PRIA Logo™
TexasHB 321189th Legislature Regular SessionHouse

Relating to vision care benefits, including participation of optometrists and therapeutic optometrists in vision care or managed care plans.

Sponsored By: Jay Dean, Stan Gerdes, Sam Harless, Suleman Lalani, Mayes Middleton (Republican), Dade Phelan

Became Law

Health Care ProvidersInsurance--Health & AccidentEYECARE & VISIONMANAGED CAREOPTOMETRY & OPTOMETRISTSTHERAPEUTIC OPTOMETRISTS

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Clearer payments and fairer audits for optometrists

Managed care contracts with optometrists, including therapeutic optometrists, must provide electronic fee schedules listing each covered medical or vision-care item. Reimbursable care must use standard codes, names, and definitions from the Healthcare Common Procedure Coding System. These include Level I codes from the American Medical Association and Level II codes from federal Medicare and Medicaid administrators. Vision plans must also use these standards to describe covered care. When auditing participating optometrists, vision plans cannot estimate broader payment errors from a sample. Any resulting extra payment or refund must reflect actual overpayments or underpayments. These rules apply to contracts entered into or renewed on or after September 1, 2025.

Faster, fairer vision plan enrollment for optometrists

Texas vision plans must post an online application method for optometrists, including therapeutic optometrists. Applications must use state-standardized or Council for Affordable Quality Healthcare information, with identical application and credential checks for everyone. Plans may consider only information in the credentialing application. After receiving an application that meets requirements, plans must provide electronic contract materials within 10 business days, including fees and manuals. They must finish credential checks and approve or deny within 30 business days, then explain denials within 10 business days. Approved providers must be added within 20 business days after completing credential checks and accepting the contract. Plans with Texas enrollees must allow participation across their plans and provider panels within the provider's full license scope. They cannot exclude qualified providers who accept contract terms because of provider numbers, travel time, distance, or appointment availability. These rules do not require coverage of any particular product or service. They apply to contracts entered into or renewed on or after September 1, 2025.

Sponsors & Cosponsors

Sponsors

  • Jay Dean

    House

  • Stan Gerdes

    House

  • Sam Harless

    House

  • Suleman Lalani

    House

  • Mayes Middleton

    Republican • Senate

  • Dade Phelan

    House

Cosponsors

  • Trent Ashby

    House

  • Keith Bell

    House

  • Greg Bonnen

    House

  • Brad Buckley

    House

  • John H. Bucy lll

    House

  • Nicole Collier

    House

  • David Cook

    House

  • Vikki Goodwin

    House

  • Erin Gámez

    House

  • Hillary Hickland

    House

  • Carrie Isaac

    House

  • Mitch Little

    House

  • Ray Lopez

    House

  • John Lujan

    House

  • Christian Manuel

    House

  • Will Metcalf

    House

  • Penny Morales Shaw

    House

  • Christina Morales

    House

  • Angelia Orr

    House

  • Jared Patterson

    House

  • Dennis Paul

    House

  • Katrina Pierson

    House

  • Mihaela Plesa

    House

  • Ana-María Rodríguez Ramos

    House

  • Matt Shaheen

    House

  • Joanne Shofner

    House

  • Shelby Slawson

    House

  • David Spiller

    House

  • Trey Wharton

    House

Roll Call Votes

All Roll Calls

Yes: 355 • No: 1

Senate vote • 5/20/2025

Record vote

Yes: 31 • No: 0

Senate vote • 5/20/2025

Record vote

Yes: 31 • No: 0

House vote • 5/2/2025

Record vote

Yes: 135 • No: 0

House vote • 5/1/2025

Record vote

Yes: 142 • No: 1

House vote • Unknown

Committee vote: Insurance

Yes: 9 • No: 0

Senate vote • Unknown

Committee vote: Health & Human Services

Yes: 7 • No: 0

Actions Timeline

  1. Effective immediately

    6/20/2025House

  2. Filed without the Governor's signature

    6/20/2025House

  3. Sent to the Governor

    5/22/2025House

  4. Signed in the Senate

    5/22/2025Senate

  5. Signed in the House

    5/21/2025House

  6. Reported enrolled

    5/21/2025House

  7. Senate passage reported

    5/21/2025House

  8. Record vote

    5/20/2025Senate

  9. Passed

    5/20/2025Senate

  10. Read 3rd time

    5/20/2025Senate

  11. Record vote

    5/20/2025Senate

  12. Three day rule suspended

    5/20/2025Senate

  13. Vote recorded in Journal

    5/20/2025Senate

  14. Read 2nd time & passed to 3rd reading

    5/20/2025Senate

  15. Rules suspended-Regular order of business

    5/20/2025Senate

  16. Placed on intent calendar

    5/20/2025Senate

  17. Committee report printed and distributed

    5/19/2025Senate

  18. Recommended for local & uncontested calendar

    5/19/2025Senate

  19. Reported favorably w/o amendments

    5/19/2025Senate

  20. Vote taken in committee

    5/15/2025Senate

  21. Considered in public hearing

    5/15/2025Senate

  22. Left pending in committee

    5/14/2025Senate

  23. Testimony taken in committee

    5/14/2025Senate

  24. Considered in public hearing

    5/14/2025Senate

  25. Scheduled for public hearing on . . .

    5/14/2025Senate

Bill Text

Related Bills

Back to State Legislation