Earlier this month, Illinois’s governor signed into law new legislation targeting vision benefit manager (VBM) reform and establishing protections for optometrists and their patients.
I’m getting some deja vu … didn’t Illinois pass a bill on this already?
Indeed … in August 2023, in fact. The Vision Care Plan Regulation Act (VCPRA) protected optometrists from vision plan-enforced discounts and outside interference into the patient and doctor relationship.
Read up on our coverage here.
So how is this latest legislation different?
It’s essentially a rewrite and expansion of that 2023 law (officially referred to as State Bill [SB] 764).
First introduced in early 2026 and signed into law by Gov. JB Pritzker on Aug. 21, SB 3707 strengthens VBM oversight while also addressing contracting and business practices that may interfere with patient choice and care.
As the American Optometric Association (AOA) noted, the new law “establishes protections designed to increase transparency, strengthen provider rights and give patients greater flexibility in using their vision benefits.”
Can you get more specific on that?
The bill basically made a few changes in provisions regarding “defined terms and noncovered services.” Among these:
- Contract transparency: Plans must give notice of contract changes and access to provider manuals, policies, and fee schedules.
- Contracts are capped at 2 years unless both parties agree otherwise.
- No fee-based reimbursement: Plans must comply with Illinois' new provider payment-method protections; they cannot force methods that skim transaction fees off providers—including virtual credit cards.
- Cash-pay choice: Providers may offer a cash-pay option when it costs the patient less than using the benefit.
- Benefit transparency: Plans must disclose copays, cost-sharing, and patient responsibility as well as confirm that services and materials stay covered when a deductible, copay, or coinsurance applies.
- No forced discount plans: Discount-plan participation cannot be a condition of network participation.
- Non-retaliation: Providers are protected when reporting violations, filing complaints, or contacting regulators, legislators, or associations.
- Broader oversight: Unfair and deceptive practice protections now reach affiliates and others acting for the plan.
- Practice asset protection: Plans cannot require a security interest in a provider's practice or business assets.
So, why was this follow-up bill needed?
Quite simply: Despite the VSPRA taking effect in 2023, state lawmakers agreed that more protections were needed for ODs and their patients.
Per Illinois Optometric Association (IOA) CEO Leigh Ann Vanausdoll: The state’s +2,400 ODs had begun experiencing vision plan issues that “revealed gaps in transparency and accountability.”
As such: "Illinois' action sends another clear message that policymakers recognize the need to protect patients and doctors from practices that restrict choice and undermine a competitive vision care marketplace,” stated Teri K. Geist, OD, AOA president.
- “This law adds to growing momentum for commonsense VBM reforms that put patients first."
And when will these updates take effect?
Jan. 1, 2027.
Now, let’s look at this situation from a national perspective.
Earlier this year, the House Committee on Oversight and Government Reform issued a release noting the imbalance of power VBMs currently hold across the country:
- Two companies control 85% of the market share for stand-alone vision insurance plans.
- In 42 states, one company holds at least a plurality of the market.
- In 28 states, a single company controls more than 75% of the market.
“Increasing concentration among vision insurance administrators threatens competition and is driving higher costs and fewer choices for patients,” wrote Chairman James Comer (R-Ky.). “The consolidation in the vision care market is enabling (VBMs) to exercise excessive market power at the expense of patients and plan sponsors.”
Go on …
As Comer added: These VBMs have “vertically integrated to own, operate, or maintain exclusive affiliations with eyeglass and lens manufacturers, optical laboratories, and retail providers, giving them substantial control over the vision care supply chain.”
The chairman called on the Department of Justice (DOJ) and Federal Trade Commission (FTC) for updates regarding their ongoing efforts to monitor, investigate, and prevent such "anticompetitive consolidation" in the vision care market.
And in other state’s developments?
Illinois is actually the second state this year to enact such legislation, as Louisiana passed its own comprehensive VBM reform (SB 404) in late May. The bill took effect immediately.
Included in the legislation: Fair (and consistent) VBM reimbursements and contracting regulation, provider transparency, and increased oversight. See here for more details.
Wasn’t there also a setback elsewhere?
Indeed—back in May in Texas, when a federal court blocked the enforcement of a 2023 law that restricted vision care plans’ patient communication on pricing and provider information.
- See our coverage for that rundown.
And stay tuned for more legislative updates …
*Disclaimer: The information provided in this article does not and is not intended to constitute legal advice; instead, all information, content, and materials available herein are for general information purposes only.