HBA-JEK, CCH C.S.H.B. 1877 77(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1877 By: Gray Public Health 4/11/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE The Contact Lens Prescription Act (Act) provides consumers with direct access to their contact lens prescriptions. However, some consumers are still encountering difficulty in accessing their contact lens prescriptions and getting their prescriptions filled by outside dispensers. C.S.H.B. 1877 clarifies the Act by requiring a physician, optometrist, or therapeutic optometrist to release a patient's contact lens prescription at the time of an exam, and to verify prescriptions to those who hold a contact lens dispenser permit. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 1 (Section 353.007, Occupations Code) and in SECTION 15 of this bill. ANALYSIS C.S.H.B. 1877 amends the Occupations Code to provide that a holder of a contact lens dispenser permit who is not a licensed physician, optometrist, or therapeutic optometrist (ocular professional) is exempt from the requirements of the Medical Practice Act and the Texas Optometry Act as long as the permit holder complies with the Contact Lens Prescription Act (Sec. 353.005). C.S.H.B. 1877 provides that a written electronic communication sent from or received in Texas in connection with dispensing contact lenses is considered signed if a digital signature is transmitted with the communication. The bill provides that the use of a digital signature is subject to criminal laws relating to fraud and computer crimes (Sec. 353.006). The bill requires the Texas Board of Health (TBH) to adopt rules governing the prompt release or confirmation of a patient's valid prescription no later than January 1, 2002, and authorizes TBH to adopt rules to give effect to the requirements of the Contact Lense Prescription Act (Sec. 353.007 and SECTION 15). C.S.H.B. 1877 authorizes contact lenses to be dispensed by a business entity that holds a contact lens dispensing permit (Sec. 353.051). The bill authorizes a person other than an ocular professional to sell or dispense contact lenses, if the person confirms the validity of the consumer's contact lens prescription (Sec. 353.101). The bill requires an ocular professional upon request to provide confirmation of a person's valid prescription to a contact lens dispenser. The bill prohibits an ocular professional from failing to respond promptly to a request to release or confirm a prescription. The bill authorizes an ocular professional to require a follow-up examination only if warranted by the patient's ocular health to determine the parameters of the prescription (Secs. 353.104, 353.156, and 353.158). C.S.H.B. 1877 removes provisions regarding the notations that must be made on the prescription of a patient who requests fewer than the total number of lenses authorized to be dispensed by the prescription. The bill requires a person dispensing contact lenses to maintain a copy of the prescription or confirmation record for each order until the fifth anniversary of the date the prescription was filled and to notify the ocular professional of the date and number of each prescribed lens dispensed (Sec. 353.103). C.S.H.B. 1877 provides that a contact lens prescription must contain the signature of or documentation of the oral approval of the ocular professional (Sec. 353.152). The bill requires an ocular professional to authorize a two-month prescription extension on a request of an agent of the patient (Sec. 353.155). The bill requires an ocular professional to prepare and give a prescription to a patient if the patient requests more than one prescription while the prescription is valid (Sec. 353.156). C.S.H.B. 1877 requires a person filling a contact lens prescription to contact the prescribing ocular professional to confirm the validity of the prescription and to maintain an appropriate prescription record, and requires the prescribing ocular professional to promptly confirm the validity of the patient's prescription to an authorized lens dispenser (Sec. 353.1521). The bill authorizes an ocular professional to declare promptly that a prescription is invalid if the expiration date of the prescription has passed or the patient's record reflects that the total number of lenses dispensed exceeds by 20 percent the authorized number (Sec. 353.1522). The bill authorizes an ocular professional to refuse to give a contact lens prescription to a patient only if the prescription has expired, or the patient has not paid for the examination, fitting, or any other financial obligations unless a claim is pending or being disputed. An ocular professional who refuses to release or confirm a patient's contact lense prescription is required to give the patient or lens dispenser a written explanation of the reason for the refusal (Sec. 353.157). The bill prohibits an ocular professional from filling a prescription that the professional has refused to release to a patient unless the refusal is based on the patient's ocular health (Sec. 353.158). C.S.H.B. 1877 provides that TBH has the exclusive responsibility for enforcing the Contact Lens Prescription Act and for enforcing an alleged violation by a business that holds a contact lens dispensing permit (Sec 353.204). The bill also provides that it is a defense to any action against a permit holder if the permit holder was prevented from complying as a result of the refusal by an ocular professional to promptly release or confirm a prescription (Sec. 353.2041). EFFECTIVE DATE September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 1877 differs from the original bill by removing the provision in the original that prohibited an ocular professional from issuing a contact lens prescription that expired before the second, rather than the first, anniversary of the date the patient's prescription parameters are determined. The substitute also deletes provisions that required notations to be made on the prescription of a patient requesting fewer than the total number of lenses authorized to be dispensed by that prescription. The substitute requires a person dispensing contact lenses to maintain a copy of the prescription or confirmation record for each order until the fifth anniversary of the date the prescription was filled and to notify the ocular professional of the date and number of each prescribed lens dispensed (Sec. 353.103). The substitute authorizes an ocular professional to declare a prescription invalid if the patient's record reflects that the total number of lenses dispensed exceeds by 20 percent the authorized number (Sec. 353.1522). The substitute removes the provision in the original that a patient's prescription is considered valid if an ocular professional fails to respond to request for a prescription's verification within a medically reasonable time. C.S.H.B. 1877 removes the provision that required a health care professional who sells contact lenses to post a sign stating that patients have a right to receive their contact lens prescription following the final fitting of the contacts (Sec. 353.156). The substitute provides that a contact lens prescription must contain the signature or documentation of the oral approval of an ocular professional (Sec. 353.152). C.S.H.B. 1877 requires an ocular professional to provide a prescription to a patient if the patient requests more than one prescription while the prescription is valid. The substitute authorizes an ocular professional to refuse to give a contact lens prescription to a patient only if the prescription has expired, or the patient has not paid for the examination, fitting, or any other financial obligations unless a claim is pending or being disputed. The substitute requires an ocular professional who refuses to release or confirm a patient's contact lens prescription to give the patient a written explanation of the reason for the refusal (Secs. 353.156 and 353.157). The substitute prohibits an ocular professional from filling a prescription that the professional has refused to release unless the refusal is based on the patient's ocular health (Sec. 353.158). The substitute authorizes the Texas Board of Health (TBH) to adopt rules to give effect to the requirements of the Contact Lense Prescription Act and requires TBH to adopt rules governing the prompt release or confirmation of a patient's valid prescription (Sec. 353.007).