States fighting to advance optometry

July 21, 2015

Article

This is the first in a series of regular updates about optometric legislation from around the country. Optometry can be a localized profession; however, changes in one state might lay groundwork for similar changes in another. Know what’s happening around the country because it might be coming soon to your area.

Maine

Optometrists in Maine are benefitting from new legislation surrounding vision care plans.

Maine Optometric Association President Tim Kearins, OD, says optometry fought and won a big battle against vision plans from Anthem and Cigna.

Dr. Kearins says the bill laid out the following details:

• Vision care plans cannot dictate fees, discounts, or other reimbursement control on goods or services unless they are “covered” services or goods. In this case, “covered” means the plans reimburse the provider directly for the service or good.

• A health insurer cannot require a provider to be a member of a vision plan as a condition of being allowed onto a medical panel.

• A vision care plan cannot restrict a provider’s choice of optical labs.

• A vision care plan, if changing the terms of a contract with a provider, must notify the provider of such changes at least 60 days before the change takes place.

There has been a rise of startups in the eyecare space-for example, Blink-offering refraction. Optometrists in Maine are proactively addressing the potential problems with these new offerings.

“This bill says that a prescription from a ‘mall kiosk autorefractor,’ online refraction, or cell phone app refraction, is not valid unless it is accompanied by an actual examination of the eye by an optometrist or ophthalmologist,” says Dr. Kearins. “The legislators who heard this bill agreed that a stand-alone refraction by electronic means without an actual exam is extremely misleading to the public, as the public in general would think-as they do now-that a refraction is an eye exam.

“The passage of this bill ensures that timely diagnoses will continue to be made on non-symptomatic or mildly symptomatic ocular/systemic diseased patients,” he says.

State optometrists also faced a bill that stated that expiration dates on spectacle prescriptions were to be ignored and that ODs must fill expired spectacle prescriptions whether ODs believed it ethical or not.

“This bill was introduced out of the blue by a state representative by request from one of his constituents,” says Dr. Kearins. “We defeated this bill. Actually, we completely crushed this bill.”

And finally, the Maine Optometric Association worked with the state’s ophthalmologists on a bill that allows glaucoma patients to refill their eye drop prescriptions early as long as they have a refill authorization on file from the doctor. Prior to this bill, if a patient used his eye drop supply for the month and tried to refill before 30 days had elapsed, the pharmacist would tell the patient to come back when 30 days had gone by.

Next: Alabama takes on vision plans

Alabama

A new law in Alabama helps protect optometrists from interference from managed vision care companies.

This law prohibits insurers and health plans from:

• Establishing a fee optometrists can charge for services or materials not covered by the plan or contract

• Credentialing as a condition of participation

• Restricting a provider's choice of optical labs or suppliers of services and materials

• Forcing discounts

Alabama Governor Robert Bentley signed this bill into law in June 2015.

Next: Texas joins the fight

Texas

Texas optometrists also worked to establish additional boundaries between eyecare providers and vision care plans.

This law prohibits vision plan from:

• Attempting to control the professional judgment of an optometrist

• Employing an optometrist

• Restricting a provider's choice of optical labs or suppliers of services and materials

• Paying an optometrist for a service not provided

• Releasing patient information unless the release is compliant with HIPAA

Next: Louisiana adds Schedule II drugs

Louisiana

In Louisiana, a new law allows optometrists to prescribe, order, and administer Schedule II drugs.

“Shortages of all skilled health personnel, particularly in rural and urban medically underserved areas and in the field of primary care medicine, new scientific and technological developments, and new methods of organizing health services have made the question of new uses for allied health personnel the critical issue to be resolved if our supply of health manpower is to be used effectively and productively,” the law states.

Governor Bobby Jindal signed the bill into law in July 2015.

“This law will give optometrists more options to provide even better care to our patients,” says Optometry Association of Louisiana Executive Director James D. Sandefur, OD.

Watch for more updates about optometric advocacy.

What’s going on in your state? E-mail me at cmccarthy@advanstar.com with legislative news.