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To amend title XXVII of the Public Health Service Act to improve health care coverage under vision plans, and for other purposes.
Summary
This bill amends the Public Health Service Act to regulate agreements between optometrists and health insurance vision plans. It limits initial agreements to a maximum of two years, with optional extensions of up to two years each, and allows unlimited subsequent extensions. The bill prohibits health insurance issuers from restricting an optometrist's choice of laboratories or sources and suppliers of services and materials provided to patients. The bill requires the Department of Health and Human Services to annually notify states of their authority to enforce these provisions, and states that fail to enforce or do not respond within 90 days are treated as not substantially enforcing the requirements. State laws regarding vision benefit plans retain exclusive authority and take precedence if they conflict with the bill's provisions.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Sen. Cramer, Kevin [R-ND] (R-ND)
23 cosponsors
- Sen. Blackburn, Marsha [R-TN] (R-TN)
- Sen. Blumenthal, Richard [D-CT] (D-CT)
- Sen. Boozman, John [R-AR] (R-AR)
- Sen. Budd, Ted [R-NC] (R-NC)
- Sen. Capito, Shelley Moore [R-WV] (R-WV)
- Sen. Coons, Christopher A. [D-DE] (D-DE)
- Sen. Duckworth, Tammy [D-IL] (D-IL)
- Sen. Gillibrand, Kirsten E. [D-NY] (D-NY)
- Sen. Grassley, Chuck [R-IA] (R-IA)
- Sen. Hassan, Margaret Wood [D-NH] (D-NH)
- Sen. Hoeven, John [R-ND] (R-ND)
- Sen. Hyde-Smith, Cindy [R-MS] (R-MS)
- Sen. Kaine, Tim [D-VA] (D-VA)
- Sen. Luján, Ben Ray [D-NM] (D-NM)
- Sen. Lummis, Cynthia M. [R-WY] (R-WY)
- Sen. Marshall, Roger [R-KS] (R-KS)
- Sen. Merkley, Jeff [D-OR] (D-OR)
- Sen. Mullin, Markwayne [R-OK] (R-OK)
- Sen. Murphy, Christopher [D-CT] (D-CT)
- Sen. Shaheen, Jeanne [D-NH] (D-NH)
- Sen. Tillis, Thomas [R-NC] (R-NC)
- Sen. Warren, Elizabeth [D-MA] (D-MA)
- Sen. Welch, Peter [D-VT] (D-VT)
Actions (2)
- May 12, 2025 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. · senate
- May 12, 2025 Introduced in Senate
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE SENATE OF THE UNITED STATES
May 12, 2025
Mr. Cramer (for himself, Mr. Murphy, and Mr. Mullin) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
A BILL
To amend title XXVII of the Public Health Service Act to improve health care coverage under vision plans, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Vision Lab Choice Act of 2025”.
SEC. 2. IMPROVING HEALTH CARE COVERAGE UNDER VISION PLANS.
(a) In General.—Title XXVII of the Public Health Service Act is amended by inserting after section 2719A (42 U.S.C. 300gg-19a) the following new section:
“SEC. 2719B. IMPROVING COVERAGE UNDER VISION PLANS.
“(a) In General.—With respect to a group health plan or individual or group health insurance coverage that provides benefits for items and services relating to vision care (including such a plan or coverage that offers limited scope vision benefits), the following shall apply:
“(1) Duration of limited scope vision plans.—In the case of a doctor of optometry who has an agreement or is the beneficiary of an agreement with respect to a group health plan or health insurance coverage that offers limited scope vision benefits—
“(A) the term of the initial agreement shall be not longer than 2 years;
“(B) the agreement may be extended with the prior acceptance by such doctor for each such term extension, and any such extension may be for a term not longer than 2 years; and
“(C) the agreement may be extended for unlimited terms, subject to subparagraph (B).
“(2) No restrictions on choice of laboratories and sources and suppliers.—A group health plan or health insurance issuer offering such coverage may not, directly or indirectly, restrict or limit a doctor of optometry described in paragraph
(1) with respect to choice of laboratories, or choice of source or supplier of services or materials provided by the doctor to an individual who is enrolled under the plan or coverage.
“(b) Notification.—The Secretary shall on an annual basis notify each State of the State’s authority to enforce the provisions of subsection (a) against a group health plan or a health insurance issuer offering health insurance coverage described in subsection (a) pursuant to section 2723(a)(1) and request confirmation from the State whether or not the State will enforce the provisions of subsection (a). If a State notifies the Secretary that the State will not enforce the provisions of subsection (a) or fails to respond within 90 days of the Secretary’s request, the Secretary shall treat such State as failing to substantially enforce such provisions for purposes of subsections
(a)(2) and (b) of section 2723.
“(c) Definition.—In this section, the term ‘doctor of optometry’ means a doctor of optometry who is legally authorized to practice optometry by the State in which the doctor so practices.”.
(b) Conforming Amendment.—Section 2722(c)(1) of the Public Health Service Act (42 U.S.C. 300gg-21(c)(1)) is amended by inserting “(other than the requirements under section 2719B)” after “section 2791(c)(2)”.
(c) Exclusive Applicability of State Law.—Notwithstanding any amendment made by this Act, State law that directly affects any standard or requirement relating to health insurance issuers and vision benefit plans, shall have exclusive application and the amendments made by this Act shall not apply to the extent that such State law conflicts with such amendments. The State shall retain exclusive jurisdiction over health insurance issuers and limited scope vision benefit plans that are directly governed by such State. <all>
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