Bill Text: NJ A1035 | 2014-2015 | Regular Session | Introduced
Bill Title: Prohibits health insurance carriers from requiring optometrists to become providers with vision care plans as condition of becoming providers in carriers' panel of providers.
Spectrum: Slight Partisan Bill (Democrat 10-6)
Status: (Enrolled - Dead) 2016-01-19 - Pocket Veto - Bills not Acted on by Governor-end of Session [A1035 Detail]
Download: New_Jersey-2014-A1035-Introduced.html
STATE OF NEW JERSEY
216th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2014 SESSION
Sponsored by:
Assemblyman DANIEL R. BENSON
District 14 (Mercer and Middlesex)
Assemblyman DAVID P. RIBLE
District 30 (Monmouth and Ocean)
Assemblywoman BONNIE WATSON COLEMAN
District 15 (Hunterdon and Mercer)
SYNOPSIS
Prohibits health insurance carriers from requiring optometrists to become providers with vision care plans as condition of becoming providers in carriers' panel of providers.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning optometrists and vision care plans and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. A carrier shall not require an optometrist to participate in a vision care plan as a condition for entering into a contract with that carrier for the provision of medically necessary physician services within the scope of practice of an optometrist when those services are provided as a health benefit for covered persons. If a carrier subcontracts medically necessary physician services within the scope of practice of an optometrist which are also covered services in its healthcare plan, those subcontracted services shall be identical to those services offered as part of the carrier's own healthcare plan.
For purposes of this section, "vision care plan" means an organization with which a carrier subcontracts to provide or administer supplemental vision or medically necessary physician services within the scope of practice of an optometrist, or both, to covered persons on behalf of the carrier.
2. This act shall take effect immediately.
STATEMENT
This bill prohibits health insurance carriers from requiring optometrists to accept a contract with a vision care plan as a condition for participation in the carrier's provider networks for the provision of medically necessary physician services within the scope of practice of an optometrist.
Currently, optometrists may be required by health insurance carriers to accept a contract with a vision care plan in order to be part of the provider network for the provision of medically necessary physician services within the scope of practice of an optometrist, while the same requirement is not applied to other eye care providers. Vision care plans often restrict or deny access to patients for medically necessary physician services within the scope of practice of an optometrist, even when those benefits are otherwise covered services in the carrier's health insurance plans. Patients are also denied the freedom to choose an optometrist for necessary medical eye care if an optometrist is denied participation in the carrier's provider network, resulting in duplication of services and increased costs.
