Florida Laws and Rules for Optometric Physicians Robert M Easton Jr OD FAAO Florida Board of Optometry 1999-2007 ARBO Pres...
2011 Optometry Board and Staff Composition Terrance Naberhaus, OD, Chair, Merritt Island Timothy Underhill, OD, Vice-Chair...
2010 Optometry Board Committee Structure <ul><li>Budget -Rod Presnell, RPh </li></ul><ul><li>Complaints, Investigations-  ...
DOH/MQA/Bureau of Health Care Practitioner Regulation   <ul><li>Mission:  Promote, protect and improve the health of all p...
COPE APPROVED 25381-EJ 25381-EJ - Florida Laws and Rules for Optometric Physicians   Format:  Live Category:  Ethics/Juris...
Chapter 463.002 Optometry   463.002   Definitions.   (3)(a)  &quot; Licensed practitioner &quot; means a person who is a  ...
TMOD <ul><li>The Treatment and Management of Ocular Disease (TMOD) examination will  continue to  be administered as an em...
<ul><li>(4)  &quot; Certified optometrist &quot; means a licensed practitioner authorized by the board to administer and p...
American Board Certification  <ul><li>Based upon 2.5 year equal input from multiple stakeholders such as AAO, AOA, AOSA, A...
Board Certification <ul><li>Complete Initial Application </li></ul><ul><li>Supply demographic information.  </li></ul><ul>...
Board Certification <ul><li>Meet Post-Graduate Requirements </li></ul><ul><li>Post-Graduate Requirements (During Phase-In ...
American Board of Optometry Board Certification Process <ul><li>Must obtain 150 points within a three year period to apply...
Website for ABO Certification <ul><li>http://americanboardofoptometry.org / </li></ul><ul><li>The ABO Board Certification ...
Board Certification Contact Info <ul><li>American Board of Optometry 243 N. Lindbergh Boulevard, Suite 312 Saint Louis, MO...
Optometrists now classified as &quot;physicians&quot; by Joint Commission <ul><li>Effective July 1, 2009, the Joint Commis...
Physician under Medicare <ul><li>r) The term “physician”, when used in connection with the performance of any function or ...
Chapter 463.005 Optometry 463.005   Authority of the board. (1)  The Board of Optometry has authority to adopt rules pursu...
Chapter463.005 Optometry (d)  Procedures for the  safekeeping and transfer of prescription files  or case records upon the...
Chapter463.0055 Optometry <ul><li>463.0055   Administration and prescription of topical ocular pharmaceutical agents; comm...
(d)  Upon adoption of the formulary required by this section, and upon each addition, deletion, or modification to the for...
Practitioners Authorized to Write Prescriptions <ul><li>&quot;Prescription claims filed by practitioners such as optometri...
Misuse of DEA Number Complaint Form <ul><li>Date of Denial________________________________________ </li></ul><ul><li>Docto...
Chapter 463.007 Optometry 463.007   Renewal of license; continuing education. --  (1)  The department shall renew a licens...
License Renewal Notification <ul><li>Your license can expire 2/28/2011 </li></ul><ul><li>Log on to  www.FLHealthsource.com...
Chapter 463.007 Optometry <ul><li>(4)  Criteria or course content of continuing education must be approved by the board an...
Chapter 463.009 Optometry 463.009   Supportive personnel. --No person other than a licensed practitioner may engage in the...
Chapter 463.011 Optometry <ul><li>463.011   Exhibition of license. --Each person to whom a license or branch office licens...
Chapter 463.012 Optometry <ul><li>463.012  Prescriptions; filing; release; duplication. --  </li></ul><ul><li>(1)  A licen...
Chapter 463.0135 Optometry 463.0135   Standards of practice. --  (1)  A licensed practitioner shall provide that degree of...
Chapter 463.0135 Optometry <ul><li>(4)  A licensed practitioner shall promptly advise a patient to seek evaluation by a ph...
Chapter 463.0135 Optometry <ul><li>(7)  The licensed practitioner shall place in a patient's permanent record information ...
Chapter 463.014 Optometry 463.014   Certain acts prohibited. –  (1)(a)  No corporation, lay body, organization, or individ...
Chapter 463.014 Optometry <ul><li>(b)  No licensed practitioner shall engage in the practice of optometry with any corpora...
Chapter 463.014 Optometry <ul><li>(d)  No licensed practitioner may practice under practice identification names, trade na...
Chapter 463.014 Optometry (3)  Prescribing, ordering, dispensing, administering, supplying, selling, or giving any  system...
Texas Optometry’s Bill of Rights Upheld in Court Decision vs. Walmart <ul><li>On August 24, 2010 a federal court jury retu...
Texas Optometry’s Bill of Rights Upheld   <ul><li>The optometrists filed suit against Wal-Mart for violation of the Texas ...
Texas Optometry’s Bill of Rights Upheld   <ul><li>The Texas Optometry Act provides that an optometrist whose rights are vi...
Texas Optometry’s Bill of Rights Upheld   <ul><li>The evidence introduced during trial established Wal-Mart required all o...
Texas Optometry’s Bill of Rights Upheld   <ul><li>Evidence was presented to the jury that demonstrated on multiple occasio...
Orals Bill Died in Committee in 2009 & 2010 <ul><li>… . The formulary shall also consist of the following (13) oral ocular...
HB135/SB330 were identical <ul><li>Practice of Optometry:  Authorizes Board of Optometry to adopt rules for administration...
Chapter 463.014 Optometry <ul><li>(4)  Surgery of any kind, including the use of  lasers , is expressly prohibited.  Certi...
Chapter 463.015 Optometry <ul><li>463.015   Violations and penalties. — </li></ul><ul><li>(1)  Each of the following acts ...
Chapter 463.015 Optometry <ul><li>(2)  Each of the following acts constitutes a  misdemeanor  of the second degree, punish...
Chapter 463.016 Optometry 463.016   Grounds for disciplinary action; action by the board. –  (1)  The following acts const...
Chapter 463.016 Grounds for Disciplinary Action <ul><li>c)  Having a license to practice optometry revoked, suspended, or ...
Chapter 463.016 Grounds for Disciplinary Action (e)  Making or filing a report or record which the licensee knows to be fa...
Rule 64B13-3.009 <ul><li>Rule 64B13-3.009 identifies the following circumstances when advertisement will be considered fra...
Chapter 463.016 Grounds for Disciplinary Action <ul><li>(g)  Fraud or deceit, negligence or incompetence, or misconduct in...
Chapter 463.016 Grounds for Disciplinary Action <ul><li>(k)   Failing to keep written optometric records  about the examin...
Chapter 463.016 Grounds for Disciplinary Action <ul><li>(o)  Being unable to practice optometry with reasonable skill and ...
PRN 1-800-888-8776, ext. 0 <ul><li>The OD must contact PRN for help </li></ul><ul><li>3 Evaluators are given to the OD </l...
Chapter 463.016 Grounds for Disciplinary Action (p)  Having been disciplined by a regulatory agency  in another state  for...
Chapter 463.016 Grounds for Disciplinary Action <ul><li>( t)  Violating any provision of this chapter or chapter 456, or a...
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463 Laws

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Chapter 463 is the Laws governing the Florida Practice of Optometry

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463 Laws

  1. 1. Florida Laws and Rules for Optometric Physicians Robert M Easton Jr OD FAAO Florida Board of Optometry 1999-2007 ARBO President 2006-2007 AOA-PAC Chair 1999-2000 FOA President 1993-1994 Florida Board Certified Optometric Physician 1982- I have no financial interest in any eye related companies
  2. 2. 2011 Optometry Board and Staff Composition Terrance Naberhaus, OD, Chair, Merritt Island Timothy Underhill, OD, Vice-Chair, Fort Myers Ed Walker, OD, FAAO, Tallahassee Tamara Maule, OD, Lake Worth Rebecca Del Moral, OD, Miami Rod Presnell, RPh, Tallahassee Bruce M. Deterding, Executive Director Lee Ann Gustafson, Board Counsel, Sr Asst Attorney Gen Mr. Mark Hanson, ESQ, Acting Prosecuting Counsel, DOH <ul><li>If you have board questions please call </li></ul><ul><li>850/245-4355 </li></ul><ul><ul><li>MQA_Optometry@doh.state.fl.us         </li></ul></ul>2011 Meeting Dates January 14, Orlando April 1, Tampa July 8, Conference Call July 20, Orlando October 7, Tampa
  3. 3. 2010 Optometry Board Committee Structure <ul><li>Budget -Rod Presnell, RPh </li></ul><ul><li>Complaints, Investigations- Ed Walker, OD FAAO </li></ul><ul><li>Continuing Education- Tamara Maule, OD </li></ul><ul><li>Corporate Practice- Ed Walker, OD, FAAO </li></ul><ul><li>Disciplinary/Compliance- Ed Walker, OD FAAO </li></ul><ul><li>Examination- Rebecca Del Moral, OD </li></ul><ul><li>FOA - Tim Underhill, OD </li></ul><ul><li>Legislation- Tim Underhill, OD </li></ul><ul><li>Probable Cause- Rod Presnell, RPh </li></ul><ul><li>Rules- Terry Naberhaus, OD </li></ul><ul><li>ULA- Tamara Maule, OD </li></ul>
  4. 4. DOH/MQA/Bureau of Health Care Practitioner Regulation <ul><li>Mission: Promote, protect and improve the health of all people in Florida. </li></ul><ul><li>Vision: A healthier future for the people of Florida. </li></ul><ul><li>Purpose: To protect the public through health care licensure, enforcement and information. </li></ul><ul><li>Focus: To be the nation's leader in quality health care regulation. </li></ul>
  5. 5. COPE APPROVED 25381-EJ 25381-EJ - Florida Laws and Rules for Optometric Physicians Format: Live Category: Ethics/Jurisprudence Total CE Hours: 2 Description: The Optometric Practice Act defines the limits of optometric physicians in the state of Florida. The Rules and Regulations are in place to protect the citizens of the state of Florida. Unlicensed activity is the practice of optometry without a valid Florida license and comes under the purview of the Attorney General. CEE: No Expires: Course Expires: 08/01/2012 Instructor: Robert Easton Jr, O.D.
  6. 6. Chapter 463.002 Optometry 463.002   Definitions. (3)(a)  &quot; Licensed practitioner &quot; means a person who is a primary health care provider licensed to engage in the practice of optometry under the authority of this chapter. (b)  A licensed practitioner who is not a certified optometrist shall be required to display at her or his place of practice a sign which states, &quot; I am a Licensed Practitioner, not a Certified Optometrist, and I am not able to prescribe topical ocular pharmaceutical agents .&quot; (The font size is being worked on) (c)  All practitioners initially licensed after July 1, 1993, must be certified optometrists. (In 2009, 177 Non certified OD’s of which 51 are out-of- state and 126 are in-state. Only 8/381 are non certified in Broward County.)
  7. 7. TMOD <ul><li>The Treatment and Management of Ocular Disease (TMOD) examination will continue to be administered as an embedded subtest within the overall Part II - Patient Assessment and Management (PAM) examination.  If a candidate is taking the Part II - PAM examination for the purpose of obtaining an embedded TMOD score, the entire Part II examination must be taken.  They will be charged with the same TMOD-only fee of $450. </li></ul><ul><li>  </li></ul><ul><li>The Part II - PAM exam is comprised of 2 testing sessions.   Each PAM exam session will be 3½ hours in length, and will consist of 30 cases for a total of 60 cases. The cases will be of variable length and will include 5 or 6 multiple choice items.  For those PAM exam cases that pertain to the embedded TMOD exam, the multiple choice items pertaining to the treatment and management of ocular disease will comprise the TMOD score.” </li></ul>
  8. 8. <ul><li>(4)  &quot; Certified optometrist &quot; means a licensed practitioner authorized by the board to administer and prescribe topical ocular pharmaceutical agents. </li></ul><ul><li>(6)  &quot; Direct supervision &quot; means supervision to an extent that the licensee remains on the premises while all procedures are being done and gives final approval to any procedures performed by an employee. </li></ul><ul><li>(7)  &quot; General supervision &quot; means the responsible supervision of supportive personnel by a licensee who need not be present when such procedures are performed, but who assumes legal liability therefore. Except in cases of emergency, &quot;general supervision&quot; shall require the easy availability or physical presence of the licensee for consultation with and direction of the supportive personnel. </li></ul>Chapter 463.002 Optometry
  9. 9. American Board Certification <ul><li>Based upon 2.5 year equal input from multiple stakeholders such as AAO, AOA, AOSA, ARBO, ASCO and NBEO. </li></ul><ul><li>Passed AOA house of Delegates 6/26/09. </li></ul><ul><li>Board Certification and Maintenance of Certification for optometry will become a means of demonstrating ongoing clinical competence independent of established licensing and regulatory boards. Board Certification will not confer legal qualification, privilege or license to practice optometry. </li></ul><ul><li>As of 2010, the American Board of Optometry (ABO) will govern the process with representation from AAO, AOA, AOSA, and ASCO. </li></ul>
  10. 10. Board Certification <ul><li>Complete Initial Application </li></ul><ul><li>Supply demographic information. </li></ul><ul><li>Submit Application Fee of $300.00. </li></ul><ul><li>Identify Qualifying Requirements: </li></ul><ul><li>Graduation from School or College of Optometry accredited by the Accreditation Council on Optometric Education (ACOE). </li></ul><ul><li>Active License to practice therapeutic optometry in a State, District of Columbia, U.S. Commonwealth or Territory. </li></ul><ul><li>State adherence to principles of the Optometric Oath . </li></ul><ul><li>Affirm that all supplied information is true and correct. </li></ul><ul><li>Grant permission to the American Board of Optometry to verify all credentials. </li></ul><ul><li>Authorize search of National Practitioner Data Bank (NPDB) and Health Integrity and Protection Data Bank (HIPDB) . </li></ul>
  11. 11. Board Certification <ul><li>Meet Post-Graduate Requirements </li></ul><ul><li>Post-Graduate Requirements (During Phase-In Period 2010-2012) To become eligible to take the examination, Active Candidates must attain 150 points within the three years prior to exam application. Residency (ACOE Accredited) - 150 Points Fellowship in the American Academy of Optometry - 50 Points Fellowship in the College of Optometrists in Vision Development - 50 Points Experience in Clinical Practice - Up to 150 Points Accrued equal to 5 points per year of active practice. </li></ul><ul><li>i.e. (FAAO=50pts) + (28 years in practice x 5=140pts)=190pts </li></ul>
  12. 12. American Board of Optometry Board Certification Process <ul><li>Must obtain 150 points within a three year period to apply to take the ABO Exam; Active Candidates should pass the Examination within 12 months of submitting the Examination Application </li></ul><ul><li>Take the ABO Exam involving patient assessment and management in three subject areas of interest, </li></ul><ul><li>A passing score on the ABO exam makes you Board Certified for 10 years. </li></ul>
  13. 13. Website for ABO Certification <ul><li>http://americanboardofoptometry.org / </li></ul><ul><li>The ABO Board Certification Application is now available. The 1 st test will be given during the Summer of 2011.  Active Candidates will be notified to make application for the ABO Board Examination once they have met the requirements. </li></ul>
  14. 14. Board Certification Contact Info <ul><li>American Board of Optometry 243 N. Lindbergh Boulevard, Suite 312 Saint Louis, MO 63141 [email_address] ( 314) 983-4244 </li></ul>
  15. 15. Optometrists now classified as &quot;physicians&quot; by Joint Commission <ul><li>Effective July 1, 2009, the Joint Commission has changed the definition of &quot;physician&quot; in its hospital accreditation program to match the Medicare definition (Section 1861(r) of the Social Security Act, which includes optometrists).  The Joint Commission, formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), accredits 88 percent of the nation's hospitals. </li></ul>
  16. 16. Physician under Medicare <ul><li>r) The term “physician”, when used in connection with the performance of any function or action, means (4) a doctor of optometry, but only for purposes of subsection (p)(1) with respect to the provision of items or services described in subsection (s) which he is legally authorized to perform as a doctor of optometry by the State in which he performs them. </li></ul>
  17. 17. Chapter 463.005 Optometry 463.005   Authority of the board. (1)  The Board of Optometry has authority to adopt rules pursuant to ss. 120.536 (1) and 120.54 to implement the provisions of this chapter conferring duties upon it. Such rules shall include, but not be limited to, rules relating to: (a)   Standards of practice , including, but not limited to, those provided for in s. 463.0135. (b)   Minimum equipment which a licensed practitioner shall at all times possess to engage in the practice of optometry. (c)   Minimum procedures which shall constitute a visual examination.
  18. 18. Chapter463.005 Optometry (d)  Procedures for the safekeeping and transfer of prescription files or case records upon the discontinuance of practice. (e)   Supervision of supportive personnel. (f)  Courses and procedures for continuing education. (g)  Administration and prescription of topical ocular pharmaceutical agents. (2)  The board is authorized to disseminate information , the sole purpose of which is to inform licensed practitioners and the public of regulations regarding the practice of optometry.
  19. 19. Chapter463.0055 Optometry <ul><li>463.0055   Administration and prescription of topical ocular pharmaceutical agents; committee. </li></ul><ul><li>(1)   Certified optometrists may administer and prescribe topical ocular pharmaceutical agents as provided in this section for the diagnosis and treatment of ocular conditions of the human eye and its appendages without the use of surgery or other invasive techniques. However, a licensed practitioner who is not certified may use topically applied anesthetics solely for the purpose of glaucoma examinations , but is otherwise prohibited from administering or prescribing topical ocular pharmaceutical agents. </li></ul>
  20. 20. (d)  Upon adoption of the formulary required by this section, and upon each addition, deletion, or modification to the formulary, the board shall mail a copy of the amended formulary to each certified optometrist and to each pharmacy licensed by the state. (DOH website) (3)  A certified optometrist shall be issued a prescriber number by the board. Any prescription written by a certified optometrist for a topical ocular pharmaceutical agent pursuant to this section shall have the prescriber number printed thereon. ( Your License number OPC00XXXX is your prescriber number. DEA numbers are not to be used by insurance companies or pharmacies to verify prescribing authority) Chapter 463.055 Optometry
  21. 21. Practitioners Authorized to Write Prescriptions <ul><li>&quot;Prescription claims filed by practitioners such as optometrists 463.0055(1), F.S. and nurse practitioners Section 464.003(3), F.S. who are fully authorized to write all non-controlled substance prescriptions must not require a DEA number.&quot; </li></ul>
  22. 22. Misuse of DEA Number Complaint Form <ul><li>Date of Denial________________________________________ </li></ul><ul><li>Doctor’s Last Name, First Name_________________________ </li></ul><ul><li>City, State___________________________________________ </li></ul><ul><li>Prescription Denied by (Circle) Pharmacy, Carrier, Employer. </li></ul><ul><li>Retail Pharmacy name_________________________________ </li></ul><ul><li>Mail Order/Internet Pharmacy Name______________________ </li></ul><ul><li>Insurance Company Name______________________________ </li></ul><ul><li>Location (State) of Insurance Co ________________________ </li></ul><ul><li>Name of Employer which Benefits Originate_______________ </li></ul><ul><li>Comments___________________________________________ </li></ul><ul><li>Fax to David Danielson, at the AOA: 703-739-9497 </li></ul>
  23. 23. Chapter 463.007 Optometry 463.007   Renewal of license; continuing education. -- (1)  The department shall renew a license upon receipt of the renewal application and the fee set by the board not to exceed $300. ($5 added fee is assessed to fight ULA that’s why it is $305) (3)  Unless otherwise provided by law, the board shall require licensees to periodically demonstrate their professional competence, as a condition of renewal of a license, by completing up to 30 hours of continuing education during the 2-year period preceding license renewal. For certified optometrists, the 30-hour continuing education requirement shall include 6 or more hours of approved transcript-quality (CEE) coursework in ocular and systemic pharmacology and the diagnosis, treatment, and management of ocular and systemic conditions and diseases during the 2-year period preceding application for license renewal.
  24. 24. License Renewal Notification <ul><li>Your license can expire 2/28/2011 </li></ul><ul><li>Log on to www.FLHealthsource.com </li></ul><ul><li>Click Renew License </li></ul><ul><li>Renew on Line or Submit by mail </li></ul><ul><li>456.0635 may affect your ability to renew </li></ul><ul><li>All renewals must be submitted by 2/28/2011 to avoid delinquent fees. </li></ul>
  25. 25. Chapter 463.007 Optometry <ul><li>(4)  Criteria or course content of continuing education must be approved by the board and must be regularly reviewed by the board to assure that the programs adequately and reliably contribute to the professional competence of the licensee. (COPE numbered courses for regular CE must go through CE Broker to be approved by the Florida Board of Optometry, COPE CEE (TQ) must be approved by the Board prior to the date of the course.) </li></ul>
  26. 26. Chapter 463.009 Optometry 463.009   Supportive personnel. --No person other than a licensed practitioner may engage in the practice of optometry as defined in s. 463.002 (5). Except as provided in this section, under no circumstances shall non-licensed supportive personnel be delegated diagnosis or treatment duties; however, such personnel may perform data gathering, preliminary testing, prescribed visual therapy, and related duties under the direct supervision of the licensed practitioner. Non-licensed personnel, who need not be employees of the licensed practitioner, may perform ministerial duties, tasks, and functions assigned to them by and performed under the general supervision of a licensed practitioner, including obtaining information from “consumers” for the purpose of making appointments for the licensed practitioner. The licensed practitioner shall be responsible for all delegated acts performed by persons under her or his direct and general supervision. (Consumers=Patients, not customers!)
  27. 27. Chapter 463.011 Optometry <ul><li>463.011   Exhibition of license. --Each person to whom a license or branch office license is issued by the department shall keep said license conspicuously displayed in the appropriate office and shall, whenever required, exhibit said license to any authorized representative of the department. </li></ul>
  28. 28. Chapter 463.012 Optometry <ul><li>463.012 Prescriptions; filing; release; duplication. -- </li></ul><ul><li>(1)  A licensed practitioner shall keep on file for a period of at least 2 years any prescription she or he writes. </li></ul><ul><li>(2)(a)  A licensed practitioner shall make available to the patient or her or his agent any spectacle prescription or duplicate copy determined for that patient. Such prescription shall be considered a valid prescription to be filled for a period of 5 years. </li></ul><ul><li>(b)  A licensed practitioner shall make available to the patient or her or his agent any daily wear soft contact lens prescription or duplicate copy determined for that patient. Such prescription shall be considered a valid prescription to be filled for a period of 2 years. </li></ul>
  29. 29. Chapter 463.0135 Optometry 463.0135   Standards of practice. -- (1)  A licensed practitioner shall provide that degree of care which conforms to that level of care provided by medical practitioners in the same or similar communities. A licensed practitioner shall advise or assist her or his patient in obtaining further care when the service of another health care practitioner is required. (2)  A licensed practitioner diagnosing angle closure, infantile, or congenital forms of glaucoma shall refer the patient to a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459. (3)  When an infectious corneal disease condition has not responded to standard methods of treatment within the scope of optometric practice, the certified optometrist shall consult with a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459.
  30. 30. Chapter 463.0135 Optometry <ul><li>(4)  A licensed practitioner shall promptly advise a patient to seek evaluation by a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459 for diagnosis and possible treatment whenever the licensed practitioner is informed by the patient of the sudden onset of spots or &quot;floaters&quot; with loss of all or part of the visual field. </li></ul><ul><li>(5)  The licensed practitioner shall routinely advise a patient to immediately contact the licensed practitioner if the patient experiences an adverse drug reaction. </li></ul><ul><li>(6)  The licensed practitioner shall, when appropriate, refer to medical specialists or facilities patients who notify a licensed practitioner of an adverse drug reaction. </li></ul>
  31. 31. Chapter 463.0135 Optometry <ul><li>(7)  The licensed practitioner shall place in a patient's permanent record information describing any adverse drug reaction experienced by the patient, the date of such reaction, and whether any referral was made. </li></ul><ul><li>(8)  The licensed practitioner shall maintain the names of at least three physicians, physician clinics, or hospitals to whom the licensed practitioner will refer patients who experience an adverse drug reaction. At least one of these physicians shall be a physician skilled in the diagnosis and treatment of diseases of the eye and licensed under chapter 458 or chapter 459. </li></ul><ul><li>(9)  A licensed practitioner who believes a patient may have glaucoma shall promptly advise the patient of the serious nature of glaucoma. The licensed practitioner shall place in the patient's permanent record that the practitioner provided such advice to the patient. </li></ul>
  32. 32. Chapter 463.014 Optometry 463.014   Certain acts prohibited. – (1)(a)  No corporation, lay body, organization, or individual other than a licensed practitioner shall engage in the practice of optometry through the means of engaging the services, upon a salary , commission , or other means or inducement, of any person licensed to practice optometry in this state. Nothing in this section shall be deemed to prohibit the association of a licensed practitioner with a multidisciplinary group of licensed health care professionals, the primary objective of which is the diagnosis and treatment of the human body. (The FOA and Corporate Optometry have met since 2006 to resolve issues within this act and rules that pertain to corporate practice. After 4 years of discussion I have yet to see the final white paper )
  33. 33. Chapter 463.014 Optometry <ul><li>(b)  No licensed practitioner shall engage in the practice of optometry with any corporation, organization, group, or lay individual. This provision shall not prohibit licensed practitioners from employing, or from forming partnerships or professional associations with, licensed practitioners licensed in this state or with other licensed health care professionals, the primary objective of whom is the diagnosis and treatment of the human body. (You can only be employed by and OD, MD or DO) </li></ul><ul><li>(c)  No rule of the board shall forbid the practice of optometry in or on the premises of a commercial or mercantile establishment. (OD must retain independence) </li></ul>
  34. 34. Chapter 463.014 Optometry <ul><li>(d)  No licensed practitioner may practice under practice identification names, trade names, or service names, unless any dissemination of information by the practitioner to consumers contains the name under which the practitioner is licensed or that of the professional association in which the practitioner participates. Any advertisement or other dissemination of information to consumers may contain factual information as to the geographic location of licensed practitioners or of the availability of optometric services. (You must ensure the public realizes you are an OD, Optometrist, Optometric Physician, or Doctor of Optometry within the advertisement) </li></ul><ul><li>(e)  No licensed practitioner shall adopt and publish or cause to be published any practice identification name, trade name, or service name which is, contains, or is intended to serve as an affirmation of the quality or competitive value of the optometric services provided at the identified practice. (Cannot use words like “Best, Finest, Perfect”,ect.) </li></ul>
  35. 35. Chapter 463.014 Optometry (3)  Prescribing, ordering, dispensing, administering, supplying, selling, or giving any systemic drugs by a licensed practitioner is prohibited. (Our rules do not define how topical medications are dispensed. I.E. ,CL imbibed with FDA approved medication.) (47 states allow oral medications for the treatment of ocular disease; NY, MASS and FL do not)
  36. 36. Texas Optometry’s Bill of Rights Upheld in Court Decision vs. Walmart <ul><li>On August 24, 2010 a federal court jury returned a unanimous verdict in favor of Doris Forte, O.D., David Wiggins, O.D., Bridget Lee Sang, O.D., and John Boldan, O.D., four Texas licensed optometrists, for the total sum of $3.953 million against Wal-Mart Stores, Inc. Mark Burgess of Boyd, Poff & Burgess from Texarkana, Texas and Hector Canales of Canales & Simonson from Corpus Christi, Texas represented the four optometrists in a one week trial held in the United States District Court, Southern District of Texas, Corpus Christi Division, from August 16-24, 2010. </li></ul>
  37. 37. Texas Optometry’s Bill of Rights Upheld <ul><li>The optometrists filed suit against Wal-Mart for violation of the Texas Optometry Act. The Act makes it illegal for commercial optical companies like Wal-Mart / Sam’s Club who lease office space to optometrists next door to their optical stores to control or attempt to control the professional judgment and manner of practice of optometrists. The unanimous verdict found the optometrists’ complaint that Wal-Mart’s lease and business practices in Texas violate the Texas Optometry Act was valid. </li></ul>
  38. 38. Texas Optometry’s Bill of Rights Upheld <ul><li>The Texas Optometry Act provides that an optometrist whose rights are violated by prohibited actions is entitled to a statutory penalty of up to $1000 per day for each day of a violation. The purpose of the Texas Optometry Act, as established by the Texas Legislature, is to safeguard the visual welfare of the public and the doctor patient relationship, and to prevent optical companies from interfering and damaging those important interests by interfering with the independent judgment of optometrists. </li></ul>
  39. 39. Texas Optometry’s Bill of Rights Upheld <ul><li>The evidence introduced during trial established Wal-Mart required all optometrists in the State of Texas leasing from Wal-Mart to list their days and hours of operation as a term of the lease and as a condition of obtaining and renewing their leases. Wal-Mart’s Texas Form lease contained a provision which provided Wal-Mart with the option to terminate the optometrists’ lease if the doctor deviated from the listed hours of operation. The four optometrists alleged that Wal-Mart violated the Act each day their days and hours of operation were listed in their leases. The doctors sought a statutory penalty as a means to effectuate the purpose of the Texas Optometry Act. </li></ul>
  40. 40. Texas Optometry’s Bill of Rights Upheld <ul><li>Evidence was presented to the jury that demonstrated on multiple occasions Wal-Mart had used its lease terms to control and threaten optometrists. Counsel for Plaintiffs optometrists presented Wal-Mart memos, emails and analysis revealing Wal-Mart’s motive to control and threaten optometrists. Wal-Mart in a memo entitled “Doctor Project” sought to “determine what correlations exist between store sales volume and doctor coverage”. Wal-Mart’s conclusions reflect that an optometrist with “contract hours” of greater than forty hours nearly doubled Wal-Mart’s average weekly sales revenue compared to a doctor “without contracted hours”. </li></ul><ul><li>Legal Counsel for the successful plaintiffs also represent eight other optometrists who have filed a lawsuit against Wal-Mart for the same violations. Questions or comments about the case may be addressed to Mr. Burgess at 903-838-6123 </li></ul>
  41. 41. Orals Bill Died in Committee in 2009 & 2010 <ul><li>… . The formulary shall also consist of the following (13) oral ocular pharmaceutical agents: </li></ul><ul><li>1. Analgesics -limited to Acetaminophen/Propoxyphene, Tramadol HCL, and Tylenol 300mg/Codiene 30mg*, and only for a period not to exceed 72 hrs.. </li></ul><ul><li>2. Antibiotics -limited to Amoxicillin, Azythromycin, Ciprofloxacin, Dicloxicillin, and Doxycycline. </li></ul><ul><li>3. Antivals - limited to Acyclovir, Famcyclovir and Valacyclovir. </li></ul><ul><li>4. Oral Anti-Glaucoma Agents- limited to Diamox and Neptazane, and only for a period not to exceed 72 hrs…. </li></ul><ul><li>An optometrist certified pursuant to chapter 463 to administer and prescribe topical and oral ocular pharmaceutical agents may not administer or prescribe any controlled substance listed on Schedule I in subsection 893.03(1), F.S. or Schedule II in subsection 893.03 (2), F.S. </li></ul><ul><li>*DEA number would be required to write this Rx. </li></ul>
  42. 42. HB135/SB330 were identical <ul><li>Practice of Optometry:  Authorizes Board of Optometry to adopt rules for administration & prescription of oral ocular pharmaceutical agents; authorizes certified optometrists to administer & prescribe oral ocular pharmaceutical agents under certain circumstances; revises requirements for certified optometrist formulary of ocular pharmaceutical agents; revises qualifications of certain members of formulary committee; prohibits committee from reviewing requests or issuing advisory opinions or recommendations regarding oral ocular pharmaceutical agents; requires formulary to include certain oral ocular pharmaceutical agents; prohibits board from adding to, deleting from, or modifying formulary with respect to oral ocular pharmaceutical agents; revises definition to specify that certified optometrists are practitioners for purposes of Florida Comprehensive Drug Abuse Prevention & Control Act; prohibits certified optometrists from administering & prescribing certain controlled substances. Effective Date: July 1, 2010 Passed the Senate Health Care Regulation Policy Committee and the bill never went any further in the House. </li></ul>
  43. 43. Chapter 463.014 Optometry <ul><li>(4)  Surgery of any kind, including the use of lasers , is expressly prohibited. Certified optometrists may remove superficial foreign bodies. For the purposes of this subsection, the term &quot;superficial foreign bodies&quot; means any foreign matter that is embedded in the conjunctiva or cornea but which has not penetrated the globe. </li></ul><ul><li>(5)  No rule of the board shall prohibit a licensed practitioner from authorizing a board-certified optician to fill, fit, adapt, or dispense a contact lens prescription as authorized under chapter 484. (Opticians cannot Refract) </li></ul>
  44. 44. Chapter 463.015 Optometry <ul><li>463.015   Violations and penalties. — </li></ul><ul><li>(1)  Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082 , s. 775.083 , or s. 775.084 : </li></ul><ul><li>(a)  Practicing or attempting to practice optometry without a valid active license issued pursuant to this chapter. </li></ul><ul><li>(b)  Attempting to obtain or obtaining a license to practice optometry by fraudulent misrepresentation. </li></ul><ul><li>(c)  Using or attempting to use a license to practice optometry which has been suspended or revoked. </li></ul>
  45. 45. Chapter 463.015 Optometry <ul><li>(2)  Each of the following acts constitutes a misdemeanor of the second degree, punishable as provided in s. 775.082 </li></ul><ul><li>(a)  Identifying one's activity by using the name or title &quot;optometrist,&quot; &quot;licensed practitioner,&quot; &quot;certified optometrist,&quot; &quot;Doctor of Optometry,&quot; or &quot;O.D.&quot; in a manner which represents to the public that the person is a licensed practitioner or certified optometrist when the person has not been licensed or certified pursuant to this chapter. </li></ul><ul><li>(b)  Knowingly employing unlicensed persons in the practice of optometry, except as specifically authorized by this chapter. (Unlicensed OD’s cannot write Rx’s, be unsupervised, diagnose or treat.) </li></ul><ul><li>(c)  Knowingly concealing information relating to violations of this chapter. </li></ul><ul><li>(d)  Willfully making any false oath or affirmation when required to make an oath or affirmation pursuant to this chapter. </li></ul>
  46. 46. Chapter 463.016 Optometry 463.016   Grounds for disciplinary action; action by the board. – (1)  The following acts constitute grounds for denial of a license or disciplinary action, as specified in s. 456.072 (2): (a)  Procuring or attempting to procure a license to practice optometry by bribery, by fraudulent misrepresentations, or through an error of the department or board. (b)  Procuring or attempting to procure a license for any other person by making or causing to be made any false representation .
  47. 47. Chapter 463.016 Grounds for Disciplinary Action <ul><li>c)  Having a license to practice optometry revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of another jurisdiction. (You cannot hide, all states report to a national practitioner data bank. This data is available to all state boards and health departments.) </li></ul><ul><li>(d)  Being convicted or found guilty, regardless of adjudication, of a crime in any jurisdiction which directly relates to the practice of optometry or to the ability to practice optometry. Any plea of nolo contendere shall be considered a conviction for the purposes of this chapter. </li></ul><ul><li>(It’s best to disclose your issue to the board as soon as you are found guilty) </li></ul>
  48. 48. Chapter 463.016 Grounds for Disciplinary Action (e)  Making or filing a report or record which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, willfully impeding or obstructing such filing, or inducing another person to do so. Such reports or records shall include only those which are signed by the licensee in her or his capacity as a licensed practitioner. (f)  Advertising goods or services in a manner which is fraudulent, false, deceptive, or misleading in form or content. (bait and switch has zero tolerance)
  49. 49. Rule 64B13-3.009 <ul><li>Rule 64B13-3.009 identifies the following circumstances when advertisement will be considered fraudulent, false, deceptive, or misleading: </li></ul><ul><li>Contains a misrepresentation of facts; </li></ul><ul><li>Has the capacity or tendency to mislead or deceive because in its content or in the context which it is presented makes only a partial disclosure of relevant facts; </li></ul><ul><li>Has the capacity or tendency to create false or unjustified expectations of beneficial treatment or successful cures; </li></ul><ul><li>Contains false, fraudulent, deceptive, or misleading representations relating to the quality or quantity of the optometric services offered; </li></ul><ul><li>Contains any representation or claims which the optometrist referred to in the advertising fails to perform or </li></ul><ul><li>Contains any other representation, statement, or claim which has the capacity or tendency to mislead or deceive. </li></ul><ul><li>Rule 64B13-3.009 places an affirmative obligation on the advertising optometrist to review and proof his or her advertisements prior to publication.  The advertising optometrist is fully responsible for the content of the advertisements. </li></ul>
  50. 50. Chapter 463.016 Grounds for Disciplinary Action <ul><li>(g)  Fraud or deceit, negligence or incompetence, or misconduct in the practice of optometry. </li></ul><ul><li>(h)  A violation or repeated violations of provisions of this chapter, or of chapter 456 , and any rules promulgated pursuant thereto. (456 is DOH’s Law over all health care practitioners) </li></ul><ul><li>(i)  Conspiring with another licensee or with any person to commit an act, or committing an act, which would coerce, intimidate, or preclude another licensee from lawfully advertising her or his services. </li></ul><ul><li>(j)  Willfully submitting to any third-party payer a claim for services which were not provided to a patient. (No Tolerance) </li></ul>
  51. 51. Chapter 463.016 Grounds for Disciplinary Action <ul><li>(k)   Failing to keep written optometric records about the examinations, treatments, and prescriptions for patients. </li></ul><ul><li>(l)  Willfully failing to report any person who the licensee knows is in violation of this chapter or of rules of the department or the board. </li></ul><ul><li>(m)  Gross or repeated malpractice . </li></ul><ul><li>(n)   Practicing with a revoked, suspended, inactive, or delinquent license. </li></ul>
  52. 52. Chapter 463.016 Grounds for Disciplinary Action <ul><li>(o)  Being unable to practice optometry with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. A licensed practitioner affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that she or he can resume the competent practice of optometry with reasonable skill and safety to patients. (PRN requires 5 year contract with random drug testing, if you violate your 5 year commitment, your license is suspended.) </li></ul>
  53. 53. PRN 1-800-888-8776, ext. 0 <ul><li>The OD must contact PRN for help </li></ul><ul><li>3 Evaluators are given to the OD </li></ul><ul><li>Addiction, Mental Health, Sexual Boundary </li></ul><ul><li>OD determines evaluator in problem area </li></ul><ul><li>Evaluator preliminary report sent to PRN </li></ul><ul><li>OD’s must pay for evaluations and drug screens </li></ul><ul><li>Takes 4 weeks for the process to begin treatment </li></ul><ul><li>The 28 day treatment is all confidential </li></ul><ul><li>(2 OD’s in PRN as of June 2010) </li></ul>
  54. 54. Chapter 463.016 Grounds for Disciplinary Action (p)  Having been disciplined by a regulatory agency in another state for any offense that would constitute a violation of Florida laws or rules regulating optometry. (National Practitioner Data Bank has disciplinary information on all practitioners) (q)  Violating any provision of s. 463.014 or s. 463.015. (r)  Violating any lawful order of the board or department, previously entered in a disciplinary hearing, or failing to comply with a lawfully issued subpoena of the board or department. (s)   Practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities which the licensed practitioner knows or has reason to know she or he is not competent to perform. (i.e. no cyst draining, removing skin tags, yag capsulotomy, or chalazion surgery)
  55. 55. Chapter 463.016 Grounds for Disciplinary Action <ul><li>( t)  Violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto. </li></ul><ul><li>(2)  The board may enter an order imposing any of the penalties in s. 456.072 (2) against any licensee who is found guilty of violating any provision of subsection (1) of this section or who is found guilty of violating any provision of s. 456.072 (1). </li></ul><ul><li>(3)  The board shall not reinstate the license of a person, or cause a license to be issued to a person it has deemed unqualified, until such time as it is satisfied that she or he has complied with all the terms and conditions set forth in the final order and that such person is capable of safely engaging in the practice of optometry. </li></ul>

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