SPRINGFIELD — Vision care plan enrollees could soon have increased access to more providers under a measure led by State Senator Cristina Castro.
“Illinois took an important first step by regulating vision care plans, but it is clear that loopholes remain. When vision care organizations are allowed to ignore the law, patients lose choice and small businesses are weakened,” said Castro (D-Elgin). “This legislation would ensure compliance, transparency and accountability so health and vision care decisions are made by patients and their doctors, not by insurance companies or third parties.”
Vision care organizations are third-party entities that administer vision insurance benefits, negotiate provider networks, and determine reimbursement rates and coverage policies on behalf of insurers, employers or other health plans. Over time, vision care organizations have gained control of the vision care marketplace. The two largest companies control approximately 85% of all U.S. vision coverage and are vertically integrated, meaning they administer vision plans while also owning eyewear manufacturing. This practice puts small and local eye clinics out of business, discouraging competition.
Current law regulates vision benefits and vision care plans but not vision care organizations – leading Castro to champion a measure to protect patients and the coverage they rely on.
Senate Bill 3707 would create a regulatory framework for vision care organizations in the state. The legislation would include patient and provider protections, including providing enrollees with more freedom to choose in-network providers without influence from vision care organizations and preventing vision care organizations from retaliating against eye care providers.
“Monopolizing any kind of care that the public relies on is unethical,” said Castro. “Protecting small providers and patients from unethical practices is the priority with this bill.”
Senate Bill 3707 passed the Senate Executive Committee last Wednesday.
