22 Tex. Admin. Code § 279.2 - Contact Lens Prescriptions
(a) Prescription. A
prescription for contact lenses is defined as a written order signed by the
examining optometrist, therapeutic optometrist, or physician, or a written
order signed by an optometrist, therapeutic optometrist, or physician
authorized by the examining doctor to issue the prescription.
(1) If the prescription is signed by the
examining optometrist or therapeutic optometrist, the prescription may be
signed electronically, provided that:
(A) the
prescription is electronically signed by the practitioner using a system which
electronically replicates the practitioner's manual signature on the written
prescription; and
(B) the security
features of the system require the practitioner to authorize each
use.
(2) If the
prescription is signed by a doctor other than the examining optometrist,
therapeutic optometrist, or physician, the prescription must contain:
(A) the name of the examining doctor;
and
(B) the license number of both
the examining doctor and the doctor signing the
prescription.
(b) Applicable Law. A contact lens
prescription must comply with the requirements of the Texas Optometry Act,
Sections 351.005, 351.356, 351.357, 351.359, and 351.607, and the Contact Lens
Prescription Act, Sections 353.152, 353.153 and 353.158 and federal law,
15 U.S.C. Sections
7601 -
7610 (Public Law
108-164 ).
(c) Contents of Prescription. A fully written
contact lens prescription must contain all information required to accurately
dispense the contact lens, including:
(1)
patient's name;
(2) the name,
postal address, telephone number, and facsimile telephone number of the
prescribing optometrist or therapeutic optometrist (required by federal
law);
(3) the date of examination
(not including date of follow-up examinations) (required by federal
law);
(4) date the prescription is
issued;
(5) an expiration date of
not less than one year, unless a shorter period is medically
indicated;
(6) examining
optometrist's signature or authorized signature;
(7) name of the lens manufacturer, if
required to accurately dispense the lens;
(8) lens brand name, including:
(A) a statement that brand substitution is
permitted if the optometrist intends to authorize a contact lens dispenser to
substitute the brand name; and
(B)
name of manufacturer, trade name of private label brand, and, if applicable,
trade name of equivalent brand name when the prescribed brand name is not
available to the optical industry as a whole, unless the prescribing of a
proprietary lens brand is medically indicated;
(9) lens power;
(10) lens diameter, unless set by the
manufacturer;
(11) base curve,
unless set by the manufacturer; and
(12) number of lenses and recommended
replacement interval.
(d)
Release of Prescription, Timing. Regardless of whether the release is requested
by the patient, the optometrist or therapeutic optometrist shall release a
prescription once the parameters of the prescription are determined. An
exception to this requirement exists if the optometrist or therapeutic
optometrist determines that because of a medical indication further monitoring
is required, and the optometrist or therapeutic optometrist gives the patient a
verbal explanation of the reason the prescription is not released and documents
in the patient's records a written explanation of the reason.
(e) Release of Prescription, Method. An
optometrist or therapeutic optometrist shall issue a prescription by giving or
delivering an original signed copy of the prescription to the patient or to
another person in accordance with subsection (d) of this section.
(f) Verification of Prescription. An
optometrist or therapeutic optometrist shall verify a prescription when a
dispenser designated to act on behalf of the patient requests a verification by
telephone, facsimile, or electronic mail.
(g) Verification Procedure. A dispenser
designated to act on behalf of the patient is required to provide the
optometrist or therapeutic optometrist with the following information when
seeking a verification of a prescription:
(1)
the patient's full name and address;
(2) contact lens power, manufacturer, base
curve or appropriate designation, and diameter, as appropriate;
(3) quantity of lenses ordered;
(4) the date on which the patient requests
lenses to be ordered or dispensed;
(5) the date and time of the verification
request; and
(6) the name,
telephone number, and facsimile number of a person at the contact lens
dispenser's company with whom to discuss the verification.
(h) Verification Requirements. If the format
of the verification request allows, the optometrist or therapeutic optometrist,
when verifying a prescription, should provide the contact lens dispenser with
all of the information required in subsection (c) of this section. An
optometrist or therapeutic optometrist who did not perform the examination, may
verify a prescription according to subsection (a) of this section, providing to
the dispenser the name and license number of the examining doctor if the format
of the verification request so allows. Each request for a prescription
verification should be recorded in the patient record, including the name of
the dispenser, the date verification is requested, number of lenses requested,
and response of the optometrist or therapeutic optometrist.
(i) Inaccurate or Invalid Verification. A
contact lens dispenser seeking a contact lens prescription verification shall
not fill the prescription if an optometrist or therapeutic optometrist informs
a dispenser that the contact lens prescription is inaccurate, expired, or
otherwise invalid. An optometrist or therapeutic optometrist is required to
communicate the basis for the inaccuracy or invalidity of the prescription. If
the prescription communicated by the dispenser to the optometrist or
therapeutic optometrist is inaccurate or invalid, the optometrist or
therapeutic optometrist is required to provide the correct information to the
dispenser. A dispenser may dispense lenses without verification if an
optometrist or therapeutic optometrist fails to communicate with the dispenser
within 8 business hours, or a similar time as defined by the Federal Trade
Commission.
(j) Number of Lenses.
An optometrist or therapeutic optometrist dispensing contact lenses shall
record on the prescription the number of lenses dispensed and return the
prescription to the person. If all the contact lenses authorized by the
prescription are dispensed by an optometrist or therapeutic optometrist, the
following procedure complies with state law and should not be in conflict with
federal law: the optometrist or therapeutic optometrist writes on the
prescription "All Lenses Dispensed," makes a copy of the prescription to retain
in the licensee's records, and returns the original to the person presenting
the prescription.
(k) Extension.
The Contact Lens Prescription Act requires an optometrist or therapeutic
optometrist to authorize, upon request of the patient, a one-time, two-month
extension of the contact lens prescription.
(l) Private Labels. The prescribing
optometrist or therapeutic optometrist has the authority to specify any and all
parameters of an optical prescription for the therapeutic and visual health and
welfare of a patient, but the prescription shall not contain restrictions
limiting the parameters to private labels not available to the optical industry
as a whole, unless the prescribing of a proprietary lens brand is medically
indicated. The specifications of the prescription may not be altered without
the consent of the prescribing doctor.
(m) Fee. The Contact Lens Prescription Act
prohibits an optometrist or therapeutic optometrist from charging the patient a
fee in addition to the examination fee and the fitting fee as a condition for
giving a contact lens prescription to the patient or verifying a prescription
according to subsections (h) and (i) of this section. An optometrist or
therapeutic optometrist may not refuse to release a prescription solely because
charges assigned or presented for payment to an insurance carrier, health
maintenance organization, managed care entity, or similar entity have not been
paid by that entity.
(n) Fitting
Process. An optometrist or therapeutic optometrist may charge a fitting fee
that includes fees for lenses required to be used in the fitting process. The
fitting process may include the initial eye examination, an examination to
determine the specifications of the contact lenses, and follow-up examinations
that are medically necessary. Unless medically necessary, the optometrist or
therapeutic optometrist may not require the patient to purchase a quantity of
lenses in excess of the lenses the optometrist or therapeutic optometrist was
required to purchase to complete the fitting process.
(o) An optometrist or therapeutic optometrist
may not sign, or cause to be signed, an ophthalmic lens prescription without
first personally examining the eyes for whom the prescription is made pursuant
to Section 351.435 of the Optometry Act. An optometrist or therapeutic
optometrist is responsible for the prescriptions signed under the
practitioner's name even if they are produced by non-clinical staff. Should a
licensee discover a prescription for lenses was issued without his knowledge or
permission, the licensee shall report it to the Board within seven business
days.
(p) The Executive
Commissioner of the Health and Human Services Commission and the Executive
Director of the Texas Optometry Board may enter into interagency agreements as
necessary to implement and enforce this chapter.
Notes
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