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NM ODs can perform minor surgical procedures
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A new law in New Mexico modifies the state’s optometry act to include specific minor surgical privileges, such as punctal occlusion, corneal débridement and removal of foreign bodies, eyelashes and lid lesions.
New Mexico Gov. Bill Richardson signed Senate Bill 367 into law on April 3.
While the New Mexico Optometry Act previously specified that “the practice of optometry does not include surgery or injections in the treatment of eye disease,” minor surgical procedures had been authorized by the board of optometry, according to Robert L. Jarrell III, OD, FAAO, legislative chair of the New Mexico Optometric Association (NMOA). “This bill took those procedures that the board had previously authorized and codified them in the New Mexico Optometry Act,” he told Primary Care Optometry News.
Specifically the bill states: “The practice of optometry … does not include the use of surgery or injections in the treatment of eye disease except for the use of the following in-office minor surgical procedures:
- non-laser removal, destruction or drainage of superficial eyelid lesions and conjunctival cysts;
- removal of nonperforating foreign bodies from the cornea, conjunctiva and eyelid;
- non-laser corneal débridement, culture, scrape or anterior puncture, not including removal of pterygium, corneal biopsy or removal of corneal neoplasias;
- removal of eyelashes;
- probing, dilation, irrigation or closure of the tear drainage structures of the eyelid;
- scalpel use is to be applied only for the purpose of use on the skin surrounding the eye.”
The opposition to this bill from ophthalmologists was so intense that the State of New Mexico House of Representatives Business and Industry Committee sent a strongly worded letter to the American Academy of Ophthalmology.
The letter reads: “The offensive ads that you have been running on television and radio are both appalling and ill-founded ... We are elected to represent the people of this state, and the insinuation in these ads that we would put the health of the public at risk is outrageous and offensive.”
Dr. Jarrell commented that the profession’s history of developing its scope of practice is based on the expanded curriculum within the schools of optometry. This recent initiative, however, was a direct result of information from Medicare carriers that surgically coded procedures would no longer be reimbursed.
“The denial from Medicare included everything from foreign body removals to punctal plugs, skin tags – pretty much all the basic procedures we’ve been performing,” Dr. Jarrell said. “Without an actual change to the wording of the optometry act itself, patients would continue to be denied access to this kind of care from their optometrists.”
The bill went into effect immediately, as both chambers of legislature enacted an emergency clause viewing the situation as critical for the health, safety or welfare of the people.
Because the procedures listed in the bill have been standard up until this point, New Mexico state optometrists will require no additional training beyond the customary continuing education. “We’ve offered minor surgical procedures courses for the past 10 to 15 years,” Dr. Jarrell said.
The NMOA is pleased with the outcome of this situation. “We know that other states are facing challenges with denials of reimbursement. We feel that this is a precedent-setting law.”
For more information:
- Robert L. Jarrell III, OD, FAAO, can be reached at Cottonwood Vision Care, 1646 Alameda Blvd., NW, Albuquerque, NM 87114; (505) 792-3500; e-mail: drjarrell@cottonwoodvision.com. Web site coming soon: www.newmexicooptometry.org.