Spectera, Inc. v. Wilson, 294 Ga. 23

Background

Spectera, a vision insurer, replaced its prior "Patriot" provider contracts with new IPP agreements that required independent providers to source covered materials (lenses/frames/formulary contacts) from Spectera’s optical lab.
Independent optometrists (Wilson, McMurray, Summers, Price) provided eye care at Wilson Eye Center (WEC); under Patriot contracts they could use their own or third-party materials and receive reimbursement/co-pays.
Spectera’s IPP made independent providers act as conduits: ordering finished materials from Spectera’s lab and dispensing them, rather than assembling/supplying from their own inventory; retail chains were not subject to this requirement.
Appellees sued under Georgia’s Patient Access to Eye Care Act, OCGA § 33-24-59.12, claiming the IPP violated multiple subsections; the trial court enjoined enforcement and later granted summary judgment to appellees (with a permanent injunction, later partially stayed).
The Court of Appeals affirmed in part (finding violations of subsections (c)(2) and (c)(5) as applied) and reversed in part; this Court granted certiorari to resolve statutory interpretation.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether IPP’s covered-materials requirement violates OCGA § 33-24-59.12(c)(2) (insurer shall not preclude covered person from obtaining eye care directly from a panel provider)	Appellees: IPP prevents providers from directly providing covered eye care (assembling/supplying lenses/contacts), so it precludes insureds from obtaining care directly.	Spectera: "Directly" only bars referral requirements; providers still dispense final products so care is still provided directly.	Court: IPP violates (c)(2); it prevents providers from directly providing certain covered eye care.
Whether IPP violates OCGA § 33-24-59.12(c)(5) (no discrimination between classes of eye care providers)	Appellees: IPP discriminates among provider groups by restricting independent providers’ ability to supply materials.	Spectera: Court of Appeals’ broad reading of "class" is incorrect; subsection contemplates licensed classes (ophthalmologists, opticians, optometrists), not ad hoc groups.	Court: Reversed Court of Appeals as to (c)(5); IPP does not unlawfully discriminate between classes of licensed providers.
Whether IPP violates OCGA § 33-24-59.12(c)(3) (not promote/recommend any class to detriment of others)	Appellees argued IPP improperly favors retail chains.	Spectera maintained no violation; racial? (not applicable)	Court: Court of Appeals found no violation; this Court declined to fully address (no cross-appeal by appellees).
Whether Spectera violated OCGA § 33-24-59.12(c)(6) by denying panel admission/conditioning admission on signing IPP	Price: Refusal to sign unlawful IPP was basis to exclude him, which (c)(6) forbids.	Spectera: Has discretion in admitting providers; contracting choices not restricted.	Court: Spectera violated (c)(6) by denying Price admission based on refusal to sign unlawful agreement.

Key Cases Cited

Chase v. State, 285 Ga. 693 (court must apply plain statutory language)
Berryhill v. Ga. Community Support and Solutions, Inc., 281 Ga. 439 (courts must give effect to every part of a statute)
State v. Fielden, 280 Ga. 444 (courts cannot rewrite statutes)
Spectera, Inc. v. Wilson, 317 Ga. App. 64 (Court of Appeals decision under review)