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Illinois ODs writing scripts, patient access is next
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GALESBURG, Ill. - With nearly 70% of its membership writing prescriptions 3 years after passing therapeutic pharmaceutical agent (TPA) legislation, the Illinois Optometric Association is considering TPA amplification and patient access issues in the coming months.
According to state association president Peter Kehoe, OD, "We have a very good TPA bill, but our association is considering broadening it in the next year or two to include orals."
Noting the American Optometric Association's push to standardize TPA laws across the country, Dr. Kehoe said, "It is critical with multi-state managed care organizations that therapeutic legislation be as level as possible, and that level area is in orals. Our bordering states (Wisconsin, Indiana, Kentucky, Missouri, Iowa) all have orals, and that makes it important for us."
Dr. Kehoe estimates it took about 6 months from the time Illinois passed TPA legislation in July 1995 to the time ODs began writing prescriptions.
Illinois' TPA law allows certified ODs to write prescriptions for all topical allergy medicines, antibiotics, anti-inflammatories and glaucoma agents, in addition to performing foreign body removal. Those optometrists can also prescribe non-narcotic oral analgesics, which entitles them to Drug Enforcement Administration (DEA) licensure.
Dr. Kehoe said TPA-certified ODs have not had trouble acquiring a DEA license, which has helped state association officials comfortably say 70% of the 1,600 practicing optometrists prescribe.
"But, like everywhere else, the exact number of optometrists who prescribe varies among doctors," Dr. Kehoe said.
According to records he kept on his practice, in 1997 Dr. Kehoe wrote about 300 prescriptions for a weekly average of six. Of those 300, about 100 were for glaucoma medications. The other 200 prescriptions were divided among steroids, antibiotics, combination drops and allergy drops.
Dr. Kehoe works in a private, large contact lens practice with another optometrist in Galesburg, a town of about 35,000 residents located 3 hours southeast of Chicago. He said TPA legislation has improved the relationships between optometry and ophthalmology.
"We hope to work together on managed care issues," he said. "TPA has not hurt our relationship. If anything, it has really helped."
That improved relationship includes comanagement. Dr. Kehoe comanages cataract surgery patients in addition to a few refractive surgery patients and advanced glaucoma cases. Dr. Kehoe also manages 125 to 150 glaucoma patients.
Illinois law does not exclude optometrists from acquiring hospital privileges, said Dr. Kehoe, and more ODs are applying for such privileges.
Dr. Kehoe does not have hospital privileges but plans to apply for them. "One of the reasons is to get past this artificial barrier in some managed care plans that ask you what hospital you're affiliated with," he said. "If you're not affiliated with a hospital, they automatically exclude you."
The state association also wants to promote a nondiscriminatory language law at the state level, Dr. Kehoe said.
"With out it (nondiscriminatory language), managed care plans can arbitrarily exclude optometry or limit the services we can provide," he said. "That hurts patients, and it hurts optometrists."
For Your Information:
- Peter Kehoe, OD, may be contacted at 4L Plaza, Suite 35, Galesburg, IL 61401; (309) 343-1179; fax: (309) 343-5287. The Illinois Optometric Assn. may be contacted at 304 W. Washington St., Springfield, IL 62701; (217) 525-8012.