HB362 Alabama 2013 Session

Summary

Primary Sponsor

Ed Henry

Republican

Co-Sponsor

Jim McClendon

Session

Regular Session 2013

Title

Access to Eye Care Act, public and private insurance policies, plans, contracts or programs shall provide coverage, prohibits requiring a provider to participate, prohibits requiring products and services at a set fee, Secs. 27-56-2 to 27-56-8, inclusive, am'd.

Summary

HB362 would require public and private health plans to cover optometrists under the Access to Eye Care Act and prohibit insurers from forcing provider participation or setting fixed fees.

What This Bill Does

It would extend the Access to Eye Care Act to require both public and private insurance policies to provide coverage for eye care services by optometrists. It would prohibit insurers from making eye care providers participate as a condition of payment and from setting a fixed price for products or services unless those charges are part of the subscriber agreement. It would require direct access to eye care services without referral for covered services (including glaucoma treatment and postoperative care) and would prohibit various discriminatory or restrictive practices while ensuring reasonable access to providers. It would also ensure optometrist services are reimbursed under the same deductible or coinsurance as other eye care services and clarify provider networks and credentialing.

Who It Affects

• Patients with eye care coverage: gain direct access to eye care providers, have coverage for optometrists, and face fewer barriers to payment and access for covered services.
• Eye care providers (optometrists and ophthalmologists) and insurers: providers are protected from mandatory participation and fixed-fee requirements, must be treated fairly in reimbursement, and must be included in networks with reasonable access; insurers must adhere to non-discriminatory practices and reasonable credentialing.

Key Provisions

• Provision 1: Amends Sections 27-56-2 to 27-56-8 to require public and private insurance plans to provide coverage for eye care services by optometrists under the Act.
• Provision 2: Prohibits requiring eye care providers to participate as a condition of payment.
• Provision 3: Prohibits setting products or services at a fixed fee unless the charges are part of the subscriber agreement.
• Provision 4: Prohibits certain restrictions and discriminatory practices, including overly restrictive eye care practice restrictions, discrimination among eye care providers, hospitalPrivileges requirements, restrictions based on provider degree, discrimination in reimbursement, mandatory purchase of specific ophthalmic materials, cross-policy participation requirements, and price-setting outside the subscriber agreement.
• Provision 5: Requires direct access for eye care services (including glaucoma treatment and postoperative care) without referral and ensures provider lists include eye care providers.
• Provision 6: Requires eye care benefits for optometrists within the scope of their license to be subject to the same annual deductible or coinsurance as other eye care providers.
• Provision 7: Specifies applicability to services delivered after August 1, 2001 and to existing policies on renewal.
• Provision 8: Allows insurers to apply standard selection criteria, utilization protocols, and credentialing, while ensuring reasonable access and provider inclusion.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Access to Eye Care Act