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S.B. 48
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5 AN ACT RELATING TO OCCUPATIONS AND PROFESSIONS; IMPOSING DISCLOSURE
6 REQUIREMENTS ON HEALTH INSURERS WHO OFFER VISION BENEFITS; INCLUDING
7 OPTOMETRISTS IN THE LIST OF HEALTH CARE PROVIDERS COVERED BY HEALTH
8 INSURANCE AND THE GOOD SAMARITAN ACT; PERMITTING A CONTACT LENS
9 PRESCRIPTION TO BE GIVEN VERBALLY AND SPECIFYING THE COMPONENTS OF
10 SUCH A PRESCRIPTION; ESTABLISHING A GENERAL EXEMPTION FROM LICENSURE
11 FOR CONTACT LENS SELLERS AND THE MANNER FOR FILLING PRESCRIPTIONS
12 BASED ON NOTIFICATION; CLARIFYING THE EXEMPTION FOR PERSONS WHO FIT
13 CONTACT LENSES; REQUIRING AN OPTOMETRIST TO PROVIDE PRESCRIPTION
14 CONTACT LENS TO A PATIENT AND A SELLER OF CONTACT LENSES; LIMITING THE
15 LIABILITY OF AN OPTOMETRIST FOR PROVIDING A PRESCRIPTION; AND MAKING
16 TECHNICAL AND CONFORMING AMENDMENTS.
17 This act affects sections of Utah Code Annotated 1953 as follows:
18 AMENDS:
19 31A-22-613, as last amended by Chapter 38, Laws of Utah 1996
20 58-13-2, as last amended by Chapter 288, Laws of Utah 1998
21 58-13-3, as last amended by Chapter 288, Laws of Utah 1998
22 58-16a-102, as last amended by Chapter 13, Laws of Utah 1997
23 58-16a-305, as renumbered and amended by Chapter 13, Laws of Utah 1997
24 58-16a-306, as enacted by Chapter 13, Laws of Utah 1997
25 58-16a-501, as enacted by Chapter 13, Laws of Utah 1997
26 58-16a-502, as enacted by Chapter 13, Laws of Utah 1997
27 58-16a-503, as renumbered and amended by Chapter 13, Laws of Utah 1997
28 58-16a-601, as renumbered and amended by Chapter 13, Laws of Utah 1997
29 58-17a-305, as enacted by Chapter 247, Laws of Utah 1996
30 ENACTS:
31 58-16a-801, Utah Code Annotated 1953
32 Be it enacted by the Legislature of the state of Utah:
33 Section 1. Section 31A-22-613 is amended to read:
34 31A-22-613. Permitted provisions for disability insurance policies.
35 The following provisions may be contained in a disability insurance policy, but if they are
36 in that policy, they shall conform to at least the following minimum requirements for the
37 policyholder:
38 (1) Any provision respecting change of occupation may provide only for a lower maximum
39 benefit payment and for reduction of loss payments proportionate to the change in appropriate
40 premium rates, if the change is to a higher rated occupation, and this provision shall provide for
41 retroactive reduction of premium rates from the date of change of occupation or the last policy
42 anniversary date, whichever is the more recent, if the change is to a lower rated occupation.
43 (2) Section 31A-22-405 applies to misstatement of age in disability policies, with the
44 appropriate modifications of terminology.
45 (3) Any policy which contains a provision establishing, as an age limit or otherwise, a date
46 after which the coverage provided by the policy is not effective, and if that date falls within a
47 period for which a premium is accepted by the insurer or if the insurer accepts a premium after that
48 date, the coverage provided by the policy continues in force, subject to any right of cancellation,
49 until the end of the period for which the premium was accepted. This Subsection (3) does not
50 apply if the acceptance of premium would not have occurred but for a misstatement of age by the
51 insured.
52 (4) Any provision dealing with preexisting conditions shall be consistent with Subsections
53 31A-22-605 (9)(a) and 31A-22-609 (2), and any applicable rule adopted by the commissioner.
54 (5) (a) If an insured is otherwise eligible for maternity benefits, a policy may not contain
55 language which requires an insured to obtain any additional preauthorization or preapproval for
56 customary and reasonable maternity care expenses or for the delivery of the child after an initial
57 preauthorization or preapproval has been obtained from the insurer for prenatal care. A
58 requirement for notice of admission for delivery is not a requirement for preauthorization or
59 preapproval, however, the maternity benefit may not be denied or diminished for failure to provide
60 admission notice. The policy may not require the provision of admission notice by only the
61 insured patient.
62 (b) This Subsection (5) does not prohibit an insurer from:
63 (i) requiring a referral before maternity care can be obtained;
64 (ii) specifying a group of providers or a particular location from which an insured is
65 required to obtain maternity care; or
66 (iii) limiting reimbursement for maternity expenses and benefits in accordance with the
67 terms and conditions of the insurance contract so long as such terms do not conflict with
68 Subsection (5)(a).
69 (6) An insurer may only represent that a policy:
70 (a) offers a vision benefit if the policy:
71 (i) charges a premium for the benefit; and
72 (ii) provides reimbursement for materials or services provided under the policy; and
73 (b) covers laser vision correction, whether photorefractive keratectomy, laser assisted
74 in-situ keratomelusis, or related procedure, if the policy:
75 (i) charges a premium for the benefit; and
76 (ii) the procedure is at least a partially covered benefit.
77 Section 2. Section 58-13-2 is amended to read:
78 58-13-2. Emergency care rendered by licensee.
79 A person licensed under Title 58, Occupations and Professions, to practice as any of the
80 following health care professionals, who is under no legal duty to respond, and who in good faith
81 renders emergency care at the scene of an emergency gratuitously and in good faith, is not liable
82 for any civil damages as a result of any acts or omissions by the person in rendering the emergency
83 care:
84 (1) osteopathic physician;
85 (2) physician and surgeon;
86 (3) naturopath;
87 (4) dentist or dental hygienist;
88 (5) chiropractic physician;
89 (6) physician assistant; [
90 (7) optometrist; or
91 [
92 Section 3. Section 58-13-3 is amended to read:
93 58-13-3. Qualified immunity -- Health professionals -- Charity care.
94 (1) (a) The Legislature finds many residents of this state do not receive medical care and
95 preventive health care because they lack health insurance or because of financial difficulties or
96 cost. The Legislature also finds that many physicians, charity health care facilities, and other
97 health care professionals in this state would be willing to volunteer medical and allied services
98 without compensation if they were not subject to the high exposure of liability connected with
99 providing these services.
100 (b) The Legislature therefore declares that its intention in enacting this section is to
101 encourage the provision of uncompensated volunteer health care in charity care settings in
102 exchange for a limitation on liability for the health care facilities and health care professionals who
103 provide those volunteer services.
104 (2) As used in this section:
105 (a) "Health care facility" means any clinic or hospital, church, or organization whose
106 primary purpose is to sponsor, promote, or organize uncompensated health care services for people
107 unable to pay for health care services.
108 (b) "Health care professional" means individuals licensed under Title 58, Occupations and
109 Professions, as physicians and surgeons, osteopaths, podiatrists, optometrists, chiropractors,
110 dentists, dental hygienists, registered nurses, certified nurse midwives, and other nurses licensed
111 under Section 58-31b-301 .
112 (c) "Remuneration or compensation":
113 (i) (A) means direct or indirect receipt of any payment by the physician and surgeon, health
114 care facility, other health care professional, or organization, on behalf of the patient, including
115 payment or reimbursement under medicare or medicaid, or under the state program for the
116 medically indigent on behalf of the patient; and
117 (B) compensation, salary, or reimbursement to the health care professional from any source
118 for the health care professional's services or time in volunteering to provide uncompensated health
119 care; and
120 (ii) does not mean any grant or donation to the health care facility used to offset direct
121 costs associated with providing the uncompensated health care such as medical supplies or drugs.
122 (3) A health care professional who provides health care treatment at a health care facility
123 is not liable in a medical malpractice action if:
124 (a) the treatment was within the scope of the health care professional's license under this
125 title;
126 (b) neither the health care professional nor the health care facility received compensation
127 or remuneration for the treatment;
128 (c) the acts or omissions of the health care professional were not grossly negligent or
129 willful and wanton; and
130 (d) prior to rendering services, the health care professional disclosed in writing to the
131 patient, or if a minor, to the patient's parent or legal guardian, that the health care professional is
132 providing the services without receiving remuneration or compensation and that in exchange for
133 receiving uncompensated health care, the patient consents to waive any right to sue for
134 professional negligence except for acts or omissions which are grossly negligent or are willful and
135 wanton.
136 (4) A health care facility which sponsors, promotes, or organizes the uncompensated care
137 is not liable in a medical malpractice action for acts and omissions if:
138 (a) the health care facility meets the requirements in Subsection (3)(b);
139 (b) the acts and omissions of the health care facility were not grossly negligent or willful
140 and wanton; and
141 (c) the health care facility has posted, in a conspicuous place, a notice that in accordance
142 with this section the health care facility is not liable for any civil damages for acts or omissions
143 except for those acts or omissions that are grossly negligent or are willful and wanton.
144 (5) Immunity from liability under this section does not extend to the use of general
145 anesthesia or care that requires an overnight stay in a general acute or specialty hospital licensed
146 under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act.
147 Section 4. Section 58-16a-102 is amended to read:
148 58-16a-102. Definitions.
149 In addition to the definitions in Section 58-1-102 , as used in this chapter:
150 (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201 .
151 (2) "Contact lens" means any lens that:
152 (a) has a spherical, cylindrical, or prismatic power or curvature;
153 (b) is made pursuant to a current prescription; and
154 (c) is intended to be worn on the surface of the eye.
155 (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses that
156 includes:
157 [
158 [
159 [
160 [
161 (iii) for a written order, the signature of the prescribing optometrist or physician; and
162 (iv) for a verbal order, a record maintained by the recipient of:
163 (A) the name of the prescribing optometrist or physician; and
164 (B) the date when the prescription was issued or ordered.
165 (b) A prescription may include:
166 (i) a limit on the quantity of lenses that may be ordered under the prescription if:
167 (A) the prescription is for more than one contact per eye; or
168 (B) required for medical reasons documented in the patient's files; and
169 (ii) the expiration date of the prescription, which may not be less than one year from the
170 commencement date, unless documented medical reasons require continuous monitoring, nor more
171 than two years.
172 (c) A prescription shall be valid for two years if the prescription does not include an
173 expiration date.
174 (4) "Contact lens prescription verification" means a written request from a person who
175 sells contact lenses that:
176 (a) is sent to the prescribing optometrist or physician; and
177 (b) seeks the confirmation of the accuracy of a patient's prescription.
178 [
179 orbit, including the conjunctiva, lids, lashes, and lacrimal system.
180 [
181 (a) the using of a keratometer to measure the human eye;
182 (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
183 (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit and
184 performance, to determine a tentative contact lens prescription for a patient if the patient:
185 (i) has not worn contact lenses before; or
186 (ii) has changed to a different type or base curve.
187 [
188 by means of laser or ionizing radiation.
189 [
190 (a) has a spherical, cylindrical, or prismatic power;
191 (b) is made pursuant to an unexpired prescription; and
192 (c) is intended to be used in eyeglasses or spectacles.
193 [
194 (a) working under the direct and immediate supervision of a licensed optometrist; and
195 (b) engaged in specific tasks assigned by the licensed optometrist in accordance with the
196 standards and ethics of the profession.
197 [
198 chapter.
199 [
200 the following practices:
201 (a) examination of the human eye and its adnexa to detect and diagnose defects or
202 abnormal conditions;
203 (b) determination or modification of the accommodative or refractive state of the human
204 eye or its range or power of vision by administration and prescription of pharmaceutical agents or
205 the use of diagnostic instruments;
206 (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
207 lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to diagnose
208 and treat diseases, defects, or other abnormal conditions of the human eye and its adnexa; [
209 (d) display of any advertisement, circular, sign, or device offering to:
210 (i) examine the eyes;
211 (ii) fit glasses or contact lenses; or
212 (iii) adjust frames; [
213 [
214
215 (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
216 anterior [
217 (f) consultation regarding the eye and its adnexa with other appropriate health care
218 providers, including referral to other appropriate health care providers; and
219 (g) a person, not licensed as an optometrist, directing a licensee under this chapter to
220 withhold or alter the eye care services the licensee has ordered.
221 [
222 combination of drugs that has the property of assisting in the diagnosis, prevention, treatment, or
223 mitigation of abnormal conditions or symptoms of the eye and its adnexa.
224 [
225 [
226 (a) not more than two years prior to presentation of the prescription for an ophthalmic lens
227 [
228 (b) in accordance with Subsection (3)(a)(iii) for a contact lens.
229 Section 5. Section 58-16a-305 is amended to read:
230 58-16a-305. License -- Exemptions.
231 In addition to the exemptions from licensure in Section 58-1-307 , the following persons
232 may engage in acts included in the definition of the practice of optometry subject to the stated
233 circumstances and limitations without being licensed under this chapter:
234 (1) a person who sells [
235 authorized under state law to practice either optometry or medicine and surgery if the person
236 complies with Section 58-16a-801 ;
237 (2) a person who sells eyeglasses or spectacles as articles of merchandise or who fabricates
238 them from a prescription if the person:
239 (a) [
240 place of business;
241 (b) [
242 adapting lenses according to the test;
243 (c) [
244
245
246 (d) [
247 lenses actually sold; and
248 (e) [
249 13-26-2 ; and
250 (3) a person who [
251 (a) he has a current certification from both the American Board of Opticianry and the
252 National Contact Lens Examiners;
253 (b) he does not give or offer contact lenses as premiums;
254 (c) he does not perform a refraction, over-refraction, or attempt to traffic upon assumed
255 skill in testing the eye;
256 (d) he operates in the ordinary course of trade from a permanently located and established
257 place of business;
258 (e) he performs the work involved in fitting contact lenses himself and does not delegate
259 the contact lens fitting to any other individual who is not qualified under this Subsection (3);
260 (f) he does not use in the testing of the eye any lenses or instruments other than the lenses
261 he actually will sell;
262 [
263 (i) presents an unexpired contact lens prescription; or
264 (ii) has had an eye examination within the prior six months by an optometrist or
265 ophthalmologist meeting the requirements under Section 58-16a-306 ; [
266 [
267 seven years[
268 (i) he enters into a written agreement with an optometrist or an ophthalmologist before
269 July 1, 2000, to fit contact lenses prescribed by that optometrist or ophthalmologist;
270 (j) he fits contact lenses for at least two years under the direct supervision of the
271 optometrist or ophthalmologist identified in Subsection (3)(i) before July 1, 2000, as documented
272 in the written agreement; and
273 (k) the optometrist or ophthalmologist described in Subsection (3)(i):
274 (i) ensures that the final contact lens is accurate;
275 (ii) presents a written copy of the prescription to the person fitting the contact lens; and
276 (iii) ensures that a copy of the prescription is provided to the patient, except as provided
277 in Section 58-16a-306 .
278 Section 6. Section 58-16a-306 is amended to read:
279 58-16a-306. Contact lens prescription -- Qualifications.
280 (1) An optometrist or ophthalmologist issuing a contact lens prescription [
281
282 [
283 [
284
285 [
286
287
288 [
289 (c) present a written copy of the prescription to the [
290
291 (i) there are unpaid fees associated with the examination or treatment; or
292 (ii) providing a copy is not in the best medical interests of the patient in the professional
293 judgement of the prescribing optometrist or physician; and
294 (d) provide a copy of the patient's contact lens prescription to a person who sells contact
295 lenses upon the request of the patient or the person selling the contact lenses.
296 (2) An optometrist or physician may not be held liable as a result of providing a
297 prescription to a patient as required by Subsection (1).
298 Section 7. Section 58-16a-501 is amended to read:
299 58-16a-501. Unlawful conduct.
300 "Unlawful conduct" includes, in addition to the definition in Section 58-1-501 :
301 (1) buying, selling, or fraudulently obtaining, any optometry diploma, license, certificate,
302 or registration;
303 (2) aiding or abetting the buying, selling, or fraudulently obtaining, of any optometry
304 diploma, license, certificate, or registration;
305 (3) selling contact lenses [
306 manner inconsistent with Section 58-16a-801 or intentionally altering a prescription unless the
307 person selling the lenses is a licensed optometrist or ophthalmologist[
308
309 (4) representing oneself as or using the title of "optometrist," "optometric physician,"
310 "doctor of optometry," or "O.D.," unless currently licensed [
311 chapter.
312 Section 8. Section 58-16a-502 is amended to read:
313 58-16a-502. Unprofessional conduct.
314 "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501 :
315 (1) using or employing the services of an optometric assistant to assist a licensee in any
316 manner not in accordance with:
317 (a) the generally recognized practices and standards of ethics of the profession; or
318 (b) applicable state law or division rule;
319 (2) failure to refer a patient to an appropriate licensed practitioner when:
320 (a) the patient's condition does not respond to treatment; or
321 (b) the treatment is not within the scope of competence or licensure of the licensee;
322 (3) providing confidential information regarding a patient to any third party who does not
323 have a legal and professional ground for obtaining the information;
324 (4) knowingly prescribing, selling, giving away, or administering any prescription drug
325 except for a legitimate medical purpose and upon a proper diagnosis indicating the use of the drug
326 in the amount prescribed or provided;
327 (5) giving or receiving directly or indirectly any fee, commission, rebate, or other
328 compensation for professional services not actually and personally rendered, except as part of a
329 legal relationship within a lawful professional partnership, corporation, or association; [
330 (6) failure to transfer pertinent and necessary information from a patient's medical records
331 to another optometrist or physician when so requested by the patient or his representative, as
332 designated in writing[
333 (7) failure to provide a contact lens prescription to a person who sells contact lenses in
334 accordance with Section 58-16a-306 .
335 Section 9. Section 58-16a-503 is amended to read:
336 58-16a-503. Penalty for unlawful conduct.
337 [
338 conduct provision defined in Section 58-16a-501 or Subsection 58-1-501 (1)(a) or (1)(c) is guilty
339 of a third degree felony.
340 (2) A person who violates Subsection 58-16a-501 (3) is guilty of a class C misdemeanor.
341 Section 10. Section 58-16a-601 is amended to read:
342 58-16a-601. Scope of practice.
343 (1) An optometrist may:
344 (a) provide any optometric services not specifically prohibited under this chapter or
345 division rules and that are within the optometrist's training, skills, and scope of competence; and
346 (b) prescribe or administer any pharmaceutical agent for the eye and its adnexa, including
347 all oral pharmaceutical agents S [
347a for: [
348 (A) [
349 (B) [
349a (ii) SCHEDULE III CONTROLLED SUBSTANCES MAY ONLY BE PRESCRIBED h [
349a1
349b ORALLY
349b2 OR ADNEXA IN A QUANTITY NOT TO
349b1 EXCEED 72 HOURS IN
349c DURATION AND WHICH MAY NOT BE REFILLED. s
350 (2) An optometrist may not:
351 (a) perform surgery, including laser surgery; or
352 (b) prescribe or administer any Schedule II [
353 defined in Title 58, Chapter 37, Controlled Substances.
354 (3) An optometrist is a health care provider for purposes of Sections 31A-22-617 and
355 31A-22-618 .
356 Section 11. Section 58-16a-801 is enacted to read:
357
358 58-16a-801. Contact lens seller.
359 (1) A person may sell contact lenses if the person:
360 (a) does so in the ordinary course of trade from a permanently located and established
361 place of business;
362 (b) does not perform refractions, over-refractions, or attempts to traffic upon assumed skill
363 in testing the eye;
364 (c) does not offer or give contact lenses as premiums, as defined in Section 13-26-2 ;
365 (d) does not fit contact lenses;
366 (e) provides a contact lens to a patient after:
367 (i) receiving an unexpired verbal or written prescription; or
368 (ii) sending a contact lens prescription verification to the prescribing optometrist or
369 physician, regardless of whether the prescribing optometrist or physician responds to or confirms
370 the verification, provided that:
371 (A) the person has all of the information necessary to fill the prescription;
372 (B) the prescribing optometrist or physician has not informed the person that the
373 prescription has expired or is otherwise inaccurate prior to the person shipping or hand-delivering
374 the contact lens to the patient;
375 (C) the person confirms a valid, unexpired contact lens prescription for the patient if the
376 person is aware that the patient provided inaccurate prescription information in his last order; and
377 (D) the person informs the patient that the prescription has expired or that there is a
378 medical problem associated with the prescription if the information is communicated by the
379 prescribing optometrist or physician to the person within 72 hours of the contact lens
379a S PRESCRIPTION s verification
380 being sent; and
381 (f) maintains patient information, including the method and date of any prescription
382 verification, for no less than seven years.
383 (2) Nothing in this section may be construed as requiring a person to be licensed or
384 certified in any way under this or any another chapter of this title to sell contact lenses in
385 accordance with Subsection (1).
386 Section 12. Section 58-17a-305 is amended to read:
387 58-17a-305. Exemptions from licensure.
388 In addition to the exemptions from licensure in Section 58-1-307 [
389 (1) an individual who has completed all qualifications for licensure as a pharmacy
390 technician, except an experience requirement which may be established by rule under Subsection
391 58-17a-302 (4), may practice under the direct personal supervision of a pharmacist while
392 completing that requirement for a period not to exceed six consecutive months without being
393 licensed under this chapter[
394 (2) a person may sell contact lenses in accordance with Section 58-16a-801 without being
395 licensed under this chapter.
Legislative Review Note
as of 1-24-00 3:33 PM
A limited legal review of this legislation raises no obvious constitutional or statutory concerns.