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Comanagement bill passed in Nevada
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RENO, Nev. — Optometrists and ophthalmologists in Nevada worked together to pass one of the country’s first comanagement bills, which details the conditions under which optometrists and ophthalmologists are permitted to collaborate for a “fixed fee.”
Assembly Bill No. 491 was originally presented as a bill to “authorize an ophthalmologist and optometrist to cooperate in the formation of a professional corporation or professional association.” It was signed by Gov. Kenny C. Guinn on May 29 strictly as a comanagement bill and will go into effect Oct. 1.
According to David S. Davis, OD, president of the Nevada Optometric Association, the original draft of the bill was prepared by ophthalmologists, and it soon became a joint endeavor with optometrists. “The Nevada Society of Ophthalmology had presented it, and we became aware that they were trying to attach it to a bill,” Dr. Davis said. “It became a collaborative effort from there.”
Dr. Davis said the goal of both the optometrists and ophthalmologists was to agree upon legal guidelines for comanagement. “There was nothing on the books concerning how comanagement should be appropriately carried out,” Dr. Davis said. “It was in the interest of the MDs, ODs and patients; therefore, it was a good effort.”
He said while the optometrists were initially reluctant to support the amended bill, they soon recognized it as a means to resolve a controversial issue. “We reviewed it and realized that it might be a good opportunity if we could come to an agreement with the ophthalmologists,” he recalled.
Conditions of the legislation
As a condition of the bill, the optometrist and ophthalmologist must each agree to maintain written documentation of each procedure performed, including the date of the procedure. Another stipulation of the bill is that the fee be divided by the “collaborating parties” in proportion to the services provided personally by each.
In addition, both the ophthalmologist and optometrist must each provide to the patient a written document, signed by each party and the patient, specifying the name, address and phone numbers of each party. The amount of the fixed fee, as well as the portion of such fee to be allotted to each eye care provider, must also be included.
This document must also contain a statement, signed by the patient and a witness, verifying that “the patient voluntarily, knowingly, and willingly desires the performance of the postoperative care by the collaborating optometrist.” The document must further state that the patient is entitled to return to the ophthalmologist for postoperative care at any time after the surgery.
Finally, the document must indicate that the practice of optometry and ophthalmology are respectively regulated by the Nevada state board of optometry and the board of medical examiners, and it must provide the address and telephone number of each of these boards.
An important step
Dr. Davis said Nevada’s optometrists and ophthalmologists reached a consensus on the amended bill without difficulty.
The amended bill could have significant influence on Nevada’s optometric community, Dr. Davis said. “Now we have comanagement on our books,” he said. “We have record keeping in comanagement, which we felt was really important.”
Dr. Davis did not speculate on whether the bill will set a nationwide precedent for comanagement. “I think it’s right for us,” he said. “It’s a good direction for us to go in.”
For Your Information:
- David S. Davis, OD, can be reached at the Nevada Optometric Association, 4840 East Bonanza Rd. #6, Las Vegas, NV 89110-3453; (702) 385-7331; fax: (702) 385-5431; e-mail: Doctor@DrDavisEyeCare.com.
- The bill can be found on the Nevada Legislature Web site: www.leg.state.nv.us.