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A BILL TO BE ENTITLED
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AN ACT
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relating to the participation of optometrists and therapeutic |
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optometrists in managed care plans providing vision benefits. |
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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 1451.1545 to read as follows: |
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Sec. 1451.1545. PARTICIPATION IN VISION CARE PLAN; EFFECT |
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ON OTHER PLANS. (a) In this section, "vision care plan" has the |
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meaning assigned by Section 1451.157(a). |
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(b) A vision care plan issuer must include on the issuer's |
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Internet website a method for a licensed optometrist or therapeutic |
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optometrist to submit an application for inclusion as a |
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participating provider in the plan. The application: |
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(1) may only require an applicant to provide: |
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(A) standardized information prescribed by rules |
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adopted under Section 1452.052 that is applicable to an optometrist |
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or therapeutic optometrist; or |
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(B) information available from the Council for |
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Affordable Quality Healthcare; and |
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(2) must impose the same requirements on each |
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optometrist and therapeutic optometrist. |
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(c) A vision care plan issuer shall: |
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(1) not later than the fifth day after the date the |
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issuer receives an application described by Subsection (b) that |
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meets the plan's credentialing requirements, electronically |
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deliver to the applicant a participating provider contract, |
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including applicable reimbursement fee schedules, provider |
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handbooks, and provider manuals; and |
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(2) not later than the 20th business day after the date |
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the applicant accepts the contract, include the applicant as a |
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participating provider in the plan. |
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(d) A vision care plan issuer must allow an optometrist or |
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therapeutic optometrist to be a participating provider to the full |
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extent of the optometrist's or therapeutic optometrist's license on |
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all of the issuer's: |
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(1) vision care plans and other managed care plans |
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with vision benefits that have enrollees located in this state; and |
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(2) vision panels, as defined by Section 1451.154. |
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SECTION 2. Section 1451.157(a)(2), Insurance Code, is |
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amended to read as follows: |
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(2) "Vision care plan" means a managed care plan that: |
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(A) is offered in the form of a limited-scope |
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policy, agreement, contract, or evidence of coverage; and |
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(B) [that] provides coverage for eye care |
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expenses but does not provide comprehensive medical coverage. |
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SECTION 3. The changes in law made by this Act apply only to |
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a contract between a vision care plan issuer and an optometrist or |
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therapeutic optometrist entered into or renewed on or after the |
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effective date of this Act. |
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SECTION 4. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2025. |