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Second Substitute H.B. 39

Senator John L. Valentine proposes the following substitute bill:




Chief Sponsor: James A. Dunnigan

Senate Sponsor: John L. Valentine

             7      LONG TITLE
             8      General Description:
             9          This bill amends the Utah Optometry Practice Act to permit certain people in limited
             10      circumstances to sell ophthalmic lenses without being licensed under the chapter.
             11      Highlighted Provisions:
             12          This bill:
             13          .    allows a person in certain circumstances to sell, fit, adjust, and dispense ophthalmic
             14      lenses without being licensed under the chapter;
             15          .    requires a prescription for an ophthalmic lens;
             16          .    authorizes an optometrist to designate the expiration date for an ophthalmic lens
             17      prescription;
             18          .    defines an unexpired prescription; and
             19          .    specifies the activities that the unlicensed person may engage in regarding the sale
             20      or dispensing of ophthalmic lenses.
             21      Money Appropriated in this Bill:
             22          None
             23      Other Special Clauses:
             24          None
             25      Utah Code Sections Affected:

             26      AMENDS:
             27          58-16a-102, as last amended by Laws of Utah 2004, Chapters 48 and 280
             28          58-16a-305, as last amended by Laws of Utah 2000, Chapter 160
             29          58-16a-501, as last amended by Laws of Utah 2005, Chapter 71
             30          58-16a-801, as last amended by Laws of Utah 2004, Chapter 48
             32      Be it enacted by the Legislature of the state of Utah:
             33          Section 1. Section 58-16a-102 is amended to read:
             34           58-16a-102. Definitions.
             35          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             36          (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201 .
             37          (2) "Contact lens" means any lens that:
             38          (a) has a spherical, cylindrical, or prismatic power or curvature;
             39          (b) is made pursuant to a current prescription; [or] and
             40          (c) is intended to be worn on the surface of the eye.
             41          (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses
             42      that includes:
             43          (i) the commencement date of the prescription;
             44          (ii) the base curve, power, diameter, material or brand name, and expiration date;
             45          (iii) for a written order, the signature of the prescribing optometrist or physician; and
             46          (iv) for a verbal order, a record maintained by the recipient of:
             47          (A) the name of the prescribing optometrist or physician; and
             48          (B) the date when the prescription was issued or ordered.
             49          (b) A prescription may include:
             50          (i) a limit on the quantity of lenses that may be ordered under the prescription if
             51      required for medical reasons documented in the patient's files; and
             52          (ii) the expiration date of the prescription, which shall be two years from the
             53      commencement date, unless documented medical reasons require otherwise.
             54          (c) When a provider prescribes a private label contact lens for a patient the prescription
             55      shall include:
             56          (i) the name of the manufacturer;

             57          (ii) the trade name of the private label brand; and
             58          (iii) if applicable, the trade name of the equivalent national brand.
             59          (4) "Contact lens prescription verification" means a written request from a person who
             60      sells or provides contact lenses that:
             61          (a) is sent to the prescribing optometrist or physician; and
             62          (b) seeks the confirmation of the accuracy of a patient's prescription.
             63          (5) "Eye and its adnexa" means the human eye and all structures situated within the
             64      orbit, including the conjunctiva, lids, lashes, and lacrimal system.
             65          (6) "Fitting of a contact lens" means:
             66          (a) the using of a keratometer to measure the human eye;
             67          (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
             68          (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit
             69      and performance, to determine a tentative contact lens prescription for a patient if the patient:
             70          (i) has not worn contact lenses before; or
             71          (ii) has changed to a different type or base curve.
             72          (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
             73      by means of laser or ionizing radiation.
             74          (8) "Ophthalmic lens" means any lens used to treat the eye and that:
             75          (a) has a spherical, cylindrical, or prismatic power;
             76          (b) is made pursuant to an unexpired prescription; and
             77          (c) is intended to be used in eyeglasses or spectacles.
             78          (9) "Optometric assistant" means an unlicensed individual:
             79          (a) working under the direct and immediate supervision of a licensed optometrist; and
             80          (b) engaged in specific tasks assigned by the licensed optometrist in accordance with
             81      the standards and ethics of the profession.
             82          (10) "Optometrist" or "optometric physician" means an individual licensed under this
             83      chapter.
             84          (11) "Optometry" and "practice of optometry" mean any one or any combination of the
             85      following practices:
             86          (a) examination of the human eye and its adnexa to detect and diagnose defects or
             87      abnormal conditions;

             88          (b) determination or modification of the accommodative or refractive state of the
             89      human eye or its range or power of vision by administration and prescription of pharmaceutical
             90      agents or the use of diagnostic instruments;
             91          (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
             92      lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to
             93      diagnose and treat diseases, defects, or other abnormal conditions of the human eye and its
             94      adnexa;
             95          (d) display of any advertisement, circular, sign, or device offering to:
             96          (i) examine the eyes;
             97          (ii) fit glasses or contact lenses; or
             98          (iii) adjust frames;
             99          (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
             100      anterior 1/2 of the cornea;
             101          (f) consultation regarding the eye and its adnexa with other appropriate health care
             102      providers, including referral to other appropriate health care providers; and
             103          (g) a person, not licensed as an optometrist, directing a licensee under this chapter to
             104      withhold or alter the eye care services the licensee has ordered.
             105          (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or combination
             106      of drugs that has the property of assisting in the diagnosis, prevention, treatment, or mitigation
             107      of abnormal conditions or symptoms of the eye and its adnexa.
             108          (13) "Physician" has the same meaning as defined in Subsection 58-67-102 (7).
             109          (14) "Prescription drug" has the same definition as in Section 58-17b-102 .
             110          (15) "Unexpired" means a prescription that was issued:
             111          [(a) not more than two years prior to presentation of the prescription for an ophthalmic
             112      lens; or ]
             113          (a) for ophthalmic lenses which does not expire unless the optometrist includes an
             114      expiration date on the prescription based on medical reasons that are documented in the
             115      patient's file; and
             116          (b) in accordance with Subsection (3) for a contact lens.
             117          Section 2. Section 58-16a-305 is amended to read:
             118           58-16a-305. License -- Exemptions.

             119          In addition to the exemptions from licensure in Section 58-1-307 , the following persons
             120      may engage in acts included in the definition of the practice of optometry subject to the stated
             121      circumstances and limitations without being licensed under this chapter:
             122          (1) a person who sells contact lenses on prescription provided by a person authorized
             123      under state law to practice either optometry or medicine and surgery if the person complies
             124      with Section 58-16a-801 ;
             125          (2) a person who sells eyeglasses or spectacles as articles of merchandise or who
             126      fabricates them from a prescription if the person complies with Subsection 58-16a-801 (2), and
             127      if the person:
             128          (a) does so in the ordinary course of trade from a permanently located and established
             129      place of business;
             130          (b) does not traffic or attempt to traffic upon assumed skill in testing the eye and
             131      adapting lenses according to the test;
             132          (c) does not duplicate, replace, or accept for replacement any ophthalmic lens, except
             133      in the case of an emergency;
             134          (d) does not use in the testing of the eyes any lenses or instruments other than the
             135      lenses actually sold; and
             136          (e) does not give or offer eyeglasses or spectacles as premiums as defined in Section
             137      13-26-2 ; and
             138          (3) a person who fits contact lenses under the following conditions:
             139          (a) he has a current certification from both the American Board of Opticianry and the
             140      National Contact Lens Examiners;
             141          (b) he does not give or offer contact lenses as premiums;
             142          (c) he does not perform a refraction, over-refraction, or attempt to traffic upon assumed
             143      skill in testing the eye;
             144          (d) he operates in the ordinary course of trade from a permanently located and
             145      established place of business;
             146          (e) he performs the work involved in fitting contact lenses himself and does not
             147      delegate the contact lens fitting to any other individual who is not qualified under this
             148      Subsection (3);
             149          (f) he does not use in the testing of the eye any lenses or instruments other than the

             150      lenses he actually will sell;
             151          (g) he provides services only to a patient who:
             152          (i) presents an unexpired contact lens prescription; or
             153          (ii) has had an eye examination within the prior six months by an optometrist or
             154      ophthalmologist meeting the requirements under Section 58-16a-306 ;
             155          (h) he maintains a copy of the patient's contact lens prescription for not less than seven
             156      years;
             157          (i) he enters into a written agreement with an optometrist or an ophthalmologist before
             158      July 1, 2000, to fit contact lenses prescribed by that optometrist or ophthalmologist;
             159          (j) he fits contact lenses for at least two years under the direct supervision of the
             160      optometrist or ophthalmologist identified in Subsection (3)(i) before July 1, 2000, as
             161      documented in the written agreement; and
             162          (k) the optometrist or ophthalmologist described in Subsection (3)(i):
             163          (i) ensures that the final contact lens is accurate;
             164          (ii) presents a written copy of the prescription to the person fitting the contact lens; and
             165          (iii) ensures that a copy of the prescription is provided to the patient, except as
             166      provided in Section 58-16a-306 .
             167          Section 3. Section 58-16a-501 is amended to read:
             168           58-16a-501. Unlawful conduct.
             169          "Unlawful conduct" includes, in addition to the definition in Section 58-1-501 :
             170          (1) buying, selling, or fraudulently obtaining, any optometry diploma, license,
             171      certificate, or registration;
             172          (2) aiding or abetting the buying, selling, or fraudulently obtaining, of any optometry
             173      diploma, license, certificate, or registration;
             174          (3) selling or providing contact lenses or ophthalmic lenses in a manner inconsistent
             175      with Section 58-16a-801 or intentionally altering a prescription unless the person selling or
             176      providing the lenses is a licensed optometrist or ophthalmologist; or
             177          (4) representing oneself as or using the title of "optometrist," "optometric physician,"
             178      "doctor of optometry," or "O.D.," unless currently licensed under this chapter.
             179          Section 4. Section 58-16a-801 is amended to read:
Part 8. Contact Lenses and Ophthalmic Lenses

             181           58-16a-801. Contact lens and ophthalmic lens seller or provider.
             182          (1) A person may sell or provide contact lenses if the person:
             183          (a) does so in the ordinary course of trade from a permanently located and established
             184      place of business;
             185          (b) does not perform refractions, over-refractions, or attempts to traffic upon assumed
             186      skill in testing the eye;
             187          (c) provides all contact lenses consistent with and in accordance with a valid contact
             188      lens prescription;
             189          (d) does not fit contact lenses;
             190          (e) provides a contact lens to a patient after:
             191          (i) receiving an unexpired verbal or written prescription; or
             192          (ii) sending a contact lens prescription verification to the prescribing optometrist or
             193      physician, regardless of whether the prescribing optometrist or physician responds to or
             194      confirms the verification, provided that:
             195          (A) the person has all of the information necessary to fill the prescription;
             196          (B) the prescribing optometrist or physician has not informed the person that the
             197      prescription has expired or is otherwise inaccurate prior to the person shipping or
             198      hand-delivering the contact lens to the patient;
             199          (C) the person confirms a valid, unexpired contact lens prescription for the patient if
             200      the person is aware that the patient provided inaccurate prescription information in his last
             201      order; and
             202          (D) the person informs the patient that the prescription has expired or that there is a
             203      medical problem associated with the prescription if the information is communicated by the
             204      prescribing optometrist or physician to the person within 72 hours of the contact lens
             205      prescription verification being sent; and
             206          (f) maintains patient information, including the method and date of any prescription
             207      verification, for no less than seven years.
             208          (2) (a) A person may engage in the activities described in Subsection (2)(b), without a
             209      license under this title, if the person:
             210          (i) provides the ophthalmic lenses consistent with and in accordance with a
             211      prescription from a licensed physician or optometrist that is unexpired as provided in

             212      Subsection 58-16a-102 (8)(b);
             213          (ii) dispenses the ophthalmic lenses within or from the state;
             214          (iii) does so in the ordinary course of trade from a permanently located and established
             215      place of business;
             216          (iv) does not perform refractions, over-refractions, or attempt to traffic upon assumed
             217      skill in licensed physician or optometrist testing of the eye; and
             218          (v) complies with impact tolerance standards based on ANSI Z80.1-2010, American
             219      National Standard for Ophthalmics - Prescription lenses.
             220          (b) In accordance with Subsection (2)(a), a person may:
             221          (i) sell, reproduce, or dispense ophthalmic lenses;
             222          (ii) fit or adjust ophthalmic lenses or frames;
             223          (iii) assist with the selection of frames for ophthalmic lenses;
             224          (iv) measure pupillary distance and interpret pupillary distance measurements; or
             225          (v) measure or interpret the reading segment height in bifocal, tri-focal, progressive, or
             226      multi-focal lenses.
             227          [(2)] (3) Nothing in this section may be construed as requiring a person to be licensed
             228      or certified in any way under this or any another chapter of this title to sell contact lenses in
             229      accordance with Subsection (1), or to sell ophthalmic lenses in accordance with Subsection (2).

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