Bill > HB3211

This bill addresses vision care benefits and the participation of optometrists and therapeutic optometrists in vision care and managed care plans in Texas. It requires vision care plan issuers to provide a clear online application process for optometrists and therapeutic optometrists to become participating providers, with standardized and fair application requirements. The bill mandates that plan issuers must respond to applications within specific timeframes, either approving and providing a contract or denying the application with a written explanation. It prohibits vision care plan issuers from excluding optometrists or therapeutic optometrists based on the aggregate number of providers or patient access factors, and requires them to allow providers to participate to the full extent of their professional license. Additionally, the bill restricts plan issuers from using extrapolation methods during audits of providers, ensuring that any additional payments or refunds are based on actual overpayments or underpayments. The legislation also requires vision care plans to use standardized coding systems when describing medical or vision care products and services, promoting transparency and consistency in billing and reimbursement. The bill will apply to new or renewed contracts between vision care plan issuers and optometrists or therapeutic optometrists on or after its effective date.

Business and Industry, Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB3211