(a) "Contractual discount" means a percentage reduction, required under a contract with an insurer, in a vision care provider’s usual and customary rate for vision care services and materials.
(b) "Discount card" means a card or other purchasing mechanism or device that is not insurance or a discount medical plan, as defined in ORS 742.420, that purports to offer discounts or access to discounts in health-related purchases from health care providers.
(c) "Materials" includes, but is not limited to:
(A) Lenses;
(B) Devices containing lenses;
(C) Contact lenses;
(D) Prisms;
(E) Lens treatments and contact lens coatings;
(F) Orthopedic or prosthetic devices to correct, relieve or treat defects or abnormal conditions of the human eye or adnexa; and
(G) Vision training.
(d) "Vision care insurance" means a health benefit plan or a policy or certificate of insurance that covers vision care services and materials.
(e) "Vision care provider" includes:
(A) A person licensed to practice optometry under ORS chapter 683; and
(B) A physician licensed under ORS 677.100 to 677.228 to practice medicine who has completed a residency program in ophthalmology.
(f) "Vision care services" means services provided by a vision care provider within the scope of the provider’s license to practice optometry or ophthalmology.
(2) A contract between a vision care provider and an entity that offers vision care insurance or a vision care discount card may not:
(a) Limit or specify the fee that a vision care provider may charge for vision care services or materials that are not reimbursed, in whole or in part, by the vision care insurance or discount card.
(b) Require a vision care provider to participate in one vision care insurance plan or discount card program as a condition for participating in another insurance plan.
(c) Change the terms, the contractual discount or the reimbursement rates, under vision care insurance or a vision care discount card, without a signed acknowledgment that the vision care provider agrees to the changes.
(d) Directly or indirectly restrict or limit a vision care provider’s choice of suppliers of materials.
(3) This section does not prohibit the use of a discount card by a patient of a vision care provider if:
(a) The enrollment of the vision care provider is:
(A) Completely voluntary; and
(B) Not conditioned upon the vision care provider’s participation in any other discount card program with different provider terms and conditions or in another insurance plan; and
(b) The discount card program does not reimburse the vision care provider for the cost of the vision care services that were discounted. [2015 c.832 §2; 2017 c.409 §37]
Note: 743B.406 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743B or any series therein. See Preface to Oregon Revised Statutes for further explanation.