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Oregon · Through 2025 Edition

ORS 743B.406: Vision care providers.

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Where this section sits in the code
  1. 18 - Financial Institutions, Insurance
  2. 56. Insurance
  3. Chapter 743B — Health Benefit Plans: Individual and Group

(1) As used in this section:

      (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 735.631, 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.

Collected 2026-09-03T23:50:17Z. Source file · JSON

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