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Optometrists press bill to force vision benefit managers to accept qualified providers; plans warn of cost and network effects
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Summary
House Bill 32 11 would require vision benefit managers to accept credentialed optometrists into defined benefit networks, standardize credentialing timelines and increase contracting transparency to expand patient access.
House Bill 32 11 seeks to require vision benefit managers (VBMs) that run defined‑benefit vision plans to accept any optometrist or therapeutic optometrist who meets credentialing requirements and agrees to contractual terms, to standardize credentialing timelines and increase transparency in contracting. Sponsors and optometrist witnesses said two large VBMs (VSP and EyeMed) control more than 70% of the Texas vision plan market and that closed or selectively limited networks are reducing patient choice and access, particularly for independent practices.
Dr. Tommy Lucas, speaking for the Texas Optometric Association, said the two largest plans “shut down their provider networks entirely to new doctors entering the workforce,” which alarmed new small practice owners and reduced patient access. Dr. Mary Kay Walters described being initially unable to contract with EyeMed after opening a practice in Brenham and said the bill would fix access problems if enacted.
Julian Roberts, executive director of the National Association of Vision Care Plans, opposed the bill and warned that mandatory acceptance provisions could force plans to add all applicants regardless of whether the provider is accepting new patients or meets network design criteria, potentially over‑saturating markets and increasing costs for employers and members. He also criticized the bill’s HCPCS‑coding mandate as limiting plans’ ability to use tailored reimbursement approaches.
Committee members probed both sides about credentialing, network access standards and whether providers were being excluded for business reasons (market saturation) or quality concerns. Supporters argued the bill is narrowly tailored to defined vision benefit plans and does not affect broad medical or risk‑bearing health plans. The panel closed public testimony and left House Bill 32 11 pending.
No formal vote took place at the hearing.
