Fees for covered services and covered materials

215 ILCS 161/15, under Vision Care Plan Regulation Act.

215 ILCS 161/15

(215 ILCS 161/15)     (Text of Section before amendment by P.A. 104-851)

    Sec. 15. Fees for covered services and covered materials. 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.

(Source: P.A. 103-482, eff. 8-4-23.)       (Text of Section after amendment by P.A. 104-851)     Sec. 15. 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. (Source: P.A. 103-482, eff. 8-4-23; 104-851, eff. 1-1-27.)