S. 1716: Vision Lab Choice Act of 2025

This bill is known as the Vision Lab Choice Act of 2025 and aims to improve health care coverage under vision plans. Below are the key provisions and changes proposed by the bill:

1. Purpose of the Bill

The primary goal is to enhance the coverage offered by group health plans or individual health insurance policies that include vision care benefits. The bill introduces new requirements for these plans, particularly concerning agreements with doctors of optometry.

2. Agreements with Doctors of Optometry

The bill specifies how agreements between doctors of optometry and health plans should be structured:

• The initial term of the agreement cannot exceed 2 years.
• The agreement can be extended with the agreement of the doctor for additional terms of up to 2 years each.
• Extensions can continue indefinitely, as long as they adhere to the prior terms.

3. Choice of Laboratories and Suppliers

Health plans will not be allowed to restrict doctors of optometry in selecting laboratories or suppliers for the materials and services they provide to patients enrolled in the plan. This provision aims to offer greater freedom and potentially better service to patients.

4. Notification to States

The Secretary of Health and Human Services is required to annually inform each state about its authority to enforce these new provisions against health plans. Furthermore, states must confirm whether they will enforce these provisions or risk being deemed non-compliant.

5. Definitions

The bill clarifies that a "doctor of optometry" is defined as a professional authorized to practice optometry in their respective state.

6. Conforming Amendments

The bill also includes amendments to existing laws for consistency and to ensure that the new vision plans regulations are distinctly noted within the broader framework of health insurance regulations.

7. Exclusive Applicability of State Law

This legislation acknowledges that state laws affecting health insurance and vision benefit plans will have priority over the federal changes introduced. If a state law conflicts with this bill, the state law will prevail, allowing states to regulate their health insurance issuers independently.

8. Implications

The Vision Lab Choice Act of 2025 aims to provide better options and flexibility for both patients and optometrists within the framework of health insurance that covers vision care. By improving coverage provisions, it emphasizes increased choice and competition in the vision care market while allowing states to maintain regulatory authority over health insurance practices.

Relevant Companies

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