H.B. No. 3211 amends the Texas Insurance Code to enhance the participation of optometrists and therapeutic optometrists in vision care plans. The bill introduces Section 1451.1545, which mandates that vision care plan issuers provide a method on their websites for optometrists to apply for inclusion as participating providers. The application process must be standardized and equitable for all applicants, and issuers are required to respond to applications within specified timeframes. Additionally, the bill ensures that optometrists are allowed to participate in all vision care plans to the full extent of their licenses and prohibits issuers from excluding them based on the number of providers in a geographic area or patient access issues.

The bill also modifies Section 1451.155 to require contracts between managed care plans and optometrists to include electronic access to detailed fee schedules and standardized codes for covered services. Furthermore, it amends Section 1451.157 to prohibit the use of extrapolation in audits of optometrists, ensuring that any payments or refunds are based on actual overpayments or underpayments. The changes aim to create a more transparent and fair process for optometrists participating in vision care plans, ultimately improving access to vision care for patients in Texas.

Statutes affected:
Introduced: Insurance Code 1451.157 (Insurance Code 1451)
House Committee Report: Insurance Code 1451.153, Insurance Code 1451.155, Insurance Code 1451.157 (Insurance Code 1451)
Engrossed: Insurance Code 1451.155, Insurance Code 1451.157 (Insurance Code 1451)
Senate Committee Report: Insurance Code 1451.155, Insurance Code 1451.157 (Insurance Code 1451)
Enrolled: Insurance Code 1451.155, Insurance Code 1451.157 (Insurance Code 1451)