Davis Vision Pennsylvania Vision Insurance Eyecare Antitrust Class Action Lawsuit

This antitrust class action has been brought against Davis Vision and related parties, alleging that the company has used its market dominance as a provider of vision insurance benefits to enforce anticompetitive and other unlawful practices in the Pennsylvania eye care market.

The class for this class action includes all independent ophthalmologists, optometrists, and opticians, and their practices, in Pennsylvania, who treat patients covered by a Davis Vision insurance product.

According to the complaint, Davis Vision provides vision insurance benefits to at least 65% of insured patients in Pennsylvania, a substantial share of the vision insurance market, and requires independent providers to agree to a Participating Provider Agreement (PPA) if they wish to be reimbursed through its insurance. The complaint notes that the PPA is drafted by Davis and that independent eye care providers cannot negotiate the terms of the PPA or reimbursement rates. Not only that; the complaint claims that Davis does not even disclose its reimbursement rates when requiring that an independent provider sign its PPA, and that even after the PPA is signed, Davis is not clear about the way it figures its reimbursements. According to the complaint, independent providers are simply expected to sign whatever they’re handed and accept whatever reimbursement Davis sees fit to pay.

One of the most prominent points in the complaint centers on Davis’s “mandatory laboratory policy,” which requires that independent eye care providers send eyeglass frame and lens orders for Davis Vision patients to a laboratory owned by Davis Vision for fabrication. The complaint calls this an unlawful anti-steering restriction because it does not permit independent providers from steering patients to frames and lenses by other companies that may be less expensive, more convenient to obtain, or better quality.

In an earlier case, Acuity Optical Laboratories, LLC v. Davis Vision, Inc., No. 14-cv-3231 (C.D. Ill.), an independent laboratory sued Davis Vision, arguing that the mandatory laboratory policy prevented eye care professionals from using Acuity Optical’s superior, and less costly, laboratories. The case was settled privately in December 2016.

The complaint claims that Davis Vision does not impose the same requirements on all companies, for example, it does not impose its mandatory laboratory policy on larger retailers such as Wal-Mart and CostCo. It also does not impose this requirement on Visionworks, a retail eye care provider with more than 700 locations, which advertises in-store labs which provide “one-hour service”. According to the complaint, this is because Visionworks and Davis are both part of the same corporate family: Highmark Health, one of the defendants in this case, owns Davis as well as HVHC, another defendant in this case and the parent company of Visionworks.

The complaint claims, therefore, that Davis and the other defendants have violated both the Sherman Act (a federal antitrust law), and Pennsylvania common law.

Article Type: Lawsuit
Topic: Antitrust
Tags: Antitrust, Collusion & Price Fixing