215 ILCS 161/15: Fees for covered services and covered materials.

(Text of Section before amendment by P.A. 104-851)

Fees paid under a vision care plan for covered services and covered materials, regardless of the supplier or optical lab used to obtain materials, shall be reasonable and shall be clearly listed on a fee schedule that has been provided to the eye care provider before entering into a contract with the vision care organization. Fees paid for materials supplied by a non-network lab are not required to be identical to fees paid for materials ordered through a network lab, but non-network lab fees shall be reasonable.

(Text of Section after amendment by P.A. 104-851)

Fees for covered services and covered materials.

(a) Fees paid under a vision care plan for covered services and covered materials, regardless of the supplier or optical lab used to obtain materials, shall be reasonable and shall be clearly listed on a fee schedule that has been provided to the eye care provider before entering into a provider agreement with the vision care organization. Fees paid for materials supplied by a non-network lab are not required to be identical to fees paid for materials ordered through a network lab, but non-network lab fees shall be reasonable.

(b) A vision care organization shall, before entering into a provider agreement, inform the eye care provider by email or, if requested by the eye care provider, by mail, on how to access the fee schedule. A vision care organization may make this information available by mail, email, or website listing.

(c) A vision care organization shall make an updated copy of a fee schedule available to the eye care provider every calendar quarter. Nothing in this subsection precludes a vision care organization from making the fee schedule available to the eye care provider more frequently than every calendar quarter or available at all times.