Maryland gains steroid prescribing privileges

Issue: February 2006

ByJennifer Byrne

Maryland optometrists officially gained topical steroid prescribing privileges Feb. 1, when that state’s long-awaited bill became law.

HB 719 was originally passed in a 2005 session of the Maryland General Assembly, but the official enactment of the law was contingent on the development of a protocol. “The protocol took a bit of work,” said Tom Shaner, executive director of the Maryland Optometric Association.

Issue: When to refer?

Mr. Shaner said the task of establishing this protocol was carried out in concert with the Maryland State Board of Examiners in Optometry and the Maryland State Board of Physicians. These regulatory agencies negotiated the details of the protocol, he said.

One outstanding area of disagreement pertained to how soon an optometrist would be required to refer to an ophthalmologist after prescribing steroids, Mr. Shaner told Primary Care Optometry News.

“From the MOA standpoint, we recommended to our board that this be consistent with the protocol that already exists for therapeutics, which is that the OD is required to refer if he or she does not have the anticipated results within 72 hours,” Mr. Shaner said. “Ophthalmology’s position was that an optometrist must do a referral the minute he or she uses a steroid. We were obviously very far from that opinion.”

Aside from making a recommendation to the Maryland State Board of Examiners in Optometry, the MOA did become involved in promoting this agenda. “We left it up to the board of optometry,” Mr. Shaner said. “That board did an excellent job of making the case to the Board of Physicians. Ophthalmology did come before the board with its lobbyist.”

The Board of Physicians voted in favor of optometry’s position, with a close margin of 10-8.

Certification for steroids

Mr. Shaner said the new law addresses the training that would be required for optometrists to prescribe topical steroids.

He said the enacted legislation mandates that those optometrists certified in therapeutics would be required to complete an 8-hour steroids refresher course. This course must be offered by the Maryland Optometric Association in conjunction with the Maryland Society of Eye Physicians and Surgeons, he said.

“Optometrists must complete this course by the end of June 2006 or they will lose their therapeutic privileges,” Mr. Shaner said.

The course was offered once in November and drew an attendance of 350 optometrists, Mr. Shaner said. “It is scheduled again for March 12 and April 2,” he said. “All TPA-licensed ODs have been notified, and it is on a first-come, first-serve basis.”

Optometrists in Maryland can begin prescribing steroids as soon as the protocol is announced by the Board of Examiners in Optometry, regardless of whether they have taken the refresher course, Mr. Shaner said. However, TPA-qualified optometrists will lose all therapeutic privileges if they do not take the refresher course by June.

Mr. Shaner said HB 719 will be helpful in making quality care available to patients in Maryland. “We look at it as benefiting the citizens of Maryland and giving them greater access to quality vision care,” he said.

For Your Information:

Tom Shaner is executive director of the Maryland Optometric Association. He can be reached at 720 Light St., Baltimore, MD 21230; (410) 727-7800; Fax: (410) 752-8295; e-mail: tom@assnhqtrs.com.