| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the comanagement of glaucoma by ophthalmologists and |
|
|
therapeutic optometrists and the establishment of a comanagement |
|
|
registry. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter A, Chapter 153, Occupations Code, is |
|
|
amended by adding Section 153.017 to read as follows: |
|
|
Sec. 153.017. GLAUCOMA COMANAGEMENT REGISTRY AND |
|
|
DISCIPLINARY INFORMATION. (a) The board and the Texas Optometry |
|
|
Board shall: |
|
|
(1) jointly maintain a registry of ophthalmologists |
|
|
and therapeutic optometrists engaged in the comanagement of |
|
|
patients under Section 351.3581; and |
|
|
(2) make the registry available to the public through |
|
|
a link on each board's Internet website. |
|
|
(b) The registry must be searchable by: |
|
|
(1) the name of the ophthalmologist; |
|
|
(2) the name of the therapeutic optometrist; |
|
|
(3) the county that an ophthalmologist in the registry |
|
|
lists as a primary practice location; and |
|
|
(4) the county that a therapeutic optometrist in the |
|
|
registry lists as a primary practice location. |
|
|
(c) The board and the Texas Optometry Board shall jointly |
|
|
develop a process to share information regarding license holders |
|
|
under the jurisdiction of either board who: |
|
|
(1) become the subject of an investigation involving |
|
|
the comanagement or treatment of glaucoma, including information |
|
|
regarding the final disposition of the investigation; or |
|
|
(2) have been subject to a final adverse disciplinary |
|
|
action for an act involving the comanagement or treatment of |
|
|
glaucoma. |
|
|
(d) The board or the Texas Optometry Board, as applicable, |
|
|
may use information shared under Subsection (c) to initiate an |
|
|
investigation of a license holder. |
|
|
SECTION 2. Chapter 160, Occupations Code, is amended by |
|
|
adding Subchapter D to read as follows: |
|
|
SUBCHAPTER D. PARTICIPATION IN GLAUCOMA COMANAGEMENT REGISTRY |
|
|
Sec. 160.151. PROVISION OF INFORMATION TO GLAUCOMA |
|
|
COMANAGEMENT REGISTRY. (a) An ophthalmologist engaged in the |
|
|
comanagement of patients under Section 351.3581 shall provide to |
|
|
the board the name, license number, and county of primary practice |
|
|
location of each therapeutic optometrist with whom the |
|
|
ophthalmologist is comanaging patients for inclusion in the |
|
|
comanagement registry maintained as required under Section |
|
|
153.017. |
|
|
(b) The board shall establish procedures to allow an |
|
|
ophthalmologist who provides information under Subsection (a) to |
|
|
update the information through the registry's Internet website. |
|
|
The board shall require the ophthalmologist to update the |
|
|
information at least annually. |
|
|
SECTION 3. Section 351.3581, Occupations Code, is amended |
|
|
by amending Subsection (c) and adding Subsections (c-1), (c-2), |
|
|
(k), and (l) to read as follows: |
|
|
(c) A therapeutic optometrist required to engage in |
|
|
comanagement consultation with an ophthalmologist shall: |
|
|
(1) inform the patient diagnosed with or undergoing or |
|
|
beginning treatment for glaucoma that the therapeutic optometrist |
|
|
is required to have the diagnosis confirmed and comanaged with an |
|
|
ophthalmologist with whom the therapeutic optometrist has a |
|
|
glaucoma comanagement agreement or by an ophthalmologist of the |
|
|
patient's choosing; and |
|
|
(2) obtain signed, written consent from a patient |
|
|
described by Subdivision (1) that meets the requirements of |
|
|
Subsection (c-1) [or, if the patient does not choose an
|
|
|
ophthalmologist, an ophthalmologist practicing in the geographic
|
|
|
area in which the therapeutic optometrist practices]. |
|
|
(c-1) Consent obtained under Subsection (c) must |
|
|
acknowledge receipt by the patient of the following information: |
|
|
(1) that the patient has been diagnosed with glaucoma |
|
|
by the therapeutic optometrist or is undergoing or beginning |
|
|
treatment for glaucoma; |
|
|
(2) that the therapeutic optometrist obtaining the |
|
|
consent is not a physician licensed to practice medicine by the |
|
|
Texas Medical Board; |
|
|
(3) that the patient should have the diagnosis of |
|
|
glaucoma confirmed by an ophthalmologist licensed to practice |
|
|
medicine by the Texas Medical Board not later than the 30th day |
|
|
after the date the diagnosis is determined by the therapeutic |
|
|
optometrist and that the diagnosis should be reconfirmed annually |
|
|
by an ophthalmologist; |
|
|
(4) that the therapeutic optometrist obtaining the |
|
|
consent is required to comanage the treatment for glaucoma with an |
|
|
ophthalmologist licensed to practice medicine by the Texas Medical |
|
|
Board; and |
|
|
(5) that the Texas Medical Board and the Texas |
|
|
Optometry Board maintain a searchable registry of ophthalmologists |
|
|
and therapeutic optometrists who comanage glaucoma patients. |
|
|
(c-2) A therapeutic optometrist shall maintain a patient's |
|
|
consent obtained under Subsection (c) in the patient's medical |
|
|
record and forward a copy of the consent to the comanaging |
|
|
ophthalmologist with whom the therapeutic optometrist has a |
|
|
glaucoma comanagement agreement under Subsection (l) or to an |
|
|
ophthalmologist of the patient's choice on the written request of |
|
|
the patient. |
|
|
(k) A therapeutic optometrist engaged in the comanagement |
|
|
of patients under this section shall provide to the board the name, |
|
|
physician license number, and county of primary practice location |
|
|
of each ophthalmologist with whom the therapeutic optometrist is |
|
|
comanaging patients for inclusion in the glaucoma comanagement |
|
|
registry maintained as required by Section 153.017. The board |
|
|
shall establish procedures to allow a therapeutic optometrist who |
|
|
provides information under this subsection to update the |
|
|
information through the registry's Internet website. The board |
|
|
shall require the therapeutic optometrist to update the information |
|
|
at least annually. |
|
|
(l) A therapeutic optometrist who is required to engage in |
|
|
consultation with an ophthalmologist under this section shall enter |
|
|
into a written glaucoma comanagement agreement, signed and dated by |
|
|
the parties to the agreement, that: |
|
|
(1) contains the following information: |
|
|
(A) the names, addresses, and applicable license |
|
|
numbers of the parties; |
|
|
(B) the practice locations and settings of the |
|
|
parties; |
|
|
(C) a general plan for addressing consultation |
|
|
and referral; and |
|
|
(D) a general process for communications between |
|
|
the parties; |
|
|
(2) requires the agreement and any amendment to the |
|
|
agreement to be reviewed, dated, and signed by each party at least |
|
|
annually; |
|
|
(3) requires a party to the agreement who is notified |
|
|
that the party is the subject of an investigation by the party's |
|
|
licensing board to immediately notify the other party of the |
|
|
investigation; and |
|
|
(4) provides that the agreement may be terminated by |
|
|
any party not later than the 30th day after the date the party |
|
|
seeking termination notifies all other parties. |
|
|
SECTION 4. (a) Not later than March 1, 2018, the Texas |
|
|
Medical Board and the Texas Optometry Board shall establish the |
|
|
registry and adopt rules to implement the changes in law made by |
|
|
this Act. |
|
|
(b) Notwithstanding Section 351.3581, Occupations Code, as |
|
|
amended by this Act, a therapeutic optometrist or ophthalmologist |
|
|
is not required to comply with that section until April 1, 2018. |
|
|
SECTION 5. This Act takes effect September 1, 2017. |