Bill Text: NY A01193 | 2019-2020 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Requires optometrists to meet certain standards, including the completion of a course, to prescribe oral medications.
Spectrum: Slight Partisan Bill (Democrat 76-26)
Status: (Engrossed - Dead) 2020-07-21 - REFERRED TO RULES [A01193 Detail]
Download: New_York-2019-A01193-Introduced.html
Bill Title: Requires optometrists to meet certain standards, including the completion of a course, to prescribe oral medications.
Spectrum: Slight Partisan Bill (Democrat 76-26)
Status: (Engrossed - Dead) 2020-07-21 - REFERRED TO RULES [A01193 Detail]
Download: New_York-2019-A01193-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 1193 2019-2020 Regular Sessions IN ASSEMBLY January 14, 2019 ___________ Introduced by M. of A. PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER, WEPRIN, HEVESI, RYAN, TITUS, STIRPE, BUCHWALD, DiPIETRO, BRABENEC, BLAKE, FAHY, ORTIZ, COLTON, NORRIS, BARRETT, PHEFFER AMATO, DINOWITZ, LALOR, ZEBROWSKI, STECK, HUNTER, BRONSON, SOLAGES, PEOPLES-STOKES, DE LA ROSA, B. MILLER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICK- ENS, MAGNARELLI, PICHARDO, SANTABARBARA, GIGLIO, D. ROSENTHAL, KIM, RODRIGUEZ, ABBATE, JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSEN- THAL, ENGLEBRIGHT, LAVINE, D'URSO, JAFFEE, JOYNER, SEAWRIGHT, M. L. MILLER -- Multi-Sponsored by -- M. of A. BARCLAY, BLANKENBUSH, CAHILL, CROUCH, CUSICK, EPSTEIN, FRIEND, GALEF, GOODELL, GOTTFRIED, HAWLEY, LENTOL, LIFTON, LUPARDO, PALMESANO, RIVERA, STEC, TAGUE, THIELE, WALSH, WOERNER, WRIGHT -- read once and referred to the Committee on Higher Education AN ACT to amend the education law, in relation to the use of oral medi- cations by optometrists; and providing for the repeal of certain provisions upon expiration thereof The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph (e) of subdivision 1 of section 7101-a of the 2 education law, as added by chapter 517 of the laws of 1995, is amended 3 to read as follows: 4 (e) [Phase one] Topical therapeutic pharmaceutical agents. [Phase one] 5 Topical therapeutic pharmaceutical agents shall mean those drugs which 6 shall be limited to topical application to the surface of the eye for 7 therapeutic purposes and shall be limited to: 8 (i) antibiotic/antimicrobials; 9 (ii) decongestants/anti-allergenics; 10 (iii) non-steroidal anti-inflammatory agents; 11 (iv) steroidal anti-inflammatory agents; 12 (v) antiviral agents; 13 (vi) hyperosmotic/hypertonic agents; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01275-01-9A. 1193 2 1 (vii) cycloplegics; 2 (viii) artificial tears and lubricants; and 3 (ix) immunosuppressive agents. 4 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education 5 law, as added by chapter 517 of the laws of 1995, is amended to read as 6 follows: 7 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 8 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 9 pharmaceutical agents for treatment of glaucoma and ocular hypertension 10 shall mean those drugs which shall be limited to topical application to 11 the surface of the eye and shall be limited to: 12 (i) beta blockers; 13 (ii) alpha agonists; 14 (iii) direct acting cholinergic agents; 15 (iv) prostaglandin analogs; and 16 (v) carbonic anhydrase inhibitors. 17 § 3. Subdivision 1 of section 7101-a of the education law is amended 18 by adding a new paragraph (g) to read as follows: 19 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 20 ceutical agents shall mean those orally administered drugs used for 21 therapeutic purposes solely for the treatment of diseases of the eye and 22 adnexa and shall be limited to: 23 (i) the following antibiotics, including, where applicable, the gener- 24 ic equivalent of any of the listed drugs: 25 (1) augmentin; 26 (2) keflex; 27 (3) azithromycin; 28 (4) bactrim; 29 (5) doxycycline; and 30 (6) tetracycline; 31 (ii) the following decongestants/anti-allergenic/antihistamines, 32 including the generic equivalents of the listed drugs: 33 (1) clarinex; 34 (2) xyzal; and 35 (3) singulair; 36 (iii) the following antiglaucoma agents, including the generic equiv- 37 alents of such agents, used for the management of acute increases in 38 intraocular pressure; provided, however, an optometrist may use or 39 prescribe a maximum of one twenty-four hour prescription and shall imme- 40 diately refer the patient to a licensed physician specializing in 41 diseases of the eye: 42 (1) diamox; and 43 (2) neptazane; 44 (iv) the following antiviral agents, including the generic equivalents 45 of such agents, used for herpes zoster ophthalmicus; provided an optome- 46 trist shall use or prescribe in maximum, seven-day prescriptions; 47 provided, however, if a patient is diagnosed with herpes zoster ophthal- 48 micus and has not already been examined by a primary care physician or 49 other appropriate physician for such viral condition, an optometrist 50 shall refer the patient to a licensed primary care physician, licensed 51 physician specializing in diseases of the eye, or other appropriate 52 physician within three days of such diagnosis: 53 (1) valacyclovir; and 54 (2) acyclovir; and 55 (v) the following non-steroidal anti-inflammatory agents: 56 (1) cox-2 inhibitors;A. 1193 3 1 (2) ibuprofen; and 2 (3) naproxen. 3 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 4 section 7101-a of the education law, as added by chapter 517 of the laws 5 of 1995, are amended to read as follows: 6 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 7 using or prescribing [phase one] topical therapeutic pharmaceutical 8 agents, each optometrist shall have completed at least three hundred 9 hours of clinical training in the diagnosis, treatment and management of 10 patients with ocular disease other than glaucoma and ocular hyperten- 11 sion, not fewer than twenty-five hours of such training shall have been 12 completed subsequent to June thirtieth, nineteen hundred ninety-three 13 and additionally shall either have taken and successfully passed the 14 treatment and management of ocular diseases portion of the National 15 Board of Examiners in Optometry test or have taken and successfully 16 passed an examination acceptable to the board. 17 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 18 law, as added by chapter 517 of the laws of 1995, is amended to read as 19 follows: 20 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 21 agents for treatment of glaucoma and ocular hypertension, an optometrist 22 must be certified for diagnostic and [phase one] topical therapeutic 23 agents and have completed an additional one hundred hours of clinical 24 training in the diagnosis, treatment and management of patients with 25 glaucoma and ocular hypertension, not fewer than twenty-five hours of 26 such training shall have been completed subsequent to July first, nine- 27 teen hundred ninety-four, and shall have taken and successfully passed 28 an oral or written examination acceptable by the board. 29 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 30 education law are relettered paragraphs (d) and (e) and a new paragraph 31 (c) is added to read as follows: 32 (c) Before using or prescribing oral therapeutic pharmaceutical 33 agents, an optometrist must be certified to prescribe diagnostic pharma- 34 ceutical agents and topical therapeutic and therapeutic pharmaceutical 35 agents for treatment of glaucoma and ocular hypertension, have completed 36 an oral therapeutic pharmaceutical agent certification course and have 37 passed an examination within five years of the department's approval of 38 the initial certification course or the initial examination, whichever 39 is later. 40 (i) The curriculum for the course shall include, but not be limited 41 to, instruction in pharmacology and drug interaction in treating ocular 42 disease and be taught through clinical case scenarios and emphasize 43 clinical decision making and shall be no less than forty hours, of which 44 no less than twenty-four hours shall be live instruction. 45 (ii) Such course shall qualify towards meeting the continuing educa- 46 tion per triennial registration requirement pursuant to subdivision 47 seven of this section. 48 (iii) The examination shall test the knowledge of materials in the 49 curriculum and reflect the provisions of paragraph (g) of subdivision 50 one of this section, and shall be acceptable to the department. If an 51 optometrist fails to pass the examination, such optometrist may retake 52 the examination; provided, however, that if an optometrist fails to pass 53 the examination after three attempts, such optometrist must again 54 complete the certification course in order to retake the examination. An 55 optometrist shall be required to complete the certification course after 56 each subsequent failure to pass the examination three times. If an opto-A. 1193 4 1 metrist requires more time to pass the examination and to become certi- 2 fied than the five-year period provided for in this paragraph, such 3 optometrist may be authorized to retake the examination and to become 4 certified beyond such period upon application by the optometrist and a 5 showing of good cause as may be acceptable to the commissioner. 6 (iv) The initial, and any subsequent, curriculum and examination shall 7 be subject to review and approval by the department. 8 (v) The requirement for the oral therapeutic pharmaceutical agent 9 certification course and examination shall not apply to those optome- 10 trists who graduated from an accredited college of optometry subsequent 11 to January first, two thousand seven and have taken and successfully 12 passed the National Board of Examiners in Optometry test or an examina- 13 tion acceptable to the department. 14 § 7. Subdivision 5 of section 7101-a of the education law, as added by 15 chapter 517 of the laws of 1995, is amended to read as follows: 16 5. Suspension of certification. The department shall suspend the 17 certification for the use and prescribing of [phase one] topical thera- 18 peutic agents of any optometrist who fails to receive certification for 19 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 20 and ocular hypertension within three years of having been certified for 21 [phase one] topical therapeutic pharmaceutical agents. 22 § 8. The subdivision heading of subdivision 6 of section 7101-a of the 23 education law, as added by chapter 517 of the laws of 1995, is amended 24 to read as follows: 25 Consultation with use of certain topical therapeutic pharmaceutical 26 agents for treatment of glaucoma and ocular hypertension. 27 § 9. Subdivision 7 of section 7101-a of the education law, as added by 28 chapter 517 of the laws of 1995, is amended to read as follows: 29 7. Continuing education. Each optometrist certified to use [phase one30or phase two] topical therapeutic pharmaceutical agents and therapeutic 31 pharmaceutical agents for treatment of glaucoma and ocular hypertension, 32 shall complete a minimum of thirty-six hours of continuing education in 33 the area of ocular disease and pharmacology per triennial registration 34 period. [The education shall be in the area of ocular disease and phar-35macology and may include both didactic and clinical components.] Each 36 optometrist certified to use oral therapeutic pharmaceutical agents 37 shall, in addition to the minimum thirty-six hours of continuing educa- 38 tion provided for in this subdivision, complete an additional minimum of 39 thirty-nine hours of continuing education related to systemic disease 40 and therapeutic treatment per triennial registration period. Such educa- 41 tional programs may include both didactic and clinical components and 42 shall be approved in advance by the department and evidence of the 43 completion of this requirement shall be submitted with each application 44 for license renewal as required by section sixty-five hundred two of 45 this chapter. 46 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 47 subdivision 8 of section 7101-a of the education law, as added by chap- 48 ter 517 of the laws of 1995, are amended to read as follows: 49 Notice to patient with the use or prescription of topical therapeutic 50 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 51 ment of glaucoma and ocular hypertension. 52 (i) An optometrist prescribing topical steroids or antiviral medica- 53 tion shall inform each patient that in the event the condition does not 54 improve within five days, a physician of the patient's choice will be 55 notified.A. 1193 5 1 § 11. Subdivision 10 of section 7101-a of the education law, as added 2 by chapter 517 of the laws of 1995, is amended to read as follows: 3 10. Pharmaceutical agents. Optometrists who have been approved and 4 certified by the department shall be permitted to use the following 5 drugs: 6 (a) Diagnostic pharmaceuticals. 7 (b) Those optometrists having been certified for [phase one] topical 8 therapeutic pharmaceutical agents shall be authorized [(i) to use and9recommend all nonprescription medications appropriate for ocular disease10whether intended for topical or oral use; and (ii)] to use and prescribe 11 all [phase one] topical therapeutic pharmaceutical agents specified in 12 paragraph (e) of subdivision one of this section, which are FDA approved 13 and commercially available for topical use. 14 In the event an optometrist treats a patient with topical antiviral or 15 steroidal drugs and the patient's condition either fails to improve or 16 worsens within five days, the optometrist shall notify a physician 17 designated by the patient or, if none, by the treating optometrist. 18 (c) Those optometrists having been certified for [phase two] therapeu- 19 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 20 sion shall be authorized to use and prescribe [phase two] therapeutic 21 pharmaceutical agents for treatment of glaucoma and ocular hypertension 22 specified in paragraph (f) of subdivision one of this section, which are 23 FDA approved and commercially available. 24 (d) Those optometrists having been certified for oral therapeutic 25 pharmaceutical agents shall be authorized to use and prescribe oral 26 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 27 sion one of this section, which are FDA approved and commercially avail- 28 able and shall comply with all safety information and side-effect and 29 warning advisories contained in the most current physicians' desk refer- 30 ence. 31 (e) Those optometrists having been certified for topical therapeutic 32 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 33 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 34 agents shall be authorized to use and recommend all nonprescription 35 medications, whether intended for topical or oral use, appropriate for 36 the treatment of the eye and adnexa. 37 § 12. Subdivision 8 of section 7104 of the education law, as amended 38 by chapter 517 of the laws of 1995, is amended to read as follows: 39 (8) Fees: pay a fee of two hundred twenty dollars to the department 40 for admission to a department conducted examination and for an initial 41 license, a fee of one hundred fifteen dollars for each reexamination, a 42 fee of one hundred thirty-five dollars for an initial license for 43 persons not requiring admission to a department conducted examination, 44 [and] a fee of two hundred ten dollars for each triennial registration 45 period, [and] for additional authorization for the purpose of utilizing 46 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 47 certification to use or prescribe oral therapeutic pharmaceutical 48 agents, a fee of two hundred fifty dollars. 49 § 13. Oral therapeutic pharmaceutical agent implementation review. 1. 50 For purposes of this section, the term "commissioner" shall mean the 51 commissioner of the state education department; and the term "depart- 52 ment" shall mean the state education department. 53 2. Each optometrist certified to use oral therapeutic pharmaceutical 54 agents pursuant to paragraph (c) of subdivision four of section 7101-a 55 of the education law shall provide the department with information, on a 56 form prescribed by the commissioner, related to the prescription or useA. 1193 6 1 of oral therapeutic pharmaceutical agents provided for in section 7101-a 2 of the education law. Such information shall include the optometrist's 3 license number and the national provider identifier as established by 4 the centers for medicare and medicaid services, whether no oral 5 prescriptions have been issued and in the event that oral prescriptions 6 have been issued, then the following information shall be required: the 7 prescribed or used oral therapeutic pharmaceutical agent, the dosage of 8 such agent, the date of the prescription, the diagnosis of the patient 9 for which the agent was prescribed or used, and whether a referral was 10 made in accordance with paragraph (g) of subdivision one of section 11 7101-a of the education law. Such information shall not include any 12 patient identifying information and must otherwise be in compliance with 13 all state and federal requirements related to protected health informa- 14 tion. Each form shall be submitted by mail or electronic means to the 15 department on a quarterly basis. If a database of all oral therapeutic 16 pharmaceutical agents prescribed or used by optometrists is, or becomes, 17 available to the committee provided for in this act, then optometrists 18 shall be advised by the commissioner that quarterly reporting forms will 19 no longer be required. The requirements of this section shall remain in 20 effect for five years following approval by the department of the 21 initial oral therapeutic pharmaceutical agent certification course and 22 examination pursuant to paragraph (c) of subdivision four of section 23 7101-a of the education law, after which time these requirements shall 24 expire and no longer have effect. 25 3. The commissioner shall appoint a committee to advise and assist the 26 commissioner in evaluating compliance with the provisions of section 27 7101-a of the education law and to identify any necessary enhancements 28 to the curriculum provided for in such section and other educational 29 materials and to assist in ensuring patient safety. The committee shall 30 consist of one pharmacist, one optometrist upon the recommendation of a 31 statewide professional organization consisting of optometrists, one 32 ophthalmologist upon the recommendation of a statewide professional 33 organization consisting of ophthalmologists, and one expert in the field 34 of public health who shall be designated as chair by the commissioner in 35 consultation with the commissioner of the department of health and who 36 shall be neither an ophthalmologist nor an optometrist. 37 4. The commissioner shall submit each form received pursuant to this 38 section to the committee, except as otherwise provided in this subdivi- 39 sion. The committee shall review the forms and shall randomly cross- 40 check such submissions with a publicly available or other database 41 containing electronic prescriber information. Should a database of all 42 oral therapeutic pharmaceutical agents prescribed or used by optome- 43 trists pursuant to section 7101-a of the education law become available, 44 and the commissioner determines and advises optometrists that quarterly 45 reports are no longer necessary, then the committee shall review the 46 database and ascertain the prescribing information for all optometrists 47 consistent with section 7101-a of the education law. The committee 48 shall advise the commissioner as to compliance with the provisions of 49 section 7101-a of the education law for the purpose of evaluating 50 compliance with the provisions of section 7101-a of the education law 51 including the applicable referrals and dosing limitations and to identi- 52 fy any necessary enhancements to the curriculum provided for in para- 53 graph (c) of subdivision 4 of section 7101-a of the education law and 54 other educational materials and to assist in ensuring patient safety. 55 Upon finding evidence of non-compliance by any optometrist, the commit- 56 tee shall refer such information to the commissioner and to the officeA. 1193 7 1 of professions within the department for investigation and, if applica- 2 ble, disciplinary action. Nothing in this subdivision is intended to 3 modify or otherwise limit the department's authority or discretion to 4 review, investigate and refer matters related to the professional 5 conduct of a licensed provider. 6 § 14. This act shall take effect eighteen months after it shall have 7 become a law; provided that: 8 (a) section thirteen of this act shall expire and be deemed repealed 9 five years following the approval by the department of education of the 10 initial certification course or the initial examination, whichever is 11 later, pursuant to paragraph (c) of subdivision 4 of section 7101-a of 12 the education law as added by section six of this act; 13 (b) the commissioner of education shall notify the legislative bill 14 drafting commission upon approval of the initial certification course 15 and examination required in section six of this act in order that the 16 commission may maintain an accurate and timely effective data base of 17 the official text of the laws of the state of New York in furtherance of 18 effectuating the provisions of section 44 of the legislative law and 19 section 70-b of the public officers law; and 20 (c) any rule or regulation necessary for the timely implementation of 21 this act on its effective date shall be promulgated on or before such 22 effective date.
