Is Arkansas the best place to practice optometry in the United States? Thanks to a groundbreaking new law targeting Vision Benefit Manager abuse, the state has made a powerful case. On February 25, 2024, Governor Sarah Huckabee Sanders signed Act 142 into law—legislation designed to protect optometrists and their patients from anti-competitive practices orchestrated by Vision Benefit Managers (VBMs).

This landmark win, celebrated by the American Optometric Association (AOA), is more than a local victory. It’s a national blueprint for reform—one that champions fairness, transparency, and patient-centered care. In a recent episode of Defocus Media, co-hosts Dr. Darryl Glover and Dr. Jennifer Lyerly sat down with two key figures behind the movement: Dr. Matt Jones, the 2024 AOA Optometrist of the Year, and Dr. Curtis Ono of the AOA, to explore how Arkansas led the charge and what it means for the future of optometry.

Act 142 passed with near-unanimous support—96–0 in the Arkansas House and 28–1 in the Senate. But behind that seamless result was a highly strategic campaign built over years. The law directly addresses long-standing concerns with Vision Benefit Manager practices that have negatively impacted both providers and patients. Key components of the law include:

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• Fair reimbursement: Mandating Vision Benefit Managers reimburse at or above Medicare rates
  
  
• Mandatory coordination of benefits: Ensuring patients aren’t forced into multiple visits due to disconnected medical and vision coverage
  
  
• Audit reform: Prohibiting unfair or retroactive audits
  
  
• Payment integrity: Eliminating virtual credit card-only payments that reduce provider compensation
  
  
• Transparency in provider listings: Banning tiered listings that favor doctors selling VBM-owned products
  
  
• Regulatory oversight: Empowering the state insurance department to monitor Vision Benefit Manager behavior
  

“This is a very sweeping bill,” said Dr. Lyerly. “Many states would feel like getting even one or two of these provisions passed would be a huge win.”

The Arkansas law isn’t just an economic reform—it’s a powerful statement about access to care. Vision Benefit Managers have often structured plans in ways that limit provider participation, particularly in rural areas where reimbursement rates are unsustainably low.

“All of this is about patient care,” said Dr. Curtis Ono. “It’s about not breaking and not interrupting that doctor-patient relationship.”

Dr. Matt Jones, who practices in the Mississippi Delta region of Arkansas, echoed that sentiment. “I sign up for every vision plan—not because it’s good for business, but because that’s what my patients have,” he shared. The law ensures doctors like Dr. Jones aren’t penalized for putting patients first.

So how did Arkansas achieve such an overwhelming victory against powerful Vision Benefit Manager lobbying? The answer lies in grassroots advocacy and long-standing relationships.

“This wasn’t a surprise attack,” said Dr. Jones. “It was a well-executed strategy.” Advocacy began months in advance, with conversations at the state and federal levels. Crucially, optometrists educated lawmakers—many of whom didn’t understand the full scope of Vision Benefit Manager influence or even the distinctions between eye care providers.

Dr. Darryl Glover emphasized the importance of forming local connections. “The best way to advocate for our profession is in that exam lane,” he said. “You never know who that patient is… They could be a legislator, a judge, or a key community leader.”

At the heart of Act 142 is a simple but profound change: Vision Benefit Managers must reimburse fairly. For years, reimbursement rates stagnated—many falling below Medicaid levels.

“When we told legislators how low the reimbursement rates were, they were shocked,” Dr. Jones explained. “They couldn’t believe there hadn’t been increases in years.” This provision helps ensure optometrists can continue accepting plans without incurring financial losses—ultimately protecting patient access.

The bill also ends retroactive clawbacks, where Vision Benefit Managers demand repayment months after services are rendered. “If they’re eligible the day we check, we should be paid—and that’s now protected by law,” said Dr. Jones.

With Texas, Oklahoma, and now Arkansas leading the way, the movement for Vision Benefit Manager reform is gaining momentum.

“We’re seeing what happened in the therapeutic law battles years ago,” said Dr. Ono. “Once a few states succeeded, the rest followed.” Currently:

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• 12 states have laser privileges
  
  
• 22 allow office procedures like lumps and bumps
  
  
• 15+ states are planning VBM or scope-related legislation for 2025–2026
  

These legislative wins send a message: the status quo with Vision Benefit Managers is no longer acceptable.

Dr. Ono encourages optometrists nationwide to get involved: “Relationships and advocacy matter. The AOA and SGRC (State Governmental Relations Committee) are here to help other states take that next step.”

The passing of Arkansas’s Vision Benefit Manager reform law marks a pivotal turning point for the profession. It’s a call to action—for fairness, access, and unity across optometry.

“This is how we protect the future of our profession,” said Dr. Jones. “We’ve shown that optometrists can organize, educate, and drive change that benefits both providers and patients.”

As states across the country look to Arkansas for guidance, one thing is clear: when optometrists come together, informed and united, real change is not only possible—it’s inevitable.