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Mass. glaucoma, orals bills stalled until December
One of the last remaining states where optometrists have no privileges for treating glaucoma, Massachusetts has once again been forced to shelve this legislation pending a refiling in December.
The Massachusetts Society of Optometrists (MSO) filed an enhancement of the scope of practice in its last legislative session on Beacon Hill. This scope of practice bill would allow optometrists to treat glaucoma and to prescribe oral medications to treat eye diseases and adnexa. The bill would also permit the application of epinephrine, adrenaline and other agents used in the percutaneous treatment of anaphylaxis.
“Glaucoma will be the focus of the refile,” said Richard Lawless, executive director of the MSO. “Currently, 46 states have privileges for treating glaucoma. The training is the same for optometrists across the country; it doesn’t vary. So why don’t we have the same privileges?”
Mr. Lawless said Massachusetts was among the last states to gain therapeutic privileges, passing its bill in 1997.
Strong medical opposition
The recently introduced bills died in committee, Mr. Lawless said, partly due to strong opposition from physicians.
“There is a very strong medical lobby in the greater Boston area, and the lobby does not like encroachment on what it considers to be the medical area,” he said. “So there is a very formidable opponent in Massachusetts, as there is in Pennsylvania. This is why we are traditionally at the end of the line as far as legislation goes.”
Mr. Lawless said the MSO had been in negotiations with ophthalmology regarding the glaucoma bill for several months.
“We actually engaged ophthalmology for about 18 months in a process that we hoped would bring the glaucoma issue to a conclusion,” he said. “We thought we had pretty much ironed that out, and then things changed.”
The MSO and representatives from ophthalmology had reached a tentative agreement, Mr. Lawless said, but this agreement fell apart after it was presented to the respective boards. “Our board endorsed it, but theirs did not,” Mr. Lawless said. “They then came back with a counteroffer, and we did not embrace that counteroffer.”
The offer included additional requirements and restrictions for optometrists treating glaucoma, Mr. Lawless said. “It began to put limitations on what we could do,” he said. “Originally, there was no restriction on who we could treat. Then, we couldn’t treat anybody younger than 2, and then it was nobody younger than 18. We said, ‘no thank you.’”
Issues to be revisited
The bills will be refiled in December for the legislative session beginning in January, Mr. Lawless said. Also to be introduced in that session will be a non-discrimination bill to protect Massachusetts optometrists.
“Chiropractors and podiatrists are listed in one of our laws that indicates that health plans that operate in this state cannot discriminate against a practitioner group,” Mr. Lawless said. “Our name is not listed in the current law, so we will be asking that this law be amended to include optometrists.”
Mr. Lawless maintained that although Massachusetts optometrists are currently not experiencing discrimination, it is nevertheless wise to secure protection against it.
“There have been successful suits in Massachusetts by independent groups who have sued health plans to be included as providers in their network,” he said. “There has been a precedent set, and this legislation would ensure that optometry would not be discriminated against by any health plan offered in Massachusetts.”
For Your Information:
- Richard Lawless can be reached at 1071 Worcester Rd., Suite 12, Framingham, MA 01701-5298; (508) 875-7900; fax: (508) 875-0010.