The proposed bill introduces comprehensive regulations for vision benefit plans, vision benefit managers, and vision care providers in Iowa. It establishes definitions for key terms such as "chargeback," "cost sharing," "covered service," and "vision benefit manager." The bill mandates that reimbursement for covered services must be clearly listed, comply with Medicare coding standards, and not fall below Medicare fee schedules. It also requires annual adjustments for reimbursement rates to account for inflation and prohibits vision benefit managers from imposing unfair practices on vision care providers, such as mandating participation in multiple plans or disclosing confidential patient information without consent.

Additionally, the bill outlines prohibited conduct for vision benefit managers, including restrictions on controlling the professional judgment of vision care providers and limiting contracts to a maximum of two years. It requires that any changes to contracts be communicated in advance and agreed upon by the vision care provider. The legislation also allows vision care providers to seek injunctive relief in court for violations, with the potential to recover damages, penalties, and attorney fees. The bill applies to all relevant policies and contracts issued or renewed in the state after its effective date and extends to affiliates or subcontractors of vision benefit managers, with the commissioner of insurance authorized to adopt rules for its administration. The bill is set to take effect immediately upon enactment.

Statutes affected:
Introduced: 714H.3