On February 25, Arkansas Governor Sarah Huckabee Sanders signed H.B. 1353 (Act 142 of 2025) into law, representing a groundbreaking step toward rebalancing providers’ interactions with vision benefit managers (VBMs) and preserving patient choice.
Act 142 would ensure the following for Arkansas’ doctors of optometry:
- Fair Reimbursements. Requires reimbursement rates to be at least that of Medicare for covered services and materials.
- Coordination of Benefits. Allows patients to combine and coordinate vision and medical benefits to maximize their coverage.
- Bans Unfair Audits. Prohibits the use of “batch” or “extrapolation” audits of participating providers; any additional payments due must be based on the actual over/under payment.
- Payment Protection. Prohibits VBMs from restricting cash payments to providers when it’s the lowest-cost option for patients.
- Reimbursement Certainty. Prohibits VBMs from reimbursing at a different amount based on providers’ choice of optical lab, health record software or equipment doctors choose.
- Eliminates Virtual Credit Card Requirements. Prohibits VBMs from requiring providers to accept forms of payment where a processing fee is assessed in order to get reimbursed.
- Transparent Provider and Service Listings. Prohibits VBMs from misleading enrollees about what services are fully covered, as well as prevents “steering” of enrollees and “tiering” of providers based on noncovered service discounts or brands of products carried. Also prevents “steering” of enrollees to one provider over another; to any retail establishment affiliated with the VBM; or to any internet or virtual provider affiliated with the VBM.
- Increased Oversight. Expands the Insurance Department’s regulatory authority by adding VBMs to the definition of a health benefit plan.
Act 142 takes effect in August 2025 with additional provisions rolled out based on plan renewals, contract changes, or by Jan. 1, 2026.
THE SIGNIFICANCE OF THIS ADVOCACY
Act 142 ensures VBMs offer contracts that are fair for providers and benefits that are appealing for consumers, thereby improving relations with providers and expanding access for patients with these products. Overwhelming bipartisan support for this law demonstrates that legislators agree.
“We are thrilled with how our elected leaders agreed that VBM reform was necessary,” says Matt Jones, OD, Arkansas Optometric Association (ArOA) Legislative Co-Chair. “In 2019 we passed scope of practice legislation, and now in 2025 we are able to pass sweeping VBM legislation. Both advocacy efforts serve a similar purpose, which is to give patients access to high-quality eye care across the state. Act 142 is a huge victory for all eye care providers and our patients.”
Joseph Sugg, OD, ArOA Legislative Co-Chair, adds,” “This law removes influence from insurance companies on where patients receive their eye care. It promotes competition in the vision care market, increases patient choice and access to care by the doctors they prefer to see, and allows patients to use their benefits in combination with their medical insurance. It also strengthens contract terms between doctors and VBMs, and this should only help to further increase patient choice and access.”
FUTURE ADVOCACY EFFORTS
ArOA achieved a critical win, but the AOA and affiliates’ work isn’t done. The AOA continues to advocate at the federal level and support affiliates in their advocacy efforts, as well as conduct direct intervention with plans on behalf of members. This direct advocacy is having an effect: The AOA and affiliates have driven over $2.9 million back into optometry practices. And that number is growing.
Here’s how else AOA is advocating for change:
- Federal legislation in the form of the recently reintroduced Dental and Optometric Care Access Act, a bipartisan effort by Reps. Buddy Carter, R-Ga., and Yvette Clarke, D-N.Y., to lower vision costs and put decision-making power back into the hands of patients and their doctors.
- Federal investigations currently ongoing into VBMs, their policies and market actions by the U.S. House Oversight Committee, House Energy & Commerce Committee, and Senate Appropriations Committee.
- Direct plan advocacy in the form of stopplanabuses@aoa.org where doctors of optometry report health and vision plan challenges for the AOA to fight on their behalf. Additionally, the AOA offers resources to empower doctors in these issues, including responding to automatic downcoding programs.
Click here to learn more about AOA’s advocacy. Visit AOA News for the latest updates and developments. Any challenges from VBMs can be sent to stopplanabuses@aoa.org.
