Legislation targets vertically integrated vision benefit managers and moves to close regulatory loopholes

Legislation targets vertically integrated vision benefit managers and moves to close regulatory loopholes


Springfield, Ill. — Senator Cristina Castro (D-22) introduced SB 3707, legislation to strengthen oversight and accountability for vision benefit managers (VBMs), the middlemen that administer vision plans for patients across Illinois. The legislation builds on the Vision Care Plan Regulation Act by closing loopholes, strengthening enforcement, and ensuring the law works as intended for patients and providers.

Vision benefit managers wield extraordinary control over the vision care marketplace. The two largest companies control approximately 85 percent of all U.S. vision coverage and are vertically integrated, meaning they administer vision plans while also owning the eyewear manufacturers, optical labs, brick and mortar eye clinics, and supply chains used in patient care. This concentration of power allows these profit driven middlemen to steer patients and dollars away from locally owned practices and into the pockets of the same companies that control every layer of the vision care market, prioritizing profits over patients and competition.

“Illinois took an important first step by regulating vision benefit managers, but it is clear that loopholes remain. When vision benefit managers are allowed to ignore the law, patients lose choice and small businesses are weakened,” said State Senator Cristina Castro (D-Elgin). “This legislation would ensure compliance, transparency, and accountability so health and vision care decisions are made by patients and their doctors, not by VBMs.”

The legislation would strengthen current law by requiring annual reporting and licensing, establishing meaningful penalties for violations, preventing coercive lab steering practices, adding anti retaliation protections for providers who report abuses, and requiring full transparency related to reimbursement, contracting, credentialing, and ownership.

The legislation is supported by the Illinois Optometric Association. Illinois is home to more than 2,400 licensed doctors of optometry who serve as front line family eye care providers in communities across the state.

“As doctors of optometry, we are small business owners, employers, and health care providers rooted in our communities,” said Dr. Clint Taylor, President and Chair of the Illinois Optometric Association. “When vision benefit middlemen steer patients, suppress reimbursements, and control supply chains, it weakens local practices and siphons health care dollars away from patient care. This legislation restores balance by holding these VBMs accountable and ensuring patients can continue to receive care from the doctor they trust.”

The introduction of the legislation comes amid escalating federal scrutiny of vision benefit managers. There are currently four congressional investigations into VBMs, their policies, and market conduct, which have been launched by the U.S. House Oversight Committee, the House Energy and Commerce Committee, and the U.S. Senate Appropriations Committee. Most recently, the U.S. House Judiciary Committee requested a briefing from a leading vision benefit manager regarding vertically integrated business practices, signaling growing bipartisan concern over consolidation, conflicts of interest, and the impact of VBM market power on patients and providers.

Latest Stories

Latest Podcast

Get Your House In Order 2