CopyCited 5 times | Published | Supreme Court of Georgia | Nov 4, 2013 | 749 S.E.2d 704
...ny laboratory of their choosing and prepare those materials directly for Spectera insureds.
Appellees sued Spectera contending that Spectera’s proposed IPP agreement violated various subsections of Georgia’s Patient Access to Eye Care Act, OCGA §
33-24-59.12 (the “Act”)....
...Finally, the Court of Appeals limited the award of injunctive relief to independent optometrists. We granted Spectera’s petition for a writ of certiorari and requested that the parties respond to the following question: “Did the Court of Appeals correctly construe OCGA §
33-24-59.12 (c) of the *26Patient Access to Eye Care Act?” For the reasons below, we affirm in part, reverse in part, and vacate in part.
1....
...“Eye care” is defined by the Act as “those healthcare services and materials related to the care of the eye and related structures and vision care services which a healthcare insurer is obligated to pay for or provide to covered persons under the health benefit plan.” *27OCGA §
33-24-59.12 (b) (3) (emphasis supplied)....
...s, and optometrists. The Court of Appeals, however, would expand this list to include any random and unrestricted group that happens to be involved in eye care in some way. This does not comport with the plain language and legislative intent of OCGA §
33-24-59.12 (c) (5), as the Court of Appeals’ reading of subsection (c) (5) inappropriately renders the language of the statute regarding licensure superfluous, and it undermines the clear intent of the legislature to address discrimination with respect to licensed eye care providers....
...Elliott II, for appellees.
Aubrey T. Villines, Jr., Jeffrey R. Filipovits, amici curiae.
In addition to providing vision care insurance, Spectera stated during oral argument that it operates the second largest full-service eye care laboratory in the country.
OCGA §
33-24-59.12 (c) (2) provides: “A health care insurer providing a health benefit plan which includes eye care benefits shall:... Not preclude a covered person who seeks eye care from obtaining such service directly from a provider on the health benefit plan provider panel who is licensed to provide eye care.”
OCGA §
33-24-59.12 (c) (5) provides: “A health care insurer providing a health benefit plan which includes eye care benefits shall:......
...Allow each eye care provider on a health benefit plan provider panel, without discrimination between classes of eye care providers, to furnish covered eye care services to covered persons to the extent permitted by such provider’s licensure.”
OCGA §
33-24-59.12 (c) (3) provides: “A health care insurer providing a health benefit plan which includes eye care benefits shall:... Not promote or recommend any class of providers to the detriment of any other class of providers for the same eye care service. . ..”
OCGA §
33-24-59.12 (c) (6) provides:
Ahealth care insurer providing a health benefit plan which includes eye care benefits shall:......
