Vision Lab Choice Act

Summary#

This bill would add a new section (2719B) to the Public Health Service Act. It applies to group health plans and individual or group health insurance that provide benefits for vision care, including limited-scope vision benefits. The main provisions in the bill are:

  • Initial agreements between a group health plan and a doctor of optometry may be no longer than 2 years.
  • Extensions of those agreements require the optometrist's prior acceptance for each extension, and each extension may be no longer than 2 years. Extensions may continue indefinitely if the optometrist agrees.
  • A plan or health insurance issuer may not, directly or indirectly, restrict or limit an optometrist's choice of laboratories or the sources or suppliers of services or materials the optometrist provides to enrolled individuals.
  • The Secretary (HHS) must annually notify each State of the State's authority to enforce these provisions and ask whether the State will enforce them. If a State says it will not enforce or does not respond within 90 days, the Secretary will treat the State as not substantially enforcing the provisions for certain enforcement purposes.
  • The bill defines a "doctor of optometry" as someone legally authorized to practice optometry in the State where they practice.
  • The bill also says that State law that directly affects standards for health insurance issuers and vision benefit plans has exclusive application where it conflicts with these federal changes, and that States keep jurisdiction over issuers and limited-scope vision plans they directly govern.

The bill was introduced in the Senate on May 12, 2025, and referred to the Committee on Health, Education, Labor, and Pensions.

What it means for you#

  • If you are a doctor of optometry: your contracts with group vision plans would be limited to 2-year initial terms and any extension would require your prior acceptance. Plans could not force you to use specific labs or suppliers for materials or services you provide to patients enrolled in the plan.
  • If you are a patient using a vision plan: your optometrist would be able to choose the lab or supplier that provides your lenses or other materials, rather than being forced to use a specific vendor by the plan.
  • If you are an employer or insurer offering vision benefits: you could not include terms that restrict an optometrist's choice of labs or suppliers for enrolled patients. Contract terms with optometrists would be limited to 2-year initial terms and 2-year extensions unless the optometrist agrees.
  • If you are a State official: the Department of Health and Human Services will ask each State annually whether it will enforce these provisions. States keep authority over state-regulated issuers and plans and the bill says state law controls where it conflicts with these federal changes.

Expenses#

No publicly available information.

Proponents' View#

The bill's stated purpose is "to improve health care coverage under vision plans." Its text protects optometrists from long initial contract terms and from restrictions on choosing laboratories or suppliers, and it sets up an annual notice process between the Secretary and States about enforcement.

Opponents' View#

No publicly available information.