(1) As used in this section:

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(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. [2015 c.832 § 2; 2017 c.409 § 37]

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.