THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY PIPPY, RAFFERTY, D. WHITE, FONTANA, FERLO, BREWSTER AND FARNESE, APRIL 8, 2011

SENATOR D. WHITE, BANKING AND INSURANCE, AS AMENDED, NOVEMBER 15, 2011   

AN ACT

Amending the act of July 22, 1974 (P.L.589, No.205), entitled

"An act relating to unfair insurance practices; prohibiting

unfair methods of competition and unfair or deceptive acts

and practices; and prescribing remedies and penalties,"

further providing for unfair acts.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 5(a) of the act of July 22, 1974 (P.L.

589, No.205), known as the Unfair Insurance Practices Act, is

amended by adding a paragraph to read:

Section 5.  Unfair Methods of Competition and Unfair or

Deceptive Acts or Practices Defined.--(a)  "Unfair methods of

competition" and "unfair or deceptive acts or practices" in the

business of insurance means:

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(15)  Knowingly doing any of the following:

(i)  Requiring an insured to obtain ophthalmic services and

products from a vision laboratory or company as a condition of

obtaining the payment for the vision services.

(ii)  Imposing upon an insured who is not utilizing an

ophthalmic service or product from a vision laboratory or

company a copayment fee or other condition not imposed upon

insureds utilizing an ophthalmic service or product from the

vision laboratory or company.

(iii)  Hampering competition in numerous ways, including, but

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not limited to:

(A)  Utilizing access to patient demographics and health

records, either individually or in the aggregate, to market an

ophthalmic service or product from the vision laboratory or

company.

(B)  Suppressing competition based upon quality and service.

(iv) (iii)  Creating a preferred class of providers that is

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not held to uniform conditions of participation under the same

employer's purchased health care contract, vision care contract

or other health insurance contracts.

(v)  Requiring the purchase of a minimum quantity or minimum

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dollar amount of a specified brand of materials in order to

participate as a provider in a vision or other health care plan.

(vi) (iv)  Requiring a provider to participate in a vision

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benefit plan as a condition of participation in a health care

plan.

Section 2.  This act shall take effect in 60 days.