By Maxey                                               H.B. No. 846
         Line and page numbers may not match official copy.
         Bill not drafted by TLC or Senate E&E.
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the issuance of a contact lens prescription and a
 1-3     patient's right of access to that prescription.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Section 353.101, Occupations Code, is amended to
 1-6     read as follows:
 1-7           Sec. 353.101.  Prohibited Selling or Dispensing.  A person,
 1-8     other than the prescribing physician, optometrist, or therapeutic
 1-9     optometrist, may not fill a contact lens prescription or sell or
1-10     dispense contact lenses to a consumer in this state unless the
1-11     person receives a [an original] contact lens prescription, in
1-12     accordance with Section 353.152, that has not expired and that
1-13     conforms to the requirements of this chapter.
1-14           SECTION 2.  Section 353.102, Occupations Code, is amended to
1-15     read as follows:
1-16           Sec. 353.102.  Accuracy Required.  A person who dispenses
1-17     contact lenses under this chapter from a contact lens prescription
1-18     shall fill the prescription accurately [subject to Section
1-19     353.103].
1-20           SECTION 3.  Section 353.103, Occupations Code, is amended to
1-21     read as follows:
1-22           Sec. 353.103.  [AUTHORIZED MODIFICATION OF] PRESCRIPTION
 2-1     RECORDS. (a)  When [If] a patient presents a contact lens
 2-2     prescription to be filled, [but requests that fewer than the total
 2-3     number of lenses authorized by the prescription be dispensed, the
 2-4     person dispensing the lenses shall note on the prescription:]
 2-5                 [(1)  the number of lenses dispensed;]
 2-6                 [(2)  the number of lenses that remain eligible to be
 2-7     dispensed under the prescription; and]
 2-8                 [(3)  the name, address, telephone number, and license
 2-9     or permit number of the person dispensing the lenses.]
2-10           [(b)  A notation under Subsection (a)  is a permanent
2-11     modification of the prescription.  Except as provided by this
2-12     subsection, a contact lens prescription may not be modified.]
2-13           [(c)  Subject to Subsection (d),] the person dispensing the
2-14     lenses shall:
2-15                 (1)  maintain a photocopy of the [original signed]
2-16     prescription[, as modified,] in the person's records until the
2-17     fifth anniversary of the date the prescription was filled [as if
2-18     the copy were the original prescription]; and
2-19                 (2)  return the [original] prescription to the patient
2-20     [so that the patient may have the additional lenses dispensed
2-21     elsewhere].
2-22           [(d)  When a prescription has been completely filled, the
2-23     person dispensing the lenses shall retain the original prescription
2-24     in the person's records until the fifth anniversary of the date the
2-25     prescription is completely filled.]
2-26           [(e)] (b)  The board by rule may permit a contact lens
 3-1     prescription required to be maintained under this chapter to be
 3-2     scanned into a computer and the original paper prescription
 3-3     destroyed.
 3-4           SECTION 4.  Section 353.104, Occupations Code, is amended to
 3-5     read as follows:
 3-6           Sec. 353.104.  Emergency Refill. (a)  If a patient needs an
 3-7     emergency refill of the patient's contact lens prescription, a
 3-8     physician, optometrist, or therapeutic optometrist may telephone or
 3-9     fax the prescription to a person authorized to dispense contact
3-10     lenses under Section 353.051.
3-11           (b)  The person filling the prescription shall maintain a
3-12     copy of the fax or telephone record [as if the record were an
3-13     original signed prescription].
3-14           (c)  The fax or telephone record must include the name,
3-15     address, telephone number, and license number of the physician,
3-16     optometrist, or therapeutic optometrist.
3-17           SECTION 5.  Sections 353.152 of the Occupations Code, and a
3-18     new Sec. 353.1521, are amended to read as follows:
3-19           Sec. 353.152.  Requirements for Contact Lens Prescription.
3-20     (a)  A contact lens prescription must be written and must contain:
3-21                 (1)  the patient's name;
3-22                 (2)  the date the prescription was issued;
3-23                 (3)  the manufacturer of the contact lens to be
3-24     dispensed, if warranted by the patient's ocular health [needed];
3-25                 (4)  the expiration date of the prescription, in
3-26     accordance with Section 353.153;
 4-1                 (5)  the [original] signature of the physician,
 4-2     optometrist, or therapeutic optometrist;
 4-3                 (6)  if the prescription is for disposable contact
 4-4     lenses, [the total number of lenses authorized to be issued under
 4-5     the prescription and] the recommended lens replacement interval;
 4-6                 (7)  if the prescription is issued by an optometrist,
 4-7     specification information required by Texas Optometry Board rule;
 4-8     and
 4-9                 (8)  if the prescription is issued by a physician,
4-10     specification information required by Texas State Board of Medical
4-11     Examiners rule.
4-12           (b)  A faxed or photocopied prescription is a valid
4-13     prescription only if it is confirmed by the prescribing physician,
4-14     optometrist, or therapeutic optometrist in accordance with Sec.
4-15     353.1521.
4-16           Sec. 353.1521.  FAXED AND COPIED PRESCRIPTIONS.  (a)  If a
4-17     patient presents a faxed or copied contact lens prescription to be
4-18     filled, the person filling the prescription shall:
4-19                 (1)  confirm, including telephone confirmation, the
4-20     validity of the prescription with the prescribing physician,
4-21     optometrist, or therapeutic optometrist; and
4-22                 (2)  maintain the prescription record in accordance
4-23     with Sec. 353.103.
4-24           (b)  The prescribing physician, optometrist, or therapeutic
4-25     optometrist shall promptly confirm the validity of a faxed or
4-26     copied prescription which that physician, optometrist, or
 5-1     therapeutic optometrist prescribed upon the request of a person
 5-2     authorized to dispense contact lenses under Section 353.051.
 5-3           SECTION 6.  Section 353.155, Occupations Code, is amended to
 5-4     read as follows:
 5-5           Sec. 353.155.  Extension of Prescription.  (a)  A physician,
 5-6     optometrist, or therapeutic optometrist may extend the expiration
 5-7     date for a contact lens prescription without completing another eye
 5-8     examination.
 5-9           (b)  On request by a patient, a prescribing physician,
5-10     optometrist, or therapeutic optometrist shall authorize at least
5-11     once a two-month extension of the patient's contact lens
5-12     prescription.
5-13           (c)  The physician, optometrist, or therapeutic optometrist
5-14     may extend the prescription in accordance with Section 353.104.
5-15           SECTION 7.  Section 353.156, Occupations Code, is amended to
5-16     read as follows:
5-17           Sec. 353.156.  Patient Access to Prescription; Timing.  (a)
5-18     A physician, optometrist, or therapeutic optometrist who performs
5-19     an eye examination and fits a patient for contact lenses shall[, on
5-20     request,] prepare and give a contact lens prescription to the
5-21     patient.
5-22           (b)  If the patient requests the contact lens prescription
5-23     during an initial or annual eye examination, the physician,
5-24     optometrist, or therapeutic optometrist shall prepare and give the
5-25     prescription to the patient at the time the physician, optometrist,
5-26     or therapeutic optometrist determines the parameters of the
 6-1     prescription.  The physician, optometrist, or therapeutic
 6-2     optometrist shall not require a follow-up examination unless
 6-3     warranted by the patient's ocular health in order to determine the
 6-4     parameters of the prescription.
 6-5           (c)  [On receipt of a prescription] Upon request from a
 6-6     patient [who did not request or receive an original contact lens
 6-7     prescription during an initial or annual eye examination,] the
 6-8     physician, optometrist, or therapeutic optometrist shall provide
 6-9     the patient with the prescription at any time during which the
6-10     prescription is valid.  If the patient requests more than one
6-11     prescription while it is valid, the physician, optometrist, or
6-12     therapeutic optometrist shall provide the patient with the
6-13     prescription.
6-14           (d)  If the patient requests the physician, optometrist, or
6-15     therapeutic optometrist to deliver the prescription to the patient
6-16     or to another person, the physician, optometrist, or therapeutic
6-17     optometrist may charge to the patient the cost of delivery.
6-18           SECTION 8.  Section 353.157, Occupations Code, Subsection (b)
6-19     is amended to read as follows:
6-20           (b)  Notwithstanding Section 353.156, a physician,
6-21     optometrist, or therapeutic optometrist may refuse to give a
6-22     contact lens prescription to a patient if:
6-23                 (1)  the patient's ocular health presents a
6-24     contraindication for contact lenses;
6-25                 (2)  refusal is warranted due to potential harm to the
6-26     patient's ocular health;
 7-1                 (3)  the patient has a medical condition indicating
 7-2     that:
 7-3                       (A)  the patient's ocular health would be damaged
 7-4     if the prescription were released to the patient; or
 7-5                       (B)  further monitoring of the patient is needed;
 7-6                 (4)  the patient has not paid for the examination and
 7-7     fitting or has not paid other financial obligations to the
 7-8     physician, optometrist, or therapeutic optometrist if the patient
 7-9     would have been required to make an immediate or similar payment if
7-10     the examination revealed that ophthalmic goods were not required,
7-11     unless the unpaid amount is due to a pending or disputed insurance
7-12     claim; or
7-13                 (5)  the request is made after the first anniversary of
7-14     the date of the patient's last eye examination.
7-15           SECTION 9.  Section 353.158, Occupations Code, is amended to
7-16     read as follows:
7-17           Sec. 353.158.  Prohibited Action by Physician, Optometrist,
7-18     or Therapeutic Optometrist.  A physician, optometrist, or
7-19     therapeutic optometrist may not:
7-20                 (1)  charge a patient a fee in addition to the
7-21     examination fee and fitting fee as a condition for giving a contact
7-22     lens prescription to the patient; [or]
7-23                 (2)  condition the availability to a patient of an eye
7-24     examination, a fitting for contact lenses, the issuance of a
7-25     contact lens prescription, or a combination of those services on a
7-26     requirement that the patient agree to purchase contact lenses or
 8-1     other ophthalmic goods from the physician, optometrist, or
 8-2     therapeutic optometrist or from a specific ophthalmic dispenser; or
 8-3                 (3)  fill a prescription that the physician,
 8-4     optometrist, or therapeutic optometrist has refused to release to a
 8-5     patient, unless the refusal is based on the patient's ocular health
 8-6     as allowed under Sec. 353.156(b) or Sec. 353.157(b)(1), (2), or
 8-7     (3).
 8-8           SECTION 10.  This Act takes effect September 1, 2001.
 8-9           SECTION 11.  The importance of this legislation and the
8-10     crowded condition of the calendars in both houses create an
8-11     emergency and an imperative public necessity that the
8-12     constitutional rule requiring bills to be read on three several
8-13     days in each house be suspended, and this rule is hereby suspended.