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N.M. amendment will call for prescription release to patients
“The changes to the optometry act, as they apply to contact lenses now, clearly state that a patient does not have a contact lens prescription until such time as he or she has had whatever fitting and follow-up exams are needed to determine that the prescription is accurate,” said Maurice Geldert, OD, immediate past president of the New Mexico Optometric Association. (NMOA). “Once that process takes place, the doctor, at his or her discretion, can approve a prescription for the patient.”
History of the bill
According to Dr. Geldert, the amended bill, HB248, will include restrictions to protect the eyesight of patients.
He said that the state was approached a few years ago by an online contact lens vendor seeking to change New Mexico’s contact lens laws.
“Those attempts failed, but we had made some arrangements with legislators to amend our contact lens release procedures, which we did,” he said. “We got our Board of Examiners in optometry to promulgate a rule that specified that once a patient has been fitted and the doctor has determined the fit to be accurate, the prescription would be released to the patient at his or her request.”
Dr. Geldert said New Mexico operated under this board rule for about 1.5 years. At the start of the last legislative session, the NMOA tried to amend its optometry act, which contradicted the board rule.
“The optometry act forbade an optometrist to release a prescription to anyone other than an MD or OD,” he said. “So now we had a board rule that required optometrists to release contact lens prescriptions and an optometry act that said they couldn’t do it. So, we promulgated a rule change.”
In the process of the rule change, the NMOA tried to determine exactly what constituted a contact lens prescription and what the requirements were for the prescription to be released.
“At that point, 1-800-CONTACTS showed up, and they voiced all these objections to the things we were trying to do,” he said. “We then compromised with them.”
Specifics of the amendment
Dr. Geldert discussed the restrictions to the law, which are designed to protect patients’ safety. “If the doctor feels the prescription should be good for only a year, that’s what it is,” he said. “If the doctor thinks it should be good for 2 years, that’s what it will be. There is a wide range of flexibility there.”
He said there are several medical and non-medical reasons for a practitioner to issue a reduced prescription time. “For example, children, whose eyes are changing, would probably get a reduced time,” he said. “Also, a patient who has been non-compliant in the past in terms of proper lens care might get a shorter prescription time.”
Patients with medical problems such as diabetes or previous corneal ulcers might also get a shorter prescription.
In addition, Dr. Geldert said the NMOA put what is called “positive verification” into the law. “With Internet and mail-order sites, doctors’ offices often will receive either a fax transmission during non-business hours or a recorded call seeking to verify a prescription,” he said. “So we added requirements that the doctors be contacted during normal business hours.”
In addition, Dr. Geldert said the NMOA added a provision that the doctor must respond within 72 hours. “In working with the lobbyist for 1-800-CONTACTS, we thought it was fair to assume that there was a burden on the doctors to respond in a timely fashion,” he said. “We felt that 72 hours would be a reasonable amount of time for the doctor to get back and verify the prescription.”
At that point, the NMOA also added a stipulation stating that failure to verify does not constitute passive verification. “In other words, the doctor is in the wrong if he or she doesn’t verify 72 hours after receipt,” he said. “The entity asking for verification has a right at that point to file a complaint with the board.”
Dr. Geldert emphasized the importance of verification by the doctor prior to dispensing lenses. He cited an instance where one of the NMOA’s doctors was able to get onto an Internet site and order contacts under the fictitious name “Dr. East R. Bunny.” The lenses were subsequently shipped to a state legislator.
“This proved that it was really necessary to put positive verification into the law,” he said. “But it is also fair to the company selling the lenses that the doctor can’t just sit on it forever.”
For Your Information:
- Maurice Geldert, OD, is immediate past president of the New Mexico Optometric Association. He can be reached at 200 W. Wilshire Blvd., Suite D, Roswell, NM 88201-0627; (505) 623-5111; fax: (505) 623-9639.