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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
CONFERENCE COMMITTEE
SUBSTITUTE
FOR ENGROSSED
HOUSE BILL NO. 1683 By: Roe, Hefner, and Cantrell
of the House
and
Dossett of the Senate
CONFERENCE COMMITTEE SUBSTITUTE
An Act relating to vision insurance; amending Section
2, Chapter 360, O.S.L. 2024 (36 O.S. Supp. 2024,
Section 6973), which relates to limits to agreements
or requirements, fees, reimbursement, rates, and
impact to noncovered services or materials; including
insurers for noncovered services or materials;
including insurers for reimbursement; prohibiting
insurers from using extrapolation on audits;
prohibiting insurers from incentivizing patients to
use services owned wholly or in part by the insurer;
providing compliance provision regardless of
exemption status; providing an effective date; and
declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY Section 2, Chapter 360, O.S.L.
2024 (36 O.S. Supp. 2024, Section 6973), is amended to read as
follows:
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Section 6973. A. No agreement between an insurer or prepaid
vision plan and a vision care provider may require that a provider
provide services or materials at a fee limited or set by the insurer
or prepaid vision plan, unless the services or materials are
reimbursed as covered services or covered materials under the
contract.
B. A provider shall not charge more for services and materials
that are not covered services or materials to an enrollee of a
prepaid vision plan or insurer than his or her usual and customary
rate for those services and materials.
C. Reimbursements paid by an insurer or prepaid vision plan for
covered services and covered materials, regardless of the supplier
or optical lab used to obtain materials, shall be at the usual,
customary, and reasonable rate and made available to the vision care
provider prior to the provider accepting a contract from the insurer
or prepaid vision plan. An insurer or prepaid vision plan shall not
provide nominal reimbursement or advertise services and materials to
be covered with additional copay or coinsurance in order to claim
that services and materials are covered services and materials if
the health benefit plan or prepaid vision plan does not reimburse
for the services or materials.
D. Prepaid Insurers or prepaid vision plans shall not in any
manner impact the pricing of noncovered services or materials.
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E. Prepaid Insurers or prepaid vision plans shall provide
standard reimbursements for all lenses with the same design,
quality, and composition. The period of time prescribed by a
contract between any prepaid vision plan and a provider for the plan
to recover any reimbursement amount from a provider shall be the
same period of time allowed or required for any provider to recover
any reimbursement amount from a prepaid vision plan.
F. A An insurer or a prepaid vision plan shall not use
extrapolation to complete an audit of a vision care provider. Any
additional payment due to a provider or any refund to a prepaid
vision plan shall be based on actual overpayment or underpayment and
shall not be based on extrapolation.
G. A An insurer or a prepaid vision plan shall not incentivize
patients to receive vision care services at an entity owned wholly
or in part by the insurer or plan or subsidiaries of the insurer or
plan. Any entity providing vision care services shall provide
notice to patients that an entity is owned wholly or in part by the
insurer or plan or subsidiaries of the insurer or plan.
H. No person or entity shall sell, solicit, or negotiate any
prepaid vision plan to an enrollee in this state without an approved
certificate of authority under Section 7 6978 of this act title.
I. An insurer shall comply with this section regardless of
whether an entity is otherwise exempt from all other insurance laws
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as a charitable or benevolent corporation pursuant to Sections 2651
through 2667 of this title.
SECTION 2. This act shall become effective July 1, 2025.
SECTION 3. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after its passage and approval.
60-1-13755 TJ 05/18/25