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Bill would require physicians to release contact lens prescriptions to patients
The bill is intended to put more control into the hands of patients and to foster competition, thereby lowering prices among contact lens providers.
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WASHINGTON — A bill introduced in the House of Representatives in July would force ophthalmologists and optometrists to release contact lens prescription information to patients.
The bill, introduced by Rep. Fortney “Pete” Stark, D-Calif., is intended to put more control into the hands of patients and to foster competition, hopefully lowering prices among contact lens providers as a result.
Since 1973, eye care practitioners have been required to release spectacle prescriptions to patients or third-party spectacle makers acting on behalf of patients. The new bill would do the same for contact lenses.
The bill (H.R. 2663) calls upon the Federal Trade Commission (FTC) to create a rule requiring optometrists and ophthalmologists to provide to the patient a copy of his or her prescription for contact lenses. The information would be given, regardless of whether the patient requests it, upon completion of the contact lens fitting process.
In addition, the optometrist or ophthalmologist, upon request of the patient, must provide a copy of the prescription to the patient or an agent of the patient, or promptly verify to an agent of the patient the information contained in the prescription.
Consumer fairness
In an address before Congress to introduce the bill, Mr. Stark said that “this bill would enhance consumer fairness in the contact lens industry by requiring eye care professionals to release contact lens prescriptions after completing the fitting process.”
Mr. Stark explained that currently consumers throughout the United States have unobstructed access to their eyeglass prescriptions. He noted that in 1973 the FTC issued a regulation requiring the automatic release of eyeglass prescriptions. Through this regulation, the FTC recognized that possession of both the prescription and the product constituted an unfair advantage for eye doctors and that consumers could safely manage their eyeglass prescriptions.
Mr. Stark said he thought it was natural at the time not to include contact lenses in the regulation because they were a brand-new technology; however, now 34 million Americans wear contact lenses, and 85% of them choose soft contacts.
“In most states, prescribing eye care professionals can refuse to release contact lens prescriptions — even after patients complete the initial fitting process and even to long-time contact lens wearers who simply need their time-limited prescriptions renewed,” Mr. Stark said.
He said eye doctors cite health concerns, but they have a strong financial incentive to restrict consumer access to the contact lens market. Without their contact lens prescriptions, consumers are often forced to purchase contact lenses from their prescribing eye doctor, he said.
Mr. Stark quoted Lisa McGiffert of Consumers Union, who has endorsed the bill, stating, “Swift rulemaking action by the FTC will bring a new day to consumers whose eye doctors deny them the basic right that eyeglasses wearers have had for decades – the right to shop around and save money in a competitive marketplace.”
Mr. Stark also pointed to the recent lawsuit against the American Optometric Association and several contact lens manufacturers by the attorneys general of 32 states. He explained that the plaintiffs allege the defendants conspired both to force consumers to buy replacement contact lenses from eye care professionals only and to eliminate competition from alternative distributors, including pharmacies, mail-order and Internet retailers.
“Contact lens wearers must be assured the same access to their prescriptions that eyeglass wearers currently enjoy. Yet the FTC has repeatedly failed to update its rule and extend prescription release requirements to contact lenses. This does not bode well for consumers. It means that in many states, people who wear contact lenses cannot shop around for the best value and quality products,” he said.
Mr. Stark cited an experience that his own wife had in 1994.
“Despite her request, this doctor refused to release her prescription but was more than happy to sell her contacts through his professional office. At the time, it struck me as fundamentally unfair that eye doctors stand to profit from holding their patients captive. It still does,” he said.
Effects of the bill
The bill states that any contact lens prescription will expire 2 years after the date it is issued unless the prescriber specifies in the prescription a different expiration date based on his or her medical judgment with respect to the patient’s ocular health.
Violations of the rule will be treated like those under section 18 of the Federal Trade Commission Act regarding unfair or deceptive acts or practices.
The bill also calls on the FTC to create a rule to make it an unfair trade practice for any industry member to publish any advertisement or sales presentation relating to contact lenses that says or implies that contact lenses can be obtained without a valid prescription.
Currently 27 states have contact prescription laws. The federal bill and regulations issued under it will not affect any state law that authorizes the release of prescriptions for contact lenses if the state law’s terms are more more restrictive than the federal law. It also will not affect any state law that regulates who is authorized to fit contact lenses or that regulates advertisements or sales presentations regarding contact lenses.
Response from eye care providers
The American Academy of Ophthalmology (AAO) sent a letter to Mr. Stark in June supporting the law but asking that he reconsider some points. The AAO pointed out that, although varied in content, many state laws require contact lens prescription release only upon request of the patient. Additionally, many states have determined that a prescription is valid only for 12 or 18 months.
“Although the Academy supports governance of prescriptions by state law, we would not oppose your legislation if it is modified to state that prescription release is required only upon patient request, and if the examination has been paid for. Contact lens prescription re lease contains risks for both the provider and the patient. The Academy sup ports a time period of 12 to 18 months for the prescription to be valid, unless the prescriber’s medical judgment indicates differently, but in no case to exceed 2 years. Many contact lens wearers are myopic and young. Myopia is usually progressive in young adults and therefore it is recommended that the prescription be valid only for a period of 12 to 18 months,” said William L. Rich III, MD, AAO secretary for federal affairs.
Jeffrey G. Mays, deputy executive director of the American Optometric Association, said his organization believes as a matter of principle that this entire issue is a state matter and best addressed at that level.
“Notwithstanding those reservations, we are pleased to see that Mr. Stark’s bill recognizes the prescriber’s proper role as the sole determinant as to when the contact lens fitting process is complete, and an expiration date for the prescription based upon the medical judgment of the practitioner. At the same time, we have serious concerns about the lack of an enforcement mechanism to prevent the filling of expired prescriptions,” Mr. Mays said.
For Your Information:
- Rep. Pete Stark can be reached at 239 Cannon House Office Building, House of Representatives, Washington, DC 20515; (202) 225-5065; fax: (202) 226-3805.
- William L. Rich III, MD, can be reached at 1101 Vermont Ave. NW, Suite 700, Washington, DC 20005-3570; (202) 737-6662; fax: (202) 737-7061.
- Jeffrey G. Mays can be reached at 1505 Prince St., No. 300, Alexandria, VA 22314; (703) 739-2900; fax: (703) 739-9497; e-mail: jgmays@theaoa.org.