Raleigh, N.C. — A measure that will likely mean higher out-of-pocket costs for eye care patients is headed for the desk of Gov. Pat McCrory after winning final approval in the Senate on Thursday.
Senate Bill 477 would ban insurance companies from requiring providers to give discounts to plan members on goods and services their plans don't actually cover.
Sen. Ralph Hise, R-Mitchell, cited as an example that Blue Cross Blue Shield of North Carolina and other insurers often cover a first pair of glasses or contacts, but they also require eye doctors to offer their members a deal on a second pair, which the customer would pay for out of pocket.
"The insurance companies were forcing them to give a 25 percent discount with no idea what their markup was," said Hise. "If you wanted to keep this contract, you had to give a 25 percent discount."
Sen. Bob Rucho, R-Mecklenburg, said the change is consistent with the way insurers are required to negotiate with other providers, like dentists.
"The contract has been abused," Rucho said. "All this does is level the playing field. The insurance company was not authorized to demand that of the provider."
Some senators expressed concern about rising costs for consumers.
"So, this means that patients don’t get non-covered services that they currently get under the arrangement with the health care provider," said Sen. Thom Goolsby, R-New Hanover. "It looks like there was a break in there for patients. Is this going to take away free services or increase costs for patients?
"I'm afraid what the average guy or gal that walks in off the street is going to see is that we’ve removed the potential discount that they’re getting," said Sen. Jerry Tillman, R-Randolph.
"It could potentially cause costs to go up," conceded bill co-sponsor Sen. David Curtis, R-Lincoln. "Basically, the question is a question of fairness. Should insurance companies be able to dictate fees for services they do not cover?"
The Senate voted 40-7 to give the measure final approval.