Sec. 1. 24-A MRSA §4249 is enacted to read:

§4249.__Optometrists in health maintenance organizations

A health maintenance organization shall include in its plan for health care services optometric services delivered by licensed optometrists in accordance with this section.

1.__Qualifications of optometric providers.__A health maintenance organization shall determine the qualifications of optometrists using reasonable standards that are similar to and consistent with the standards applied to other providers.

2.__Benefits.__A health maintenance organization shall provide benefits covering care by optometrists at least equal to and consistent with the benefits paid to other health care providers treating diseases and conditions of the eye and related structures.

3.__Self-referrals for optometric care.__A health maintenance organization shall provide benefits to an enrollee who uses the services of an optometrist by self-referral.

SUMMARY

This bill amends the laws applicable to payments by health maintenance organizations for eye care services.

This bill requires health maintenance organizations to include coverage for services by optometrists.