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A BILL TO BE ENTITLED
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AN ACT
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relating to prohibited conduct by vision plans with respect to the |
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practice of optometry and therapeutic optometry. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1451.155(b), Insurance Code, is amended |
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to read as follows: |
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(b) A contract between an insurer and an optometrist or |
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therapeutic optometrist may not: |
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(1) limit the fee the optometrist or therapeutic |
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optometrist may charge for a product or service that is not a |
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covered product or service; or |
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(2) include a provision in violation of Section |
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351.408, Occupations Code. |
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SECTION 2. Section 351.408, Occupations Code, is amended by |
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amending Subsections (a) and (c) and adding Subsections (b-1) and |
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(c-1) to read as follows: |
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(a) This section and Sections 351.602(c)(2), 351.603(b), |
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351.604(3), and 351.605 shall be liberally construed to prevent |
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manufacturers, wholesalers, [and] retailers of ophthalmic goods, |
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and vision plans from controlling or attempting to control the |
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professional judgment, manner of practice, or practice of an |
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optometrist or therapeutic optometrist. |
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(b-1) In this section, "vision plan" means a single or |
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limited service health insurance or managed care plan or similar |
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program that provides or arranges for, or pays benefits for, vision |
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examinations, corrective lenses, or other vision or eye health care |
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materials or procedures. |
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(c) A manufacturer, wholesaler, [or] retailer of ophthalmic |
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goods, or vision plan may not directly or indirectly: |
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(1) control or attempt to control the professional |
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judgment, manner of practice, or practice of an optometrist or |
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therapeutic optometrist; |
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(2) employ or contract for the services of an |
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optometrist or therapeutic optometrist if part of the optometrist's |
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or therapeutic optometrist's duties involves the practice of |
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optometry or therapeutic optometry; or |
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(3) pay an optometrist or therapeutic optometrist for |
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a service not provided. |
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(c-1) In addition to the conduct prohibited under |
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Subsection (c), a vision plan may not directly or indirectly: |
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(1) restrict or limit an optometrist's or therapeutic |
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optometrist's choice of sources or suppliers of services or |
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materials, including optical laboratories used by the optometrist |
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or therapeutic optometrist to provide services or materials to a |
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patient; or |
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(2) require an optometrist or therapeutic optometrist |
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to disclose a patient's confidential or protected health |
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information unless the disclosure is directly necessary for the |
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payment of a patient's claim under the vision plan. |
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SECTION 3. Section 1451.155, Insurance Code, as amended by |
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this Act, applies only to a contract entered into or renewed on or |
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after September 1, 2015. A contract entered into or renewed before |
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September 1, 2015, is governed by the law as it existed immediately |
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before that date, and that law is continued in effect for that |
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purpose. |
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SECTION 4. Section 351.408, Occupations Code, as amended by |
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this Act, applies only to a vision plan that is delivered, issued |
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for delivery, or renewed on or after the effective date of this Act. |
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A vision plan delivered, issued for delivery, or renewed before the |
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effective date of this Act is governed by the law as it existed |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2015. |