On Tuesday, May 2, 2023, Governor Kemp signed SB 27 (Brass) and HB 203 (Newton) into law. Both pieces of legislation were bills that the GOA had worked on with the sponsors for several legislative sessions. The signing of these bills was the result of countless hours of hard work by the GOA Board of Trustees and the GOA lobby team. Both laws will take effect on July 1, 2023. 

SB 27 (Brass) is an update to SB 43 (Brass), which was signed into law in 2021. The new law clarifies that requiring optometrists or ophthalmologists to provide discounts on non-covered eye care services in order to receive increased rates, reimbursements, preferential treatment, or any other benefit is illegal. 

This updates the previous law which makes it illegal for insurance companies to require optometrists to provide a discount on non-covered services in order to be in an insurance plan. Non covered services are services provided by an optometrist or ophthalmologist that are not compensated as part of the contract with an insurance carrier. An example of a non-covered service would be a discount on a second pair of glasses that the insurance carrier does not compensate the optometrist at all for the cost. This means that the optometrist would not receive any financial reimbursement from the insurance company for the services or goods being provided.

GOA believed that this update was necessary to further clarify the current law and prevent insurance companies from finding workarounds that would force optometrists and ophthalmologists to provide discounts on non-covered services. The GOA will continue to work to ensure that the original intent of the law, which is to prohibit insurance companies from mandating a discount on non-covered services, is followed.

Governor Kemp also signed HB 203 (Newton) into law, which was an attempt to inhibit online eye care companies from generating contact lens prescriptions without comprehensive eye exam. This was prompted by attempts from online eye care companies trying to pass legislation allowing online prescription of contact lenses without a comprehensive eye exam. The GOA believed this would be dangerous for patients and in previous legislative sessions had stopped similar aggressive actions from moving forward. In order to provide clarity and guidance on this subject matter, legislative leaders approached GOA and asked them to work on legislation that would align with the 47 states that allow some form of online refraction in certain cases.

The GOA Board of Trustees and legislative team worked throughout the summer and fall months to develop the legislation, which allows some use of online refraction assessments but only after several other conditions are met. These conditions include requiring a first and second comprehensive eye exam to be completed by an optometrist or ophthalmologist. The first or second eye exam is defined as 

"a real-time examination, which includes the use of telemedicine, in accordance with the applicable standard of care of the prescriber, of the ocular health and visual status of an individual that does not consist solely of objective refractive data or information generated by an automated testing device, including an autorefractor or kiosk, in order to establish a medical diagnosis or refractive diagnosis for the establishment of refractive error, conducted with the patient and prescriber in the same physical location or via telemedicine. If the eye examination is conducted via telemedicine, the patient and prescriber shall be required to be in synchronous verbal and visual contact during such parts of the examination necessary to ensure that the examination is, at a minimum, equivalent to an eye examination conducted in person."

The goal here was to require a patient to have a real time examination as defined above. Along with this the GOA sought to make sure that the length of a contact lens prescription is not lengthened from one year. This law keeps the length of the contact lens prescription at one year.

The GOA sought to require patients to have a real-time examination, as defined above, and to maintain the length of a contact lens prescription at one year. Furthermore, the legislation only allows patients who had a comprehensive eye exam within the past 24 months and did not have eye disease to have an eye assessment with an online refraction company. Conditions that would prohibit a person from using an online retailer for an eye assessment include:

• Corneal disease, such as keratoconus or herpes;  
• Vessels in the cornea;  
• Glaucoma;  
• Macular degeneration;  
• Hereditary eye disease;  
• Freckle, birthmark, or mole inside the eye;  
• Diabetes;  
• Shingle on the forehead or face;  
• Pain, redness, or itchiness of the eye;  
• High sensitivity to brightness;  
• Pain or discomfort or blurred or double vision while wearing corrective visual aids;  
• Bright flashes or floaters;  
• Temporary loss of vision; or  
• Moderate to severe dry eye;  
• Confirm that the patient is not currently taking medications with potentially serious ocular side effects.

The patient must also be between the ages of 21-50.

Only if these conditions are met can a patient, then get an online assessment to make a contact lens purchase with online retailers. Once they have had an online assessment, the patient/individual will need to return to a comprehensive eye exam for their next year’s visit.