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Maryland association files suit against vision plan
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The Maryland Optometric Association filed a complaint July 14 in U.S. District Court in Baltimore, asserting that Davis Vision Inc., CareFirst Inc. (doing business as CareFirst BlueCross/BlueShield), Care First of Maryland Inc. and CareFirst Blue Choice Inc. are violating various state and federal antitrust laws with their new vision care contract, according to an MOA press release.
The MOA stated in the lawsuit that optometrists who serve CareFirst members in this region must use Davis Vision products and labs while some large retailers, such as Wal-Mart, Drs. Vision Works, Hour Eyes and Pearle Vision, would be permitted to use their own labs. The association claims that Davis Vision and the CareFirst entities have unlawfully restrained competition through such agreements.
The MOA added that the proposed plan violates Maryland insurance codes because it does not treat all providers equally. It is seeking damages and injunctive relief.
A CareFirst representative told Primary Care Optometry News, “We are confident that CareFirst’s arrangement with Davis Vision is legally permissible in all respects.”
CareFirst: more consistent service
Beginning Oct. 1, Davis Vision will replace the existing vendors now administering CareFirst’s vision products, according to a CareFirst press release issued prior to the lawsuit. “Our contract with Davis Vision will make service more consistent and reliable across all our vision products,” said Rita A. Costello, CareFirst senior vice president of strategic marketing and analysis in the press release.
According to Ms. Costello in a Baltimore Sun article, 800,000 members in Maryland, Washington and Northern Virginia get their vision coverage as part of CareFirst’s BlueChoice HMO and Blue Preferred plans.
Effect on independent ODs
MOA President Michael Sless, OD, discussed with Primary Care Optometry News how this new vision care contract would affect his practice, of which 35% is made up of CareFirst patients. “If a patient comes to me and wants to use the eyeglass benefit, I would have to use a select group of frames that comes from the Davis laboratory,” he said. “And the patient would have to wait 1 to 2 weeks to get the glasses.”
Because the larger retailers can decide which eyeglasses to provide at no charge, plan patients would have a better selection as well as the opportunity to get their glasses in an hour, he said.
Dr. Sless believes this situation is unfair and harmful. “Suppose a patient breaks his or her glasses and needs them in an hour?” he said. “We can’t provide that service, but the other places can.”
He is also concerned about lens quality. “Our wholesale laboratory uses a certain quality of lens that we’re willing to pay for,” Dr. Sless continued. “I don’t know what Davis is using, and I have no control over it. I can only hope they’ll make the prescription the way I ordered it. For the patients who have trusted us for years to provide a certain level of quality, I’m jeopardizing that trust.”
According to the MOA press release, RESI Research and Consulting at Towson University conducted an economic impact study on the arrangement’s far-reaching effects for the region. The consulting group said the sole-source vision contract would result in a loss of more than 400 jobs, an annual loss of about $18.4 million in average wages, nearly $1.7 million in state and local tax revenues and a decline in economic activity or gross regional product of more than $33 million.
For Your Information:
- The Maryland Optometric Association can be reached at www.marylandeyes.com.
- CareFirst can be reached at www.carefirst.com.