New Arkansas bill to instate VBM regulations, prioritize fair reimbursement and patient choice

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Arkansas Governor Sarah Huckabee Sanders signed HB 1353 (Act 142 of 2025) into law, which will work to rebalance providers’ interactions with vision benefit managers (VBMs). The act will allow ODs in the state of Arkansas to receive fair reimbursements, increase reimbursement certainty, and establish payment protection, among other regulations.¹ Act 142 will take effect in August 2025 with additional provisions to roll out based on plan renewals, contract changes, or by January 1, 2026, according to an American Optometric Association (AOA) news release.

“We are thrilled with how our elected leaders agreed that VBM reform was necessary,” says Matt Jones, OD, Arkansas Optometric Association (ArOA) legislative cochair, in the release. “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.”

Specifically, the bill will expand the Insurance Department’s regulatory authority by adding VBMs to the definition of a health benefit plan, allow patients to combine and coordinate vision and medical benefits and prohibit the use of “batch” or “extrapolation” audits of participating providers (any additional payments due must be based on actual over/under payment). As for reimbursements and payments, Act 142 will prohibit VBMs from reimbursing a different amount based on providers’ choice of optical lab, health record software, or equipment that doctors choose, prohibits VBMs from restricting cash payments to providers when it’s the lowest-cost option for patients, reimbursement rates to be at least that of Medicare for covered services and materials, and prohibits VBMs from requiring providers to accept forms of payment where a processing fee is assessed in order to get reimbursed.¹

Additionally, the bill will prohibit VBMs from misleading enrollees about what services are fully covered, and “steering” enrollees and “tiering” providers based on noncovered service discounts or brands of products carried. “Steering” of enrollees to 1 provider over another, to any retail establishment or internet or virtual provider affiliated with a VBM, will also be prevented.¹

According to the release, the law received “overwhelming bipartisan support.”

"This law removes influence from insurance companies on where patients receive their eye care,” said Joseph Sugg, OD, ArOA legislative cochair, in the release. “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."

The AOA is also advocating for the federal investigations currently ongoing into VMS, their policies, and market actions by the US House Oversight Committee, House Energy and Commerce Committee, and Senate Appropriations Committee, as well as federal legislation in the form of the recently reintroduced Dental and Optometric Care Access Act for the lowering of vision costs and reestablishing decision-making power in patients and their doctors.¹

Reference:

1. New Arkansas law strengthens doctor-patient relationships, supports practices. News release. American Optometric Association. February 28, 2025. Accessed February 28, 2025.