requirements to provide covered products at a loss. - Prohibiting managed care plans from engaging in certain conduct that controls or limits an optometrist's or therapeutic optometrist's professional judgment, choices of suppliers/services, or patient information disclosure. - Prohibiting vision care plans from using extrapolation to complete audits of participating optometrists and therapeutic optometrists. - Allowing the commissioner to enforce the provisions of this subchapter. The changes in this bill would apply to contracts and plans entered into or renewed on or after January 1, 2024.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=88R&Bill=HB1696