| (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.
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| Source Note: The provisions of this §279.2 adopted to be effective September 9, 2001, 26 TexReg 6679; amended to be effective December 23, 2001, 26 TexReg 10297; amended to be effective March 28, 2002, 27 TexReg 2237; amended to be effective September 19, 2004, 29 TexReg 8813; amended to be effective December 6, 2005, 30 TexReg 8099; amended to be effective March 4, 2013, 38 TexReg 1362 ; amended to be effective February 12, 2023, 48 TexReg 680 |
