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A BILL TO BE ENTITLED
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AN ACT
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relating to contracts between optometrists or therapeutic |
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optometrists and health maintenance organizations or insurers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 1451, Insurance Code, is |
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amended by adding Section 1451.155 to read as follows: |
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Sec. 1451.155. CONTRACTS WITH OPTOMETRISTS OR THERAPEUTIC |
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OPTOMETRISTS. (a) In this section: |
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(1) "Covered product or service" means a vision care |
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product or service for which reimbursement is available under an |
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enrollee's managed care plan contract or for which reimbursement is |
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available subject to a contractual limitation, including: |
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(A) a deductible; |
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(B) a copayment; |
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(C) coinsurance; |
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(D) a waiting period; |
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(E) an annual or lifetime maximum limit; |
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(F) a frequency limitation; or |
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(G) an alternative benefit payment. |
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(2) "Vision care product or service" means a product |
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or service provided within the scope of the practice of optometry or |
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therapeutic optometry under Chapter 351, Occupations Code. |
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(b) A contract between an insurer and an optometrist or |
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therapeutic optometrist may not limit the fee the optometrist or |
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therapeutic optometrist may charge for a product or service that is |
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not a covered product or service. |
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(c) A contract between an insurer and an optometrist or |
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therapeutic optometrist may not require a discount on a product or |
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service that is not a covered product or service. |
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SECTION 2. The change in law made by this Act applies only |
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to a contract entered into or renewed on or after January 1, 2014. A |
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contract entered into or renewed before January 1, 2014, is |
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governed by the law in effect immediately before the effective date |
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of this Act, and that law is continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2013. |