As you know, your OOPA Advocacy team has been working hard to pass legislation that is important to all Oregon ODs. We urgently need your help in contacting your local Oregon Senator about HB 3530A Prohibiting Vision Plan Abuses. This amended bill has already passed the House of Representatives and has moved to the Senate. We have been informed that lobbyists for the opposition have been working hard to convince Senators that “state government should not insert itself in private contract negotiations.” OOPA members need to explain why HB 3530A is good for Oregon small business and Oregon patients, especially in rural areas of the state, and why we need state government to address this situation now. We have provided talking points and explanations as they relate to each section of the bill below.
**This same email was also sent to all OOPA Keypersons. However, due to the importance of this bill we are asking all ODs to join in and contact their Senator.
**Key Message for Legislators: Vision insurance plans are currently requiring discounts on non-covered materials and services as part of the plan contract. ODs are required to provide the discounts (20% on 2nd pair, 15% on contact lenses, etc) but do not receive any reimbursement to make up for the lost revenue. To make up for this lost revenue, ODs may need to increase their listed retail cost. This means cash-pay patients may have to pay more to cover the revenues lost by discounts for insured patients. By removing the required discounts, the cost-shifting is no longer necessary, which means lower cost for all patients. It also allows eye care providers to appropriately continue to function as a free-market small business. This does not impact required fees or discounts that are part of the plan’s covered services or materials – for which providers have a negotiated reimbursement.
**Key Message for Legislators: Vision plans will no longer be able to offer a premium plan to a provider, but require acceptance of other, unreasonable or low reimbursement plans in order to sign up for the premium plan. It allows providers to select the plans that work best for their office and their patients, without having to dramatically compromise on acceptance of other plans. This creates an a la carte situation with plan contracts, instead of an all or none situation. It is better for Oregon small businesses and allows for a more fair situation in the insurance marketplace. If a plan is bad, no one will sign up, which forces the insurance company to provide better plans. This is good for small business, which is good for Oregon employees and communities.
Today, when 80% of all patients are covered by insurance plans and one major carrier represents almost 45% of a provider’s total business – the only choice is to renew the contract. Simply put, Oregon eye care providers are stuck! The ever-evolving plans are becoming less reasonable, but the financial impact of not renewing is devastating – the choice is sign the contract or risk closing their doors. This is especially concerning for rural areas where patients may only have access to one or two providers for their eye health and vision needs.
**Key Message for Legislators: One of the main questions and concerns from legislators in regards to this bill are “Why don’t the providers just not sign up for the plan?” or “They agreed to the contract, why are they complaining?” Here is the issue that most legislators do not understand… Vision plans have been around for over 20 years. Most established Oregon optometric practices have been renewing contracts for years and in that time, the number of patients covered by insurance has grown dramatically. For some practices, up to 80% of their patient base is covered by insurance and close to half of their total business can be from one major carrier. The numbers are different for every practice, but the situation is similar. Oregon ODs do not have a choice. We have to continue to accept unreasonable and aggressive changes with contracts because the impact of NOT renewing could devastate the finances of the practice. The choice: sign the contract or possibly close your doors or lay off employees – it is a real issue many offices face. In addition, due to anti-trust laws, ODs cannot organize as a group and collectively bargain. We are stuck! At this point, our only remedy is to turn to our legislators for help in curbing these unfair contractual requirements. It is especially important to point this out in rural areas where there are only a few eye care providers available. If practices continue to lose unreimbursed revenue through forced discounts, or decide to not renew a contract – that practice could fail – which means lack of eye care for rural Oregonians.
Since the bill has already passed the House, only Senators need to be contacted. Please send your Senator an email with the attached one-pager informational document as soon as possible. Ask them to support HB 3530A. Please bcc moc.liamgnull@okcahcas so OOPA can track the communications with our legislators.
In addition, consider picking up the phone and calling your Senator. Even if you have to leave a message or talk with an aide, legislative offices “count” and “track of” the number of contacts from constituents expressing either support or opposition to legislation. Legislators want to represent their constituents and they want to hear from YOU!
Please include your contact information in the event that your legislator has questions or wants to contact you. Here is the link to the Oregon Legislature website where you can find your legislator’s contact information:
Senators (by district): https://www.oregonlegislature.gov/senate/Pages/SenatorsDistrict.aspx
Without OOPA grassroots support we would not be able to continue to protect our profession. Please take the time to contact your Senator today. Together, we can make a difference!
Please email me with any questions or concerns,
~Dr. Sagina O’Halloran
OOPAC Keyperson Coordinator