SB1503 Summary

• Prohibits health insurers from discriminating against classes of eye care providers (optometrists vs. ophthalmologists) in setting professional fees, reimbursement rates, or promotional activities for policies amended, delivered, issued, or renewed after the effective date.

• Requires insurers to allow covered patients direct access to any licensed eye care provider affiliated with the plan and prohibits insurers from promoting one class of providers over another for the same eye care services.

• Forbids insurers from requiring eye care providers or patients to purchase eye care goods (such as ophthalmic lenses) from sources owned by or affiliated with the benefits provider.

• Prohibits insurers from imposing unnecessary hospital privileges or other requirements that would effectively exclude individual eye care providers or classes of providers from participation in insurance plans.

• Allows persons adversely affected by violations to sue for injunctive relief and recover attorney's fees and costs, and makes conforming changes across multiple insurance-related statutes including HMO, health services plan, and public aid provisions.