Recently, PCS has become aware of an apparent increase in violations of the prescription release requirements under Federal law. An update on the requirements of these laws appears in order.
Eyeglasses
The FTC’s Ophthalmic Practice Rule related to eyeglass prescriptions was promulgated in 1978 – 46 years ago. The rule provides clear and definitive requirements regarding patients’ rights to their eyeglass prescription(es). The following key provisions have not changed since the law was implemented.
- Optometrists and ophthalmologists are required to provide a patient with a copy of their eyeglass prescription(s) IMMEDIATELY after an eye examination is completed.
- No additional charge may be made to the patient for the prescription.
- The prescription must be provided even if the patient does not request it.
- The prescription must be provided even if there is no change in an existing prescription.
- The provider may NOT impose a liability waiver on the patient if the patient does not fill the prescription from the provider.
- The provider may NOT require immediate payment for the examination in order to release the prescription unless they make the same requirement for immediate payment from all patients, even if the examination reveals no need for a prescription.
- The prescription must include “all written specifications for lenses for eyeglasses which are derived from an eye examination, including any information required by state law”.
This rule is very clear – give the patient their eyeglasses prescription. In a comment section of the rule, the question is asked if there are any exceptions to the rule. The ONLY exception to the rule is if the provider works for a Federal, State or local government entity. So why is this still a problem? Why do we continue to see creative attempts to circumvent the law? Repeated violations of this law, arguments over PDs and other issues are resulting in increased oversight and the FTC considering amendments to the rule that will only impose more hardship on the provider. We have seen many of these attempts but can summarize the issue in one statement – patients get their eyeglasses prescription and creative attempts to keep the prescription from the patient are almost always, if not always illegal.
Contact Lenses
The Fairness to Contact Lens Consumers Act was passed in 2004 and amended in 2020. The combined 2004 and 2020 requirements are as follows.
- Prescribers must give patients a copy of their contact lens prescription at the end of the contact lens fitting (when the prescription is finalized).
- The prescription must be provided even if the patient does not request it and even if the parameters of the prescription have not changed.
- The prescription must include all details necessary for the prescription to be accurately filled. If a private label lens is prescribed, the prescription must contain the name of the manufacturer, trade name of the private label brand, and, if applicable, trade name of the equivalent brand name.
- The FTC ruling has no exemption for specialty contact lenses. Although these are often not available from commercial markets the release rules still apply.
- Providers may charge an additional fee for the exam or fitting of contact lenses but not for a copy of the prescription itself.
- The provider may NOT require immediate payment for the examination in order to release the prescription unless the provider makes the same requirement for immediate payment from all patients, even if the examination reveals no need for a prescription.
- Proof of insurance coverage for contact lens services counts as payment.
- The prescription may be provided in any format the patient agrees to – paper, digital, email, text, or portal. Some state laws restrict certain modes of prescription delivery so know your state law.
- The provider may NOT impose a liability waiver on the patient if the patient does not fill the prescription from the provider.
- The default expiration for a contact lens prescription is one year unless there is a legitimate medical reason for setting a shorter expiration. Such reason must be clearly supported by documented medical record findings.
- Confirmation that the patient received the prescription must be maintained for at least three years. If the patient refuses to acknowledge such confirmation, that should be noted in the medical record.
NOTE: Many states have additional regulations related to contact lens prescription release. Be sure you are familiar with your individual State laws.
Again, this law is very clear – the patient is entitled to their contact lens prescription. Creative “games” to extend the definition of a fitting period, attempted liability waivers, attempts to state certain lenses are exempt from the rules and other such obvious attempts to circumvent the rules are ill-advised.
As always, PCS highly recommends all doctors always consider the patient first and foremost and abide by all State and Federal laws.
