April 02, 2025
2 min read
Key takeaways:
- The law will allow patients to coordinate vision and medical benefits.
- It will also bring vision benefit managers under the purview of the insurance department.
A new law will ensure fair reimbursement, allow for coordination of benefits and ban unfair audits for optometrists in Arkansas, according to an American Optometric Association press release.
Arkansas Gov. Sarah Huckabee Sanders signed HB 1353 (Act 142) into law on Feb. 25, aiming to “[rebalance] provider’s interactions with vision benefit managers (VBMs) and [preserve] patient choice,” the AOA said.
Arkansas Gov. Sarah Huckabee Sanders signed into law HB 1353, which targets unfair reimbursement and audits for optometrists. Image: Adobe Stock
The law, which goes into effect in August, will:
- require that reimbursement rates for optometrists are at least the same as Medicare coverage;
- allow patients to maximize coverage by coordinating vision and medical benefits;
- prohibit unfair audits through the use of “batch” or “extrapolation”;
- prohibit VBMs from restricting cash payments to providers;
- prohibit VBMs from reimbursing at a different rate depending on the provider’s choice of vendors;
- prohibit VBMs from requiring that providers accept certain forms of payment;
- prohibit VBMs from misrepresenting services covered, “steering” patients to certain providers and “tiering” of providers; and
- add VBMs to the definition of a health benefit plan, bringing them under the oversight of the insurance department.
According to the AOA, “Act 142 ensures VBMs offer contracts that are fair for providers and benefits that are appealing for consumers, thereby improving relations with providers and expanding access for patients with these products. Overwhelming bipartisan support for this law demonstrates that legislators agree.”
Matt Jones, OD, Arkansas Optometric Association (ArOA) legislative co-chair, referenced passage of the 2019 legislation granting optometrists in the state laser privileges.
“Both advocacy efforts serve a similar purpose, which is to give patients access to high-quality eye care across the state,” he said in the release.
“This law removes influence from insurance companies on where patients receive their eye care,” Joseph Sugg, OD, ArOA legislative co-chair, said in the release. “It promotes competition in the vision care market, increases patient choice and access to care by the doctors they prefer to see, and allows patients to use their benefits in combination with their medical insurance. It also strengthens contract terms between doctors and VBMs, and this should only help to further increase patient choice and access.”
While Act 142 takes effect in August, additional provisions will be rolled out by Jan. 1, 2026, based on plan renewals and contract changes, according to the release.