Eye care services and materials for patients; provide requirements for insurers and vision benefit managers.

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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Michel

SENATE BILL NO. 2703

AN ACT TO ENSURE ACCESS TO EYE CARE SERVICES AND MATERIALS 1
FOR PATIENTS THROUGH TRANSPARENT AND FAIR BUSINESS PRACTICES; TO 2
PROVIDE DEFINITIONS; TO PROVIDE TRANSPARENCY AND DISCLOSURE 3
REQUIREMENTS FOR INSURERS AND VISION BENEFIT MANAGERS; TO PROVIDE 4
FOR COVERED AND NONCOVERED SERVICES AND MATERIAL IN INSURANCE 5
POLICIES; TO PROHIBIT CERTAIN COERCIVE TACTICS BY INSURERS AND 6
VISION BENEFIT MANAGERS; TO PROVIDE FOR CREDENTIALING AND 7
CONTRACTING REQUIREMENTS FOR INSURERS OR VISION BENEFIT MANAGERS; 8
TO PROHIBIT CHANGING THE TERMS OF PROVIDER AGREEMENTS; TO 9
AUTHORIZE EYE CARE PROVIDERS TO USE ANY LAB OR SUPPLIER; TO 10
PROHIBIT EXTRAPOLATION; TO PROVIDE A PRIVATE RIGHT OF ACTION FOR 11
EYE CARE PROVIDERS; TO PROVIDE FOR ENFORCEMENT OF THIS ACT BY THE 12
MISSISSIPPI COMMISSIONER OF INSURANCE AND THE ATTORNEY GENERAL; 13
AND FOR RELATED PURPOSES. 14
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 15
SECTION 1. Definitions. For purposes of this section: 16
(a) "Contractual discount" means a percentage reduction 17
from a provider's usual and customary rate for covered services 18
and covered materials required under a participating provider 19
agreement. 20
(b) "Materials" means ophthalmic devices, including, 21
but not limited to, lenses, devices containing lenses, artificial 22
intraocular lenses, ophthalmic frames and other lens mounting 23
apparatus, prisms, lens treatments and coatings, contact lenses, 24
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low-vision devices, vision therapy devices, and prosthetic devices 25
to correct, relieve, or treat defects or abnormal conditions of 26
the human eye or its adnexa, or any material allowed to be 27
utilized by the Mississippi State Board of Optometry and Practice 28
Act. 29
(c) "Covered services" means the professional work 30
performed by an eye care provider for which reimbursement from an 31
insurer, vision benefit manager, or subcontractor is provided to 32
an eye care provider by an enrollee's plan contract, or for which 33
a reimbursement would be available but for the application of the 34
enrollee's contractual plan limitations of deductibles, 35
copayments, or coinsurance, regardless of how the services are 36
listed or described in an enrollee's benefit plan's definition of 37
benefits. 38
(d) "Covered materials" means materials for which 39
reimbursement from an insurer, vision benefit manager, or 40
subcontractor is provided to an eye care provider by an enrollee's 41
plan contract, or for which a reimbursement would be available but 42
for the application of the enrollee's contractual limitations of 43
deductibles, copayments, or coinsurance, regardless of how the 44
materials are listed or described in an enrollee's benefit plan's 45
definition of benefits. 46
(e) "Eye care provider" means a licensed doctor of 47
optometry practicing under the authority of Section 73-19-19, 48
Mississippi Code of 1972, or a licensed medical or osteopathic 49
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doctor practicing under the authority of Sections 73-19-25 and 50
73-19-43, Mississippi Code of 1972. 51
(f) "Participating eye care provider" means an eye care 52
provider that has entered into a contractual agreement or other 53
business relationship with an insurer, vision benefit manager, 54
third-party administrator, or subcontractor to provide covered 55
services or covered materials. 56
(g) "Health benefit plan" means a policy, contract, or 57
agreement offered by an insurer, third-party administrator, or 58
subcontractor to an enrollee to pay for, reimburse, discount, or 59
offset health care costs. 60
(h) "Vision benefit plan" means a policy, contract, or 61
agreement offered by an insurer or vision benefit manager to an 62
enrollee to pay for, reimburse, or offset health and vision care 63
costs. 64
(i) "Vision benefit discount plan" means a policy, 65
contract, or agreement offered by an insurer or vision benefit 66
manager to an enrollee that solely provides for a discount for 67
vision care services or materials. 68
(j) "Vision benefit manager" means an individual, 69
company, organization, group, or other entity, including, but not 70
limited to, insurers, third-party administrators, and 71
subcontractors, that creates, promotes, sells, provides, 72
advertises or administers, an integrated or stand-alone vision 73
benefit plan, vision benefit discount plan, or other insurance 74
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policy or contract which provides vision benefits or discounts to 75
an enrollee pertaining to the provision of covered services or 76
covered materials. 77
(k) "Insurer" means, for the purposes of this act, an 78
individual, corporation, partnership, company, organization, 79
group, HMO, captive, risk-retention group, self-insurance group, 80
optometric service and indemnity corporation or other entity, 81
whether organized for profit or not-for-profit, whether foreign or 82
domestic, that conducts business in this state and that offers a 83
vision benefit plan or provides coverage for vision-related 84
services or vision-related materials to enrollees. For avoidance 85
of doubt, an entity is considered an insurer for purposes of this 86
act irrespective of: (i) its corporate form or category of 87
licensure, if applicable, including whether it is otherwise 88
subject to insurance regulations or any other regulations; (ii) 89
whether it, either directly or indirectly reimburses, indemnifies, 90
pays, or discounts the costs of vision services or vision 91
materials; or (iii) whether it delegates, assigns, or contracts 92
performance of any function regulated by this act to an affiliate, 93
subsidiary, contractor, intermediary, or network leasing entity. 94
(l) "Third-party administrator" means an individual, 95
company, organization, group, or other entity that provides 96
services, including, but not limited to, administrative, 97
operational, regulatory, human resource, compliance, and claim 98
adjudication services for an insurer, vision benefit manager, 99
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individual, company, organization, group, or other entity under a 100
contract or agreement. 101
(m) "Subcontractor" means an individual, company, 102
organization, group or other entity, including, but not limited 103
to, agents, servants, brokers, wholesalers, distributors, 104
partially or wholly owned subsidiaries, and controlled 105
organizations that is contracted by the vision benefit manager to 106
supply services or materials to another vision benefit manager, 107
eye care provider, or enrollee to execute or fulfill the health 108
benefit plan, vision benefit plan, or vision benefit discount plan 109
of a vision benefit manager. 110
(n) "Enrollee" means any individual participating in a 111
health benefit plan, vision benefit plan or vision benefit 112
discount plan that is purchased by an individual or provided to an 113
individual by an insurer, company, organization, group, employer, 114
government assistance program, or any other entity that purchases 115
or supplies coverage for a health benefit plan, vision care 116
benefit plan or vision benefit discount plan. 117
(o) "Chargeback" means a dollar amount, fee, surcharge, 118
rebate, or item of value that reduces, modifies, or offsets all or 119
part of the patient responsibility, provider reimbursement, 120
allowed amount, or fee schedule for a covered service or covered 121
material. 122
(p) "Fee Schedule" means the document or system that 123
lists the predetermined payment rates or allowed amounts for 124
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covered services and/or covered materials and determines how much 125
eye care providers are reimbursed by the insurer or vision benefit 126
manager and how much patients are charged by the insurer, vision 127
benefit manager, or eye care provider. 128
(q) "Extrapolation" means a mathematical formula, 129
process, or technique used by a vision benefit manager, or the 130
vision benefit manager's agent, in the audit of an optometrist to 131
estimate audit results or findings for a larger batch or group of 132
claims not reviewed by the vision benefit manager. 133
(r) "Nominal" means, when there is no corresponding 134
reimbursement in the current year's published Physician Fee 135
Schedule (PFS) released annually by the Centers for Medicare & 136
Medicaid Services (CMS) or in the current year's published state 137
Medicaid fee schedule, an amount less than the reasonable 138
compensation to the vision care provider rendering the covered 139
service or covered materials, taking into account the provider's 140
direct and indirect costs, i.e., the actual acquisition costs and 141
actual pro rata overhead costs, and reasonable profit. 142
(s) "De minimis" means equal to zero or an otherwise 143
negligible amount. 144
SECTION 2. Transparency and disclosure requirements for 145
insurers and vision benefit managers. (1) An insurer or vision 146
benefit manager shall disclose the following information publicly 147
on its internet website and with all documents and document 148
packages, including, but not limited to, proposals, responses to 149
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requests for proposals, sales documents, enrollment documents, 150
benefit plan documents, purchaser contracts, enrollee contracts, 151
and provider agreements that are presented to purchasers, 152
potential purchasers, enrollees, potential enrollees, 153
participating eye care providers, potential participating 154
providers, and state agencies with jurisdictional, regulatory, or 155
enforcement authority over its business: 156
(a) Its legal name and entity type; 157
(b) Its legal address and state in which the legal 158
entity is formed or organized; 159
(c) The physical address, mailing address, electronic 160
mail address, and phone number of its operational headquarters; 161
(d) The agencies, departments, committees, commissions, 162
and other bodies that have jurisdictional, regulatory, or 163
enforcement authority over the business; 164
(e) A statement that no jurisdictional, regulatory, or 165
enforcement authority exists over its business, if none exists; 166
(f) The names, physical addresses, mailing addresses, 167
electronic mail addresses, and phone numbers of all parent 168
companies, related holding companies, wholly owned subsidiary 169
companies, and partially owned subsidiary companies; 170
(g) All federal and state litigation in which the 171
company is, or has been, a party to in the current year and during 172
the preceding five (5) years. 173
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(h) All State Department of Insurance formal complaints 174
against the company in the current year and during the preceding 175
five (5) years by purchasers, enrollees, or eye care providers. 176
(2) All information required to be disclosed by an insurer 177
or vision benefit manager in subsection (1) of this section shall 178
be conveyed in plain language and typed with a minimum of ten (10) 179
point font size and prominently displayed: 180
(a) On the insurer's or vision benefit manager's 181
website in a publicly accessible section titled "Required 182
Transparency Information for Patients, Doctors, and Purchasers"; 183
and 184
(b) In a separately created document titled "Required 185
Transparency Information for Patients, Doctors, and Purchasers" 186
that shall be included with all documents and document packages, 187
including, but not limited to, proposals, responses to requests 188
for proposals, benefit plan documents, sales documents, enrollment 189
documents, purchaser contracts, enrollee contracts, and provider 190
agreements. 191
(3) An insurer or vision benefit manager shall provide 192
notice to each participating eye care provider of any proposed 193
amendments to existing provider agreements, fee schedules, 194
provider handbooks, provider manuals, or related policy documents 195
via electronic mail. 196
(4) A participating eye care provider shall be provided with 197
a minimum of ninety (90) calendar days from the time of 198
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distribution to review changes and respond, if necessary, to any 199
proposed amendments from an insurer or vision benefit manager to 200
existing provider agreements, fee schedules, provider handbooks, 201
provider manuals, or related policy documents. Any such proposed 202
amendments proffered by the insurer or vision benefit manager in 203
violation of the foregoing shall be void and unenforceable as a 204
matter of law. 205
(5) Any proposed amendments to existing provider agreements, 206
fee schedules, provider handbooks, provider manuals, or related 207
policy documents by an insurer or vision benefit manager delivered 208
to a participating eye care provider shall be: 209
(a) Enumerated in a cover letter; 210
(b) Marked with highlights or in tracked changes within 211
the applicable agreements and/or documents to clearly display all 212
changes over the previous version(s); 213
(c) Structured to include implications of agreeance or 214
nonagreeance by the participating eye care provider. 215
(6) An insurer or vision benefit manager shall maintain: 216
(a) A phone number to company representatives to 217
receive questions and communications from participating eye care 218
providers at all times during standard business hours; 219
(b) The ability for an eye care provider to leave voice 220
messages at all times; and 221
(c) The ability for an eye care provider to have a live 222
phone discussion with a company representative within twenty-four 223
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(24) hours of an initial phone call or a voice message left with 224
the insurer or vision benefit manager. 225
(7) An insurer or vision benefit manager shall maintain a 226
physical mailing address and an electronic mail address to company 227
representatives to receive questions, disputes, and communications 228
from participating eye care providers about all matters, at all 229
times, including, but not limited to, proposed amendments to 230
existing provider agreements, fee schedules, provider handbooks, 231
provider manuals, and related policy documents, and will publish 232
instructions for mail submission and electronic mail submission of 233
questions, disputes, and communications in a place visible to 234
participating eye care providers including on its website and in 235
any provider agreements, provider handbooks, provider manuals, or 236
related policy documents. 237
(8) An insurer or vision benefit manager shall acknowledge 238
receipt of an electronic mail message within one (1) hour by use 239
of a return electronic mail message with a communication tracking 240
number, and shall respond to the substantive questions or 241
communications of the electronic mail message within seventy-two 242
(72) hours in writing by use of a return electronic mail message. 243
(9) An insurer or vision benefit manager shall, at all 244
times, make available to the eye care provider the most up-to-date 245
provider agreements, fee schedules, provider handbooks, provider 246
manuals, and related policy documents via website access. 247
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(10) Insurers or vision benefit managers shall not engage in 248
marketing or advertising activities that are misleading or 249
deceptive to the public. Such acts are considered deceptive trade 250
practices and subject to penalty under the Unfair Trade Practices 251
Act, Section 83-9-209, Mississippi Code of 1972. 252
(11) Upon request by a state agency with jurisdictional, 253
regulatory, or enforcement authority over its business, insurers 254
and vision benefit managers shall submit all information related 255
to a health benefit plan, vision benefit plan, or vision benefit 256
discount plan, including, but not limited to, proposals, responses 257
to requests for proposals, benefit plan documents, sales 258
documents, enrollment documents, purchaser contracts, enrollee 259
contracts, provider agreements, and marketing and advertising 260
activities for review. 261
SECTION 3. Covered and noncovered services and materials 262
provisions. (1) No agreement or contract between an insurer or 263
vision benefit manager and an eye care provider may seek to or 264
require that an eye care provider provide services or materials at 265
a fee limited or set by the insurer or vision benefit manager 266
unless the services or materials are defined and reimbursed as 267
covered services or covered materials under the agreement or 268
contract. 269
(2) An insurer or vision benefit manager shall only use 270
standardized codes, names, descriptions, and definitions published 271
in the Healthcare Common Procedure Coding System ("HCPCS"), 272
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including Current Procedural Terminology codes published by the 273
American Medical Association and Level II codes published by the 274
Centers for Medicare and Medicaid Services, to identify and 275
describe such covered services and covered materials of the vision 276
benefit plan to purchasers, enrollees, and eye care providers of 277
the vision benefit plan. 278
(3) An insurer or vision benefit manager shall adhere to the 279
standardized codes, names, descriptions, and definitions published 280
in the Healthcare Common Procedure Coding System ("HCPCS"), 281
including all Current Procedural Terminology codes published by 282
the American Medical Association and all Level II codes published 283
by the Centers for Medicare and Medicaid Services, to create and 284
offer a fee schedule for covered services and covered materials in 285
an agreement between the insurer or vision benefit manager and an 286
eye care provider. 287
(4) An insurer or vision benefit manager shall not attempt 288
to alter the meaning of any of the standardized codes, names, 289
descriptions, or definitions published in the Healthcare Common 290
Procedure Coding System ("HCPCS"), including all Current 291
Procedural Terminology codes published by the American Medical 292
Association and all Level II codes published by the Centers for 293
Medicare and Medicaid Services. Any such contractual language, 294
policies or procedures set by the insurer or vision benefit 295
manager in violation of the foregoing shall be void and 296
unenforceable as a matter of law. 297
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(5) All fee schedules in an agreement between an insurer or 298
vision benefit manager and an eye care provider and all 299
reimbursements paid by an insurer or vision benefit manager to an 300
eye care provider for all covered services and covered materials 301
shall not be nominal or de minimis. There shall be no limitation 302
on the ability of an individual eye care provider or a group of 303
eye care providers who practice under a single Employer 304
Identification Number (EIN) or Tax Identification Number (TIN) to 305
engage in direct negotiations with the insurer or vision benefit 306
manager regarding reimbursement fee schedules, and ultimately 307
agreeing to a different fee schedule than the fee schedule 308
provided by the insurer or vision benefit manager to other 309
participating providers or groups. 310
(6) All fee schedule allowed amounts and all reimbursements 311
paid by an insurer or vision benefit manager for each covered 312
service and covered material shall be clearly and individually 313
listed on a fee schedule made available to the eye care provider: 314
(a) At the time an agreement is offered to the eye care 315
provider by an insurer or vision benefit manager; 316
(b) Within ten (10) business days from the date an 317
application is made to become a participating eye care provider 318
with the insurer or vision benefit manager by the eye care 319
provider; and 320
(c) At all times via electronic means to the 321
participating eye care provider. 322
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(7) A contract between an insurer or vision benefit manager 323
and an eye care provider shall include a fee schedule that 324
includes and individually identifies each covered service and 325
covered material and its corresponding allowed amount, 326
reimbursement amount paid to the eye care provider, and any form 327
of a cost-sharing amount paid by the enrollee to the eye care 328
provider. 329
(8) Insurers or vision benefit managers shall not advertise, 330
claim, or represent to purchasers or enrollees that services and 331
materials provided by a participating eye care provider are 332
covered, included, or covered with an additional deductible, 333
copay, or coinsurance, if the insurer or vision benefit manager 334
does not remit an actual payment to the participating eye care 335
provider as full or partial reimbursement for the service or 336
material. 337
(9) A service or material provided by a participating eye 338
care provider cannot be designated as a covered service or covered 339
material by the insurer or vision benefit manager in the design of 340
a health benefit plan, vision benefit plan, or vision benefit 341
discount plan if the reimbursement amount to the participating eye 342
care provider is only comprised of an enrollee's payment to the 343
participating eye care provider. 344
(10) Insurers or vision benefit managers shall not condition 345
application to or network participation in a health benefit plan, 346
vision benefit plan, or vision benefit discount plan by an eye 347
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care provider based on the eye care provider's usual and customary 348
pricing or discounts on usual and customary pricing for services 349
or materials that are not covered services or not covered 350
materials. Any such contractual language, policies, or procedures 351
set by the insurer or vision benefit manager in violation of the 352
foregoing shall be void and unenforceable as a matter of law. 353
(11) Insurers or vision benefit managers shall not make 354
conditional a fee schedule proposed or made to an eye care 355
provider of a health benefit plan, vision benefit plan, or vision 356
benefit discount plan for covered services or covered materials 357
based on the eye care provider's usual and customary pricing or 358
discounts on usual and customary pricing for services or materials 359
that are not covered services or not covered materials. Any such 360
contractual language, policies, or procedures set by the insurer 361
or vision benefit manager in violation of the foregoing shall be 362
void and unenforceable as a matter of law. 363
(12) A contract between an insurer or vision benefit manager 364
and an eye care provider shall not contain a provision, fee 365
schedule, or reimbursement amount in which the eye care provider, 366
with consideration of any applicable deductibles, copays, 367
coinsurances, discounts, rebates, or chargebacks, to provide 368
covered services or covered materials to an enrollee at a 369
financial loss. Any such contractual language, policies or 370
procedures set by the insurer or vision benefit manager in 371
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violation of the foregoing shall be void and unenforceable as a 372
matter of law. 373
(13) The period of time prescribed by a contract between any 374
insurer or vision benefit manager and an eye care provider for the 375
insurer or vision benefit manager to recover any reimbursement 376
amount from an eye care provider shall be the same period of time 377
allowed or required for any insurer or vision benefit manager to 378
remit the applicable reimbursement following an eye care 379
provider's submission of a clean claim for services rendered 380
and/or materials furnished. The foregoing shall not limit an 381
insurer or vision benefit manager's ability to conduct an audit of 382
claims, in accordance with the insurer or vision benefit manager's 383
written policies and applicable law, in the event that the insurer 384
or vision benefit manager has a reasonable belief that the eye 385
care provider has engaged in fraud, waste, or abuse. 386
(14) Insurers or vision benefit managers shall not falsely 387
represent the number of participating providers in a region nor 388
the benefits that comprise a health benefit plan, vision benefit 389
plan, or vision benefit discount plan to clients, groups, 390
employers, purchasers, companies, enrollees, or prospective 391
enrollees. Such acts are considered deceptive trade practices and 392
subject to penalty under the Unfair Trade Practices Act, Section 393
83-9-209, Mississippi Code of 1972. 394
(15) An insurer or vision benefit manager shall not promote 395
or use in any marketing or advertising for a health benefit plan, 396
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vision benefit plan, or vision benefit discount plan that a 397
covered service or covered material is "free" or "no charge" or 398
"complimentary" or any materially similar language to induce a 399
client, group, employer, purchaser, company, enrollee or 400
prospective enrollee to purchase services, materials, supplies, or 401
plans from the insurer, vision benefit manager, or affiliate of 402
the insurer or vision benefit manager. 403
(16) Insurers or vision benefit managers shall not offer 404
enrollees of a health benefit plan, vision benefit plan, or vision 405
benefit discount plan varying deductibles, copays, coinsurances, 406
coverage amounts, rebates, gift cards, or other monetary or 407
nonmonetary incentives to obtain covered services, covered 408
materials, noncovered services, or noncovered materials: 409
(a) At any particular participating eye care provider; 410
(b) At a retail establishment owned by, partially owned 411
by, contracted with, or otherwise affiliated with the insurer or 412
vision benefit manager; or 413
(c) At any internet or virtual provider or retailer 414
owned by, partially owned by, contracted with, or otherwise 415
affiliated with the insurer or vision benefit manager. 416
(17) Insurers or vision benefit managers shall remit to the 417
participating eye care provider the contracted reimbursement 418
amount from the fee schedule for a covered service or covered 419
material provided to an enrollee if the enrollee is verified to be 420
eligible by the participating eye care provider through customary 421
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verification methods of the insurer or vision benefit manager to 422
receive the covered service or covered material on the date of 423
service. 424
(18) Insurers or vision benefit managers shall not 425
retroactively reverse a reimbursement or withhold a future 426
reimbursement to a participating eye care provider who relied in 427
good faith on an individual's presented coverage credentials and 428
the customary verification methods of the insurer or vision 429
benefit manager, if the vision benefit manager later determines 430
that the enrollee was ineligible to receive covered services or 431
covered materials on the date of service. 432
(19) Insurers or vision benefit managers shall not require a 433
participating eye care provider, purchaser, or enrollee of a 434
health benefit plan, vision benefit plan, or vision benefit 435
discount plan to obtain prior authorization, preauthorization, 436
precertification, or any similar mechanism that restricts the 437
enrollee from receiving a covered service or covered material 438
recommended by the eye care provider and requested by the 439
enrollee. 440
(20) Participating eye care providers are allowed, but not 441
required, to offer an enrollee the opportunity to pay the 442
participating eye care provider directly for covered services and 443
covered materials if such direct payment would be less costly to 444
the enrollee than the total out-of-pocket cost required under the 445
terms of a health benefit plan or vision benefit plan. A provider 446
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may not be subject to an audit, removed from participation in the 447
network, or otherwise penalized or discriminated against in any 448
manner for offering an enrollee the opportunity to pay the 449
participating provider directly under the conditions of this 450
provision. 451
(21) Insurers or vision benefit managers shall not, in the 452
course of adjudicating a claim for reimbursement by a 453
participating eye care provider for a covered service or covered 454
material, alter, delete, substitute, or otherwise change any code 455
or modifier submitted by the eye care provider, including by 456
downcoding, bundling or reassigning to a different code, if such 457
change would reduce payment or otherwise adversely affect the 458
provider and/or enrollee. For purposes of this section, "down 459
coding" means to alter, delete, substitute or assign a code that 460
results in a lower level of service, a lower-valued code, or a 461
reduced reimbursement amount relative of the code(s) submitted by 462
the eye care provider; and "bundling" means to combine, 463
substitute, or treat two (2) or more distinct services, supplied, 464
or materials reported on the same claim or date or service as 465
included within a single code, package, or global service, and 466
denying, reducing, or disallowing separate reimbursement for one 467
or more of these codes. 468
(22) All provisions in this chapter shall apply to all 469
affiliates, parent companies, third party administrators, and 470
subcontractors that are used by an insurer or vision benefit 471
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manager to supply covered services or covered materials to an eye 472
care provider or enrollee and be subject to all applicable 473
penalties as referenced in this chapter. 474
(23) An insurer or vision benefit manager shall not require 475
nor request an eye care provider to opt-in or opt-out of the 476
provisions set forth in this act. 477
SECTION 4. Prohibiting coercive tactics by insurers and 478
vision benefit managers; providing reimbursement parity for 479
Optometrists and Ophthalmologists; requiring affiliates to comply 480
with statute. (1) No agreement between an insurer or vision 481
benefit manager and an eye care provider shall require that an eye 482
care provider must participate with, be credentialed by, or enter 483
into an agreement with any specific vision benefit plan or vision 484
benefit discount plan as a condition for participation in the 485
health benefit plan provider network of the insurer or vision 486
benefit manager to provide covered services or covered materials 487
to the enrollees of the health benefit plan. 488
(2) No agreement between an insurer or vision benefit 489
manager and an eye care provider shall require that an eye care 490
provider must participate with, be credentialed by, or enter into 491
an agreement with any specific health benefit plan as a condition 492
for participation in the vision benefit plan or vision benefit 493
discount plan provider network of the insurer or vision benefit 494
manager to provide covered services or covered materials to the 495
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enrollees of the vision benefit plan or vision benefit discount 496
plan. 497
(3) Any insurer or vision benefit manager issuing or 498
renewing a health benefit plan, vision benefit plan or vision 499
benefit discount plan which provides benefits for covered services 500
or covered materials rendered by a physician or osteopath duly 501
licensed under Section 73-25-1 et seq. that are within the scope 502
of practice of an optometrist duly licensed under the provisions 503
of Section 73-19-1 et seq. shall provide the same reimbursement 504
for covered services or covered materials to optometrists as 505
allowed for those covered services or covered materials rendered 506
by physicians or osteopaths. 507
(4) An insurer or vision benefit manager shall apply the 508
same terms and conditions of participation for all eye care 509
providers, irrespective of their educational credentials, i.e., 510
MD, DO, OD, subject to the permitted scope of practice for the 511
licensee under applicable state law. 512
(5) An insurer or vision benefit manager shall not require 513
an eye care provider to possess, offer, procure, or sell materials 514
or covered materials in their office as a condition of 515
participation in the provider network of health benefit plan, 516
vision benefit plan, or vision benefit discount plan. Any such 517
contractual language, policies or procedures set by the insurer or 518
vision benefit manager in violation of the foregoing shall be void 519
and unenforceable as a matter of law. 520
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(6) If an eye care provider enters into any subcontract 521
agreement with another provider to provide his or her licensed 522
health care services to an enrollee or a covered dependent of an 523
enrollee of a health benefit plan, vision benefit plan, or vision 524
benefit discount plan where the subcontracted provider will seek 525
reimbursement from the plan or enrollee for the subcontracted 526
services, the subcontract agreement must meet all requirements of 527
this act. 528
(7) The provisions of this subsection shall also apply to 529
any agreements an insurer or vision benefit manager enters into 530
with another entity to provide an enrollee with covered services 531
or covered materials. 532
SECTION 5. Relating to conditional or coercive participation 533
of eye care providers in vision benefit manager networks. (1) It 534
is prohibited for an insurer or vision benefit manager that offers 535
multiple health benefit plans, vision benefit plans, or vision 536
benefit discount plans to require an eye care provider, as a 537
condition of participation in the network for a health benefit 538
plan, vision benefit plan or vision benefit discount plan, to 539
participate in the network of any of the insurer's or vision 540
benefit manager's other health benefit plans, vision benefit plans 541
or vision benefit discount plans. A contract provision violating 542
this subsection is void as a matter of law. The penalties and 543
remedies provided in this chapter for violation of this provision 544
shall not waive, limit, or otherwise affect the applicability of 545
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Mississippi's Unfair Trade Practices Act, or any other law 546
providing for civil or criminal penalties or remedies for unfair, 547
deceptive, or unlawful business practices. 548
(2) It is prohibited for an insurer or vision benefit 549
manager that offers multiple health benefit plans, vision benefit 550
plans, or vision benefit discount plans to withhold participation 551
in the network of one or more of the insurer's or vision benefit 552
manager's other health benefit plans, vision benefit plans, or 553
vision benefit discount plans if the eye care provider, having 554
completed the credentialing requirements of the insurer or vision 555
benefit manager for participation, is already participating in the 556
network of one or more of the insurer's or vision benefit 557
manager's health benefit plans, vision benefit plans, or vision 558
benefit discount plans and seeks to participate in the network of 559
the insurer's or vision benefit manager's other health benefit 560
plans, vision benefit plans, or vision benefit discount plans. 561
(3) Subsections (1) and (2) of this section apply to all 562
plan types that a health benefit plan, vision benefit plan, or 563
vision benefit discount plan sells, administers, or offers, 564
including, but not limited to, individually purchased plans, 565
employer-sponsored plans, and government-sponsored plans, e.g., 566
Medicare, Medicaid, and Tricare, etc. 567
SECTION 6. Credentialing and contracting requirements; 568
acceptance as participating eye care provider. (1) An insurer or 569
vision benefit manager must include on their internet website: 570
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(a) a method for an eye care provider to submit an application for 571
inclusion and credentialing as a participating provider in the 572
health benefit plan, vision benefit plan, or vision benefit 573
discount plan; and (b) a description of the credentialing 574
requirements, which must be reasonable, related to the delivery of 575
covered eye care services, and applied in an objective, uniform, 576
and nondiscriminatory manner. 577
(2) An insurer's or vision benefit manager's application for 578
inclusion and credentialing as a participating eye care provider 579
in the health benefit plan, vision benefit plan, or vision benefit 580
discount plan shall only require standardized information 581
prescribed by law or regulation or information specified on the 582
Council for Affordable Quality Healthcare credentialing 583
application. 584
(3) An insurer's or vision benefit manager's application for 585
inclusion and credentialing as a participating eye care provider 586
in the health benefit plan, vision benefit plan, or vision benefit 587
discount plan must impose the same application and credentialing 588
requirements on each eye care provider. 589
(4) No later than the 10th business day after the date the 590
insurer or vision benefit manager receives an application from an 591
eye care provider for inclusion and credentialing as a 592
participating provider in the health benefit plan, vision benefit 593
plan, or vision benefit discount plan, the insurer or vision 594
benefit manager shall make available electronically to the eye 595
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care provider a proposed participating provider agreement, 596
including applicable fee schedules, provider handbooks, and 597
provider manuals. 598
(5) No later than the 30th business day after the date the 599
insurer or vision benefit manager receives an application from an 600
eye care provider for inclusion and credentialing as a 601
participating provider in the health benefit plan, vision benefit 602
plan, or vision benefit discount plan, the insurer or vision 603
benefit manager shall complete the credentialing determination of 604
the eye care provider, approve or disapprove the application of 605
the eye care provider, and deliver electronically a proposed 606
participating provider agreement described by subsection (4) of 607
this section for acceptance and signature of the approved eye care 608
provider. 609
(6) If the application for inclusion and credentialing as a 610
participating provider is denied by the insurer or vision benefit 611
manager, the insurer or vision benefit manager shall deliver to 612
the applicant eye care provider a detailed explanation for the 613
denial both electronically and in writing via certified mail. 614
(7) If the application for inclusion and credentialing as a 615
participating provider is denied by the insurer or vision benefit 616
manager, the eye care provider must be allowed a reasonable period 617
of time in which to appeal the decision to the insurer or vision 618
benefit manager and provide in the appeal evidence that supports 619
the reconsideration of the denied application. The insurer or 620
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vision benefit manager shall consider, and render a decision on, 621
the eye care provider's appeal submission within thirty (30) days 622
of the date of receipt of the submission by the insurer or vision 623
benefit manager. 624
(8) If the appeal to the application denial for inclusion 625
and credentialing as a participating provider is denied by the 626
insurer or vision benefit manager, the insurer or vision benefit 627
manager shall deliver to the applicant eye care provider a 628
detailed explanation for the denial of the appeal both 629
electronically and in writing via certified mail. 630
(9) If the appeal to the application denial for inclusion 631
and credentialing as a participating provider is denied by the 632
insurer or vision benefit manager, the applicant eye care provider 633
may appeal the decision to the Mississippi Commissioner of 634
Insurance and seek a ruling that allows the eye care provider to 635
become a participating provider in the health benefit plan, vision 636
benefit plan, or vision benefit discount plan. 637
(10) An insurer or vision benefit manager, concurrent with 638
the electronic delivery of the proposed participating provider 639
agreement to the approved eye care provider described by 640
subsection (5) of this section, must provide the name, email 641
address, and phone number of a representative of the insurer or 642
vision benefit manager to allow the approved eye care provider the 643
opportunity to: 644
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(a) Contact the representative before signing the 645
agreement; 646
(b) Discuss the proposed agreement with the 647
representative before signing the agreement; and 648
(c) Electronically send the representative 649
modifications to the proposed agreement before signing the 650
agreement. 651
(11) In the event that the approved eye care provider sends 652
the representative of the insurer or vision benefit manager 653
modifications to the proposed participating provider agreement 654
described by subsection (10)(c) of this section, the insurer or 655
vision benefit manager must respond to the submission of the 656
approved eye care provider within five (5) business days. Each 657
subsequent response made by the insurer, vision benefit manager, 658
or approved eye care provider to the other party must be responded 659
to within five (5) business days by the receiving party. 660
(12) Once the insurer or vision benefit manager has approved 661
and delivered electronically a proposed participating provider 662
agreement described by subsection (5) of this section, the 663
approved eye care provider has a total allotted timeframe of 664
ninety (90) business days to reach agreement with the insurer or 665
vision benefit manager and sign a participating provider 666
agreement. If the parties fail to reach agreement and no 667
participating provider agreement is signed by the approved eye 668
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care provider within the allotted timeframe, the insurer or vision 669
benefit manager may retract the participating provider agreement. 670
(13) No later than the 20th business day after the date the 671
approved eye care provider signs a participating provider 672
agreement, the insurer or vision benefit manager shall include the 673
credentialed and approved eye care provider as a participating 674
provider in the health benefit plan, vision benefit plan, or 675
vision benefit discount plan, and list the eye care provider in 676
all of the plan's directories that are available to enrollees and 677
the public. 678
(14) The earliest that an eye care provider may submit 679
another application to an insurer or vision benefit manager after 680
a previous approval and subsequent unsuccessful attempt to 681
negotiate a mutually acceptable participating provider agreement 682
is one hundred eighty (180) calendar days from the date of 683
submission of the previous application. 684
(15) The earliest that an eye care provider may submit 685
another application to an insurer or vision benefit manager after 686
a previous disapproval of application is one hundred eighty (180) 687
calendar days from the date of submission of the previous 688
application. 689
(16) An insurer or vision benefit manager shall allow an eye 690
care provider to become a participating provider in the network of 691
a health benefit plan, vision benefit plan, or vision benefit 692
discount plan if the eye care provider: (a) meets the 693
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credentialing requirements of the insurer or vision benefit 694
manager; and (b) agrees in writing to the applicable provider 695
agreement. 696
(17) An insurer or vision benefit manager shall not exclude 697
an eye care provider from applying to, or becoming a participating 698
provider in, the network of a health benefit plan, vision benefit 699
plan, or vision benefit discount plan because of: 700
(a) The aggregate number of eye care providers in a 701
state, county, city, zip code, or other geographically defined 702
service area; 703
(b) The time, distance, or appointment availability for 704
an enrollee to access a participating eye care provider; 705
(c) The provider's professional designation, 706
independent practice affiliation, or participation status in other 707
health benefit plans, vision benefit plans, or vision benefit 708
discount plans. 709
SECTION 7. Prohibits insurer, vision benefit manager from 710
changing the terms of a provider agreement with a participating 711
eye care provider without clear written communication to, and 712
affirmative acceptance by, the eye care provider. (1) An insurer 713
or vision benefit manager shall not change or alter a provider 714
agreement, including terms, reimbursements, fee schedules, 715
policies, procedures, or provider manuals incorporated by 716
reference into the provider agreement, entered into with a 717
participating eye care provider unless the insurer or vision 718
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benefit manager performs the following steps at least ninety (90) 719
days before the date of the proposed change would take effect: 720
(a) A certified letter, or an electronic communication 721
requiring an electronic signature proving receipt, clearly 722
detailing proposed changes is required to be sent to the eye care 723
provider; 724
(b) A face-to-face or virtual meeting is required to 725
discuss proposed changes if requested by the eye care provider; 726
(c) The eye care provider must either agree or protest 727
in writing to the proposed changes. If the changes are not agreed 728
to by the eye care provider, then the current agreement shall 729
continue and the insurer or vision benefit manager may not remove 730
the eye care provider from participation with a health benefit 731
plan, vision benefit plan, or vision benefit discount plan for not 732
accepting the proposed changes; 733
(d) Any proposed amendment to an existing provider 734
agreement shall be presented to the participating eye care 735
provider in a manner conducive to the eye care provider's review. 736
Proposed changes will be: (i) enumerated in a cover letter; and 737
(ii) clearly marked in tracked changes within the body of the 738
applicable agreement; 739
(e) An agreement between an insurer or vision benefit 740
manager and an eye care provider shall not contain a provision 741
requiring the optometrist to accept a reimbursement payment in the 742
form of a virtual credit card or any other payment method wherein 743
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a processing fee, administrative fee, percentage amount, or dollar 744
amount is assessed for the provider to receive the reimbursement 745
payment. 746
(2) Termination of any provider agreement shall be 747
permissible only in the event of a material breach, wherein the 748
eye care provider fails to remedy the alleged breach to the 749
reasonable satisfaction of the insurer or vision benefit manager 750
within thirty (30) days of receipt of written notice specifying 751
the alleged breach. 752
(3) It shall be prohibited for an insurer or vision benefit 753
manager to require an eye care provider to establish a security 754
interest in all or part of their property and assets, including 755
assets pertaining to their practice, in a sum equivalent to the 756
funds owed to the insurer or vision benefit manager at 757
termination. Any such contractual language, policies or 758
procedures set by the insurer or vision benefit manager in 759
violation of the foregoing shall be void and unenforceable as a 760
matter of law. 761
(4) A provider agreement between an insurer or vision 762
benefit manager and an eye care provider shall not contain a 763
provision obligating the eye care provider to share equally the 764
expenses of arbitration. Any such contractual language, policies 765
or procedures set by the insurer or vision benefit manager in 766
violation of the foregoing shall be void and unenforceable as a 767
matter of law. Each party shall bear their own arbitration costs, 768
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contingent upon a fee-shifting provision that grants prevailing 769
party status. 770
(5) An insurer or vision benefit manager shall not retaliate 771
in any manner against an eye care provider for discussing, or 772
attempting in good faith to negotiate, the terms and provision of 773
a provider agreement with the insurer or vision benefit manager. 774
(6) An insurer or vision benefit manager shall not retaliate 775
in any manner against an eye care provider for filing a complaint 776
against the insurer or vision benefit manager with any state 777
agency with jurisdictional, regulatory, or enforcement authority 778
over the business of the insurer or vision benefit manager. 779
(7) Should retaliation by an insurer or vision benefit 780
manager occur against an eye care provider in violation of 781
subsections (5) and (6) of this section, a state agency that has 782
jurisdictional, regulatory, or enforcement authority over the 783
business of the insurer or vision benefit manager may sanction the 784
insurer or vision benefit manager, including fines and other 785
remedies deemed appropriate, and provide an appropriate remedy for 786
the aggrieved eye care provider. 787
SECTION 8. Permitting eye care providers to use any lab or 788
supplier. (1) No agreement between an insurer or vision benefit 789
manager and an eye care provider shall restrict or limit, either 790
directly or indirectly, the eye care provider's choice or use of 791
sources and suppliers of covered or uncovered services or 792
materials, including the choice or use of optical laboratories, 793
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provided by the eye care provider to an enrollee. Any such 794
contractual language, policies or procedures set by the insurer or 795
vision benefit manager in violation of the foregoing shall be void 796
and unenforceable as a matter of law. 797
(2) An insurer or vision benefit manager shall not directly 798
or indirectly: 799
(a) Control or attempt to control the professional 800
judgment, manner of practice, or practice of an eye care provider; 801
(b) Employ an eye care provider to provide a covered 802
service or covered material; 803
(c) Reimburse an eye care provider a different amount 804
for covered services or covered materials because of the eye care 805
provider's choice of: 806
(i) Optical laboratory; 807
(ii) Source of supplier of: 808
1. Contact lenses; 809
2. Ophthalmic lenses; 810
3. Ophthalmic glasses frames; or 811
4. Covered or noncovered services or 812
materials; 813
(iii) Equipment used for patient care; 814
(iv) Retail optical affiliation; 815
(v) Vision support organization; 816
(vi) Group purchasing organization; 817
(vii) Doctor alliance; 818
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(viii) Professional trade association membership; 819
(ix) Electronic health record software, electronic 820
medical record software, or practice management software; or 821
(x) Third-party claim filing service, billing 822
service, or electronic data interchange clearinghouse company; 823
(d) Restrict, limit or influence an eye care provider's 824
choice of sources or suppliers of services or materials, including 825
optical laboratories used by the eye care provider to provide 826
services or materials to the enrollee; 827
(e) Restrict, limit, or influence an eye care 828
provider's choice of electronic health record software, electronic 829
medical record software, or practice management software; 830
(f) Restrict, limit, or influence an eye care 831
provider's choice of third-party claim filing service, billing 832
service, or electronic data interchange clearinghouse company; 833
(g) Restrict or limit an eye care provider's access to 834
an enrollee's complete plan coverage information, including 835
in-network and out-of-network coverage details; 836
(h) Apply a chargeback to an enrollee or eye care 837
provider if the chargeback is for a covered product or service for 838
which the insurer or vision benefit manager does not incur the 839
cost to produce, deliver, or provide to the enrollee or eye care 840
provider; 841
(i) Require an eye care provider to disclose an 842
enrollee's confidential or protected health information unless the 843
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disclosure is expressly authorized by the enrollee, or permitted 844
without authorization under the Health Insurance Portability and 845
Accountability Act of 1996; 846
(j) Require an eye care provider to disclose or report 847
a medical history or diagnosis as a condition to file a claim, 848
adjudicate a claim, or receive reimbursement for a routine or 849
wellness eye exam; 850
(k) Require an eye care provider to disclose or report 851
an enrollee's glasses prescription, contact lens prescription, 852
ophthalmic device measurements, facial photograph, or unique 853
anatomical measurements as condition to file a claim, adjudicate a 854
claim, or receive reimbursement for a claim, unless the 855
information in needed for the vision benefit manager to 856
manufacture, or cause to be manufactured, a covered product that 857
is submitted on the applicable claim; or 858
(l) Require an eye care provider to disclose any 859
enrollee information, other than information identified on the 860
version of the Health Insurance Claim Form approved by the 861
National Uniform Claim Committee as of March 1, 2023, (or its 862
approved successor), as a condition to file a claim, adjudicate a 863
claim, or receive reimbursement for a claim unless the information 864
is needed for the vision benefit manager to manufacture, or cause 865
to be manufactured, a covered product that is submitted on the 866
applicable claim. 867
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(3) An insurer or vision benefit manager shall not solicit 868
patients or referrals for supplies on behalf of themselves and/or 869
their affiliates by identifying participating eye care providers 870
in an inaccurate or otherwise misleading manner in any list of 871
participating providers or in any communications to purchasers or 872
enrollees. All communications which distinguish between 873
participating eye care providers, or which otherwise claim 874
professional superiority or the performance of a professional 875
service in a superior manner, based on the following 876
characteristics, shall be readily subject to verification by the 877
Department of Insurance: 878
(a) A discount or incentive offered by the 879
participating eye care provider on services and materials that are 880
not covered by the insurer or vision benefit manager; 881
(b) The dollar amount, volume amount, or percent usage 882
amount of any material, product, or good purchased by the 883
participating eye care provider; 884
(c) The brand, source, manufacturer, or supplier of a 885
covered service or covered material utilized by the participating 886
eye care provider. 887
(4) For the avoidance of doubt, this section does not 888
prohibit advertising, provided that such advertising is: (a) not 889
false, misleading, or deceptive; or (b) readily subject to 890
verification. 891
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SECTION 9. Extrapolation prohibited. An insurer or vision 892
benefit manager shall not use extrapolation to complete an audit 893
of a participating eye care provider. Any additional payment due 894
to a participating eye care provider or any refund due to the 895
insurer or vision benefit manager shall not be based on an 896
extrapolation, but shall be based on the actual overpayment or 897
underpayment, as determined after an investigation by the insurer 898
or vision benefit manager, and participating eye care provider has 899
been afforded, and has exhausted, all opportunities to appeal the 900
insurer or vision benefit manager's findings, as set forth in the 901
provider manual or policy document, and/or applicable law. 902
SECTION 10. A private right of action for eye care 903
providers. Any eye care provider adversely affected by a 904
violation of this act may bring an action in a court of competent 905
jurisdiction for injunctive relief against the insurer or vision 906
benefit manager and, upon prevailing, in addition to such 907
injunctive relief, shall recover monetary damages, including, but 908
not limited to, direct, indirect, special and punitive damages, 909
and penalties, of no more than Ten Thousand Dollars ($10,000.00) 910
for each violation, plus attorney's fees and costs. 911
SECTION 11. Relationship to other laws. The requirements of 912
this act are in addition to, and do not limit, any other 913
requirement applicable to an insurer under state law. In the 914
event of a conflict between this act and another provision of 915
state law applicable to insurers, the provision that affords 916
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greater protection to eye care providers or plan enrollees shall 917
control. Notwithstanding any other provision of state law, 918
including any law that purports to be the sole body of law 919
governing the insurer, an insurer shall comply with this act, to 920
the extent not preempted by federal law. 921
SECTION 12. Enforcement. (1) The Mississippi Insurance 922
Commissioner, Mississippi Insurance Department, has jurisdiction 923
to administer and enforce this act with respect to any insurer, as 924
such term is defined herein. The Mississippi Insurance 925
Commissioner, Mississippi Insurance Department, may: (a) bring an 926
action, issue orders, and impose remedies authorized by this act 927
against any Insurer; (b) adopt rules to identify activities that 928
constitute the administration, management, or control of vision 929
benefits or materials; and (c) coordinate enforcement with other 930
State agencies that regulate insurers under other applicable law. 931
The Attorney General has concurrent enforcement authority for 932
violations constituting unfair or deceptive acts or practices. 933
(2) The Insurance Commissioner shall: 934
(a) Provide a mechanism for aggrieved individuals, 935
whether actively or formerly enrolled with a particular vision 936
care plan, to submit complaints to the Insurance Commissioner for 937
review, investigation, and as appropriate, discipline under 938
applicable law. 939
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(b) Enforce the state's insurance laws and this 940
provision using powers granted to the commissioner in the 941
Mississippi Insurance Code, Title 83; 942
(c) Ensure that insurers and vision benefit managers 943
comply with the requirements of this act; and 944
(d) Be entitled to seek an injunction against an 945
insurer or vision benefit manager in a court of competent 946
jurisdiction if the insurer or vision benefit manager: 947
(i) Issues a coverage policy that does not comply 948
with the requirement of this act, uses fraudulent, coercive or 949
dishonest practices, or demonstrates incompetence, 950
untrustworthiness, or financial irresponsibility in the conduct of 951
business; 952
(ii) Fails to deal equitably with any eye care 953
providers or other persons of facilities which offer services or 954
materials covered within a contract or policy issued pursuant to 955
this act; or 956
(iii) Fails to substantially comply with the 957
insurance laws of this state or violates any regulation, rule, 958
subpoena or order of the Mississippi Insurance Commissioner, 959
Mississippi Insurance Department. 960
(3) The Attorney General shall: 961
(a) Enforce the state's laws and this act's provisions, 962
using powers granted to the Attorney General in the Mississippi 963
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Insurance Code Title 83 and/or the state's consumer protection 964
statutes; and 965
(b) Be entitled to seek an injunction against an 966
insurer or vision benefit manager in a court of competent 967
jurisdiction. 968
(4) The penalties and remedies provided in this chapter for 969
violation of this provision: (a) are cumulative, and in addition 970
to any other penalties and remedies available under state law; and 971
(b) shall not waive, limit, or otherwise affect the applicability 972
of Mississippi's Consumer Protection Act, Title 75, Chapter 24, or 973
any other law providing for civil or criminal penalties or 974
remedies for unfair, deceptive, or unlawful business practices. 975
SECTION 13. Severability clause. If any provision of this 976
act or the application thereof to any person or circumstance is 977
held invalid, the remainder of the chapter and the application of 978
such provision to other persons or circumstances shall not be 979
affected thereby. 980
SECTION 14. Enactment provisions. (1) The requirements of 981
this section apply to insurer or vision benefit manager policies, 982
contracts, addenda and certificates executed, delivered, issued 983
for delivery, continued or renewed in Mississippi. 984
(a) No insurer or vision benefit manager shall construe 985
re-credentialing as re-contracting with a participating eye care 986
provider. A provider agreement must be a distinctly separate 987
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ST: Eye care services and materials for
patients; provide requirements for insurers and
vision benefit managers.
document from any credentialing materials and must be signed by 988
the eye care provider and the insurer or vision benefit manager. 989
(b) An insurer or vision benefit manager must include a 990
copy of the current plan provider manual referred to in a provider 991
agreement at the time an agreement is sent to any provider and 992
prospective provider, as well as any policies referenced in the 993
provider agreement, e.g. dispute resolution policies. 994
(2) This law shall go into effect immediately upon passage 995
and shall apply to all insurers and vision benefit managers upon 996
the earlier of: 997
(a) The renewal of enrollee's current benefit plan or 998
upon issue of a new benefit plan to any enrollee; 999
(b) The initiation of a new provider agreement with an 1000
eye care provider or upon any amendment of an existing provider 1001
agreement with an eye care provider; or 1002
(c) July 1, 2026. 1003
SECTION 15. This act shall take effect and be in force from 1004
and after its passage. 1005