policy.
"Materials." Ophthalmic devices, including, but not limited
to, lenses, devices containing lenses, ophthalmic frames and
other lens mounting apparatus, prisms, lens treatments and
coating, contact lenses and prosthetic devices to correct,
relieve or treat defects or abnormal conditions of the human eye
or its adnexa associated with the delivery of vision care.
"Noncovered services." Vision care that is not covered but
for which a discount may be provided under the terms of a health
insurance policy.
"Vision care." A provision of eye care services, materials
or both.
"Vision care provider." A licensed doctor of optometry
practicing under the authority of the act of June 6, 1980
(P.L.197, No.57), known as the Optometric Practice and Licensure
Act, or a licensed physician who has also completed a residency
in ophthalmology.
"Vision care supplier." A person or entity that creates,
promotes, sells, provides, advertises or administers vision care
supplies , including an optical laboratory. The term includes
persons or entities affiliated with a health insurer.
Section 2703. Vision care provider and vision care supplier
selection .
A health insurance policy shall allow an insured who receives
vision care from an in-network vision care provider to select an
out-of-network vision care supplier for related vision care on
the recommendation or referral of the in-network vision care
provider, provided that the in-network vision care provider
gives to the insured, prior to recommending, referring,
prescribing or ordering any vision care from the out-of-network
vision care supplier, written notice that:
(1) The out-of-network vision care supplier is not an
in-network vision care supplier.
(2) The insured has the option of selecting an in-
network vision care supplier.
(3) The insured may have different financial obligations
depending on whether the vision care supplier is in-network
or out-of-network.
Section 2704. Discount access.
A health insurance policy that has a discount program for
noncovered services shall permit an insured who receives vision
care from an in-network vision care provider to receive a
noncovered service from the in-network vision care provider at a
nondiscounted rate, provided that the vision care provider gives
to the insured, prior to receipt of the noncovered service,
written disclosure that the vision care provider does not
participate in the insured's discount program.
Section 2705. Enforcement.
(a) Scope.--The department may investigate and enforce the
provisions of this article only insofar as the actions or
inactions being investigated relate to coverage under a health
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