Lawmakers consider AB448 to curb alleged anti‑competitive practices by vision benefit managers

Assembly Member Greg Koenig presented Assembly Bill 448 to the Assembly Committee on Commerce and Labor as follow‑up legislation addressing market practices by vision benefit managers (VBMs) and vertical integration in vision care.

Sponsor and proponents described AB448 as a consumer‑protection and competition bill intended to preserve provider choice and prevent VBMs from imposing contractual requirements that steer patients to vertically integrated retail outlets, affiliated labs, or branded frames and lenses. Dr. Steve Gershkin, president of the Nevada Optometric Association and a practicing optometrist in Henderson, told the committee, “AB 4 48 will address many of the unfair and really anti competitive practices being used against Nevada doctors and our patients.”

Amendment and scope: The proponents withdrew proposed reimbursement parity language (section 26 and part of section 37) in a morning amendment to avoid creating an immediate fiscal or reimbursement mandate on state‑funded plans and to focus the bill on contracting, transparency and anti‑steering provisions. As presented, the bill would: prohibit VBMs from mandating that providers use an affiliated lab or supplier, restrict certain gag‑order contract terms, require provider choice for labs and materials in some circumstances, and increase transparency about tiering and provider network criteria. Sponsor and witnesses said the change removed any request that would alter reimbursement rates paid by payers to providers.

Why proponents support it: Optometrists and patient advocates testified that consolidation of VBMs and affiliated retailers/labs reduces patient choice, slows delivery times (they cited examples of patients waiting weeks), forces providers to use affiliated labs or pay higher costs for required products, and can obscure lower out‑of‑pocket options available to patients. Proponents referenced passage of related VBM‑focused laws in other states and urged Nevada to close identified loopholes to prior legislation.

Opposition: Vision care plans and insurers, including VSP Vision, the Nevada Association of Health Plans and the National Association of Vision Care Plans, opposed the bill as drafted. They argued it would raise consumer costs by removing discounts and negotiated savings passed through plans (one witness estimated an average $400 per person loss of savings), would constrain plan operations that qualify and monitor providers, and could create new administrative burdens and litigation exposure. VSP’s representative noted recent litigation over a similar Texas law and warned of legal risk.

Sponsor remarks and next steps: Koenig and proponents said the amendment removed reimbursement parity language in recognition of state budget concerns but maintained the bill’s core contracting and transparency reforms. Supporters urged lawmakers to prioritize patient choice and the provider‑patient relationship. No committee vote was recorded in the hearing transcript.

Ending: The committee received competing testimony from optometrists, patient advocates and vision plan representatives. Supporters framed AB448 as an anti‑steering, transparency and consumer‑choice measure; opponents warned of higher premiums, lost discounts and legal risk. The sponsor asked for further consideration and negotiation.