Nebraska optometrists urge law to curb vision‑plan practices they say limit choice and depress pay
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Summary
Supporters of LB987 told the Banking, Commerce & Insurance Committee that a small number of vision benefit managers (VBMs) use vertical integration and contracting practices to steer patients and underpay providers, reducing rural access; industry groups disputed the scale of the problem and warned the bill could raise costs and operational burdens.
Senator Dan Lonowski opened the hearing on LB987, the Vision Benefit Plan Act of 2026, saying the bill would establish market‑conduct standards for vision benefit managers and protect patient access to eye care without mandating benefits or raising taxes. ‘‘When contracts tilt the playing field against providers and mislead patients, it becomes a public problem,’’ Lonowski said in his opening remarks.
Several independent optometrists and the Nebraska Optometric Association testified in support. Dr. Andrea Eignberg of Hastings said VBMs ‘‘are gatekeepers who own the labs, manufacturers, claim systems, retail outlets and online sites that compete directly with their in‑network doctors,’’ and gave a patient example in which a child with Down syndrome was excluded from an existing local doctor unless the practice bought and stocked the plan’s proprietary frames. Derek Blumenstock, an independent practitioner in Lincoln, said the bill ‘‘empowers patient choice and protects needed access to quality eye care,’’ stressing rural access and clinic viability. Kristin Reed, president of the Nebraska Optometric Association, told the committee the association consulted with the attorney general’s office and Department of Insurance and that enforcement would proceed under the state’s Unfair Insurance Trade Practices Act.
Committee members asked detailed questions about market structure, reimbursements and whether VBMs differ materially from pharmacy benefit managers. Several proponents said VBM fee schedules and mandated lab choice steer patients and leave providers dependent on product sales because exam reimbursements are low. Proponents referenced claims that two large VBMs account for a dominant share of the market and that some fee schedules had not materially adjusted since the 1990s.
Industry representatives opposed LB987. Julian Roberts, executive director of the National Association of Vision Care Plans, disputed the 85% market‑share claim presented by proponents and said ‘‘45% of vision care is purchased outside managed plans’’; he warned that statutory reimbursement floors and forced network rules could raise costs for employers and employees and create operational burdens for plans. Robert Bell of the Nebraska Insurance Federation explained current state oversight by the Department of Insurance and consumer grievance rights and urged negotiation for middle ground language.
Senators also pressed proponents on fiscal and enforcement details, including the fiscal note that referenced potential attorney‑service additions at the Attorney General’s office. Proponents said enforcement would be funded by fines and that the bill does not change employer plan design but would prohibit deceptive steering and require transparency.
The hearing closed after extended exchanges; no committee action or vote was recorded at this session. The committee received written testimony and proponent letters described in the hearing record.