Senate Bill No. aims to enhance the regulation of eye care providers in Louisiana by amending existing laws and introducing the "Louisiana Vision Plan Transparency and Fair Practice Act." This legislation amends R.S. 22:997 and enacts Part XIII of Chapter 5 of Title 22, establishing definitions, legislative findings, and requirements for coverage of visual services. Key provisions ensure that licensed optometrists are treated equally to physicians in health benefit plans, prohibit discrimination in reimbursements, and prevent health benefit plans from imposing higher fees on patients for services provided by optometrists compared to those provided by physicians. The bill also introduces new regulations for insurers and vision benefit managers, mandating transparency in contracts and prohibiting unfair practices that could limit access to care.

The bill further outlines the rights of eye care providers in the credentialing process, including the ability to appeal denials and ensuring timely communication from insurers. It prohibits insurers from requiring providers to participate in multiple health benefit plans as a condition for network participation and mandates clear communication regarding contract changes. Additionally, the legislation establishes that insurers cannot use extrapolation in audits of eye care providers and grants providers a private right of action for violations, allowing for monetary damages and injunctive relief. The Department of Insurance is given jurisdiction to enforce these provisions, ensuring compliance and protecting the rights of eye care providers while enhancing access to vision care for Louisiana residents.

Statutes affected:
SB404 Original: