Bill Text: NY S05235 | 2017-2018 | General Assembly | Amended
Bill Title: Relates to the use of oral medications by optometrists.
Spectrum: Moderate Partisan Bill (Republican 13-4)
Status: (Engrossed - Dead) 2018-06-12 - referred to higher education [S05235 Detail]
Download: New_York-2017-S05235-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 5235--A 2017-2018 Regular Sessions IN SENATE March 16, 2017 ___________ Introduced by Sens. FUNKE, ADDABBO, AKSHAR, ALCANTARA, GALLIVAN, LITTLE, MARCHIONE, MURPHY, O'MARA, ORTT, RITCHIE, SERINO, SEWARD, VALESKY, YOUNG -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education -- recommitted to the Committee on Higher Education in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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; 14 (vii) cycloplegics; 15 (viii) artificial tears and lubricants; and 16 (ix) immunosuppressive agents. 17 § 2. Paragraph (f) of subdivision 1 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: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04288-13-7S. 5235--A 2 1 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 2 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 3 pharmaceutical agents for treatment of glaucoma and ocular hypertension 4 shall mean those drugs which shall be limited to topical application to 5 the surface of the eye and shall be limited to: 6 (i) beta blockers; 7 (ii) alpha agonists; 8 (iii) direct acting cholinergic agents; 9 (iv) prostaglandin analogs; and 10 (v) carbonic anhydrase inhibitors. 11 § 3. Subdivision 1 of section 7101-a of the education law is amended 12 by adding a new paragraph (g) to read as follows: 13 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 14 ceutical agents shall mean those orally administered drugs used for 15 therapeutic purposes solely for the treatment of diseases of the eye and 16 adnexa and shall be limited to: 17 (i) the following antibiotics, including, where applicable, the gener- 18 ic equivalent of any of the listed drugs: 19 (1) augmentin; 20 (2) keflex; 21 (3) azithromycin; 22 (4) bactrim; 23 (5) doxycycline; and 24 (6) tetracycline; 25 (ii) the following decongestants/anti-allergenic/antihistamines, 26 including the generic equivalents of the listed drugs: 27 (1) clarinex; 28 (2) xyzal; and 29 (3) singulair; 30 (iii) the following antiglaucoma agents, including the generic equiv- 31 alents of such agents, used for the management of acute increases in 32 intraocular pressure; provided, however, an optometrist may use or 33 prescribe a maximum of one twenty-four hour prescription and shall imme- 34 diately refer the patient to a licensed physician specializing in 35 diseases of the eye: 36 (1) diamox; and 37 (2) neptazane; 38 (iv) the following antiviral agents, including the generic equivalents 39 of such agents, used for herpes zoster ophthalmicus; provided an optome- 40 trist shall use or prescribe in maximum, seven-day prescriptions; 41 provided, however, if a patient is diagnosed with herpes zoster ophthal- 42 micus and has not already been examined by a primary care physician or 43 other appropriate physician for such viral condition, an optometrist 44 shall refer the patient to a licensed primary care physician, licensed 45 physician specializing in diseases of the eye, or other appropriate 46 physician within three days of such diagnosis: 47 (1) valacyclovir; and 48 (2) acyclovir; and 49 (v) the following non-steroidal anti-inflammatory agents: 50 (1) cox-2 inhibitors; 51 (2) ibuprofen; and 52 (3) naproxen. 53 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 54 section 7101-a of the education law, as added by chapter 517 of the laws 55 of 1995, are amended to read as follows:S. 5235--A 3 1 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 2 using or prescribing [phase one] topical therapeutic pharmaceutical 3 agents, each optometrist shall have completed at least three hundred 4 hours of clinical training in the diagnosis, treatment and management of 5 patients with ocular disease other than glaucoma and ocular hyperten- 6 sion, not fewer than twenty-five hours of such training shall have been 7 completed subsequent to June thirtieth, nineteen hundred ninety-three 8 and additionally shall either have taken and successfully passed the 9 treatment and management of ocular diseases portion of the National 10 Board of Examiners in Optometry test or have taken and successfully 11 passed an examination acceptable to the board. 12 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 13 law, as added by chapter 517 of the laws of 1995, is amended to read as 14 follows: 15 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 16 agents for treatment of glaucoma and ocular hypertension, an optometrist 17 must be certified for diagnostic and [phase one] topical therapeutic 18 agents and have completed an additional one hundred hours of clinical 19 training in the diagnosis, treatment and management of patients with 20 glaucoma and ocular hypertension, not fewer than twenty-five hours of 21 such training shall have been completed subsequent to July first, nine- 22 teen hundred ninety-four, and shall have taken and successfully passed 23 an oral or written examination acceptable by the board. 24 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 25 education law are relettered paragraphs (d) and (e) and a new paragraph 26 (c) is added to read as follows: 27 (c) Before using or prescribing oral therapeutic pharmaceutical 28 agents, an optometrist must be certified to prescribe diagnostic pharma- 29 ceutical agents and topical therapeutic and therapeutic pharmaceutical 30 agents for treatment of glaucoma and ocular hypertension, have completed 31 an oral therapeutic pharmaceutical agent certification course and have 32 passed an examination within five years of the department's approval of 33 the initial certification course or the initial examination, whichever 34 is later. 35 (i) The curriculum for the course shall include, but not be limited 36 to, instruction in pharmacology and drug interaction in treating ocular 37 disease and be taught through clinical case scenarios and emphasize 38 clinical decision making and shall be no less than forty hours, of which 39 no less than twenty-four hours shall be live instruction. 40 (ii) Such course shall qualify towards meeting the continuing educa- 41 tion per triennial registration requirement pursuant to subdivision 42 seven of this section. 43 (iii) The examination shall test the knowledge of materials in the 44 curriculum and reflect the provisions of paragraph (g) of subdivision 45 one of this section, and shall be acceptable to the department. If an 46 optometrist fails to pass the examination, such optometrist may retake 47 the examination; provided, however, that if an optometrist fails to pass 48 the examination after three attempts, such optometrist must again 49 complete the certification course in order to retake the examination. An 50 optometrist shall be required to complete the certification course after 51 each subsequent failure to pass the examination three times. If an opto- 52 metrist requires more time to pass the examination and to become certi- 53 fied than the five-year period provided for in this paragraph, such 54 optometrist may be authorized to retake the examination and to become 55 certified beyond such period upon application by the optometrist and a 56 showing of good cause as may be acceptable to the commissioner.S. 5235--A 4 1 (iv) The initial, and any subsequent, curriculum and examination shall 2 be subject to review and approval by the department. 3 (v) The requirement for the oral therapeutic pharmaceutical agent 4 certification course and examination shall not apply to those optome- 5 trists who graduated from an accredited college of optometry subsequent 6 to January first, two thousand seven and have taken and successfully 7 passed the National Board of Examiners in Optometry test or an examina- 8 tion acceptable to the department. 9 § 7. Subdivision 5 of section 7101-a of the education law, as added by 10 chapter 517 of the laws of 1995, is amended to read as follows: 11 5. Suspension of certification. The department shall suspend the 12 certification for the use and prescribing of [phase one] topical thera- 13 peutic agents of any optometrist who fails to receive certification for 14 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 15 and ocular hypertension within three years of having been certified for 16 [phase one] topical therapeutic pharmaceutical agents. 17 § 8. The subdivision heading of subdivision 6 of section 7101-a of the 18 education law, as added by chapter 517 of the laws of 1995, is amended 19 to read as follows: 20 Consultation with use of certain topical therapeutic pharmaceutical 21 agents for treatment of glaucoma and ocular hypertension. 22 § 9. Subdivision 7 of section 7101-a of the education law, as added by 23 chapter 517 of the laws of 1995, is amended to read as follows: 24 7. Continuing education. Each optometrist certified to use [phase one25or phase two] topical therapeutic pharmaceutical agents and therapeutic 26 pharmaceutical agents for treatment of glaucoma and ocular hypertension, 27 shall complete a minimum of thirty-six hours of continuing education in 28 the area of ocular disease and pharmacology per triennial registration 29 period. [The education shall be in the area of ocular disease and phar-30macology and may include both didactic and clinical components.] Each 31 optometrist certified to use oral therapeutic pharmaceutical agents 32 shall, in addition to the minimum thirty-six hours of continuing educa- 33 tion provided for in this subdivision, complete an additional minimum of 34 thirty-nine hours of continuing education related to systemic disease 35 and therapeutic treatment per triennial registration period. Such educa- 36 tional programs may include both didactic and clinical components and 37 shall be approved in advance by the department and evidence of the 38 completion of this requirement shall be submitted with each application 39 for license renewal as required by section sixty-five hundred two of 40 this chapter. 41 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 42 subdivision 8 of section 7101-a of the education law, as added by chap- 43 ter 517 of the laws of 1995, are amended to read as follows: 44 Notice to patient with the use or prescription of topical therapeutic 45 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 46 ment of glaucoma and ocular hypertension. 47 (i) An optometrist prescribing topical steroids or antiviral medica- 48 tion shall inform each patient that in the event the condition does not 49 improve within five days, a physician of the patient's choice will be 50 notified. 51 § 11. Subdivision 10 of section 7101-a of the education law, as added 52 by chapter 517 of the laws of 1995, is amended to read as follows: 53 10. Pharmaceutical agents. Optometrists who have been approved and 54 certified by the department shall be permitted to use the following 55 drugs: 56 (a) Diagnostic pharmaceuticals.S. 5235--A 5 1 (b) Those optometrists having been certified for [phase one] topical 2 therapeutic pharmaceutical agents shall be authorized [(i) to use and3recommend all nonprescription medications appropriate for ocular disease4whether intended for topical or oral use; and (ii)] to use and prescribe 5 all [phase one] topical therapeutic pharmaceutical agents specified in 6 paragraph (e) of subdivision one of this section, which are FDA approved 7 and commercially available for topical use. 8 In the event an optometrist treats a patient with topical antiviral or 9 steroidal drugs and the patient's condition either fails to improve or 10 worsens within five days, the optometrist shall notify a physician 11 designated by the patient or, if none, by the treating optometrist. 12 (c) Those optometrists having been certified for [phase two] therapeu- 13 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 14 sion shall be authorized to use and prescribe [phase two] therapeutic 15 pharmaceutical agents for treatment of glaucoma and ocular hypertension 16 specified in paragraph (f) of subdivision one of this section, which are 17 FDA approved and commercially available. 18 (d) Those optometrists having been certified for oral therapeutic 19 pharmaceutical agents shall be authorized to use and prescribe oral 20 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 21 sion one of this section, which are FDA approved and commercially avail- 22 able and shall comply with all safety information and side-effect and 23 warning advisories contained in the most current physicians' desk refer- 24 ence. 25 (e) Those optometrists having been certified for topical therapeutic 26 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 27 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 28 agents shall be authorized to use and recommend all nonprescription 29 medications, whether intended for topical or oral use, appropriate for 30 the treatment of the eye and adnexa. 31 § 12. Subdivision 8 of section 7104 of the education law, as amended 32 by chapter 517 of the laws of 1995, is amended to read as follows: 33 (8) Fees: pay a fee of two hundred twenty dollars to the department 34 for admission to a department conducted examination and for an initial 35 license, a fee of one hundred fifteen dollars for each reexamination, a 36 fee of one hundred thirty-five dollars for an initial license for 37 persons not requiring admission to a department conducted examination, 38 [and] a fee of two hundred ten dollars for each triennial registration 39 period, [and] for additional authorization for the purpose of utilizing 40 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 41 certification to use or prescribe oral therapeutic pharmaceutical 42 agents, a fee of two hundred fifty dollars. 43 § 13. Oral therapeutic pharmaceutical agent implementation review. 1. 44 For purposes of this section, the term "commissioner" shall mean the 45 commissioner of the state education department; and the term "depart- 46 ment" shall mean the state education department. 47 2. Each optometrist certified to use oral therapeutic pharmaceutical 48 agents pursuant to paragraph (c) of subdivision four of section 7101-a 49 of the education law shall provide the department with information, on a 50 form prescribed by the commissioner, related to the prescription or use 51 of oral therapeutic pharmaceutical agents provided for in section 7101-a 52 of the education law. Such information shall include the optometrist's 53 license number and the national provider identifier as established by 54 the centers for medicare and medicaid services, whether no oral 55 prescriptions have been issued and in the event that oral prescriptions 56 have been issued, then the following information shall be required: theS. 5235--A 6 1 prescribed or used oral therapeutic pharmaceutical agent, the dosage of 2 such agent, the date of the prescription, the diagnosis of the patient 3 for which the agent was prescribed or used, and whether a referral was 4 made in accordance with paragraph (g) of subdivision one of section 5 7101-a of the education law. Such information shall not include any 6 patient identifying information and must otherwise be in compliance with 7 all state and federal requirements related to protected health informa- 8 tion. Each form shall be submitted by mail or electronic means to the 9 department on a quarterly basis. If a database of all oral therapeutic 10 pharmaceutical agents prescribed or used by optometrists is, or becomes, 11 available to the committee provided for in this act, then optometrists 12 shall be advised by the commissioner that quarterly reporting forms will 13 no longer be required. The requirements of this section shall remain in 14 effect for five years following approval by the department of the 15 initial oral therapeutic pharmaceutical agent certification course and 16 examination pursuant to paragraph (c) of subdivision four of section 17 7101-a of the education law, after which time these requirements shall 18 expire and no longer have effect. 19 3. The commissioner shall appoint a committee to advise and assist the 20 commissioner in evaluating compliance with the provisions of section 21 7101-a of the education law and to identify any necessary enhancements 22 to the curriculum provided for in such section and other educational 23 materials and to assist in ensuring patient safety. The committee shall 24 consist of one pharmacist, one optometrist upon the recommendation of a 25 statewide professional organization consisting of optometrists, one 26 ophthalmologist upon the recommendation of a statewide professional 27 organization consisting of ophthalmologists, and one expert in the field 28 of public health who shall be designated as chair by the commissioner in 29 consultation with the commissioner of the department of health and who 30 shall be neither an ophthalmologist nor an optometrist. 31 4. The commissioner shall submit each form received pursuant to this 32 section to the committee, except as otherwise provided in this subdivi- 33 sion. The committee shall review the forms and shall randomly cross- 34 check such submissions with a publicly available or other database 35 containing electronic prescriber information. Should a database of all 36 oral therapeutic pharmaceutical agents prescribed or used by optome- 37 trists pursuant to section 7101-a of the education law become available, 38 and the commissioner determines and advises optometrists that quarterly 39 reports are no longer necessary, then the committee shall review the 40 database and ascertain the prescribing information for all optometrists 41 consistent with section 7101-a of the education law. The committee 42 shall advise the commissioner as to compliance with the provisions of 43 section 7101-a of the education law for the purpose of evaluating 44 compliance with the provisions of section 7101-a of the education law 45 including the applicable referrals and dosing limitations and to identi- 46 fy any necessary enhancements to the curriculum provided for in para- 47 graph (c) of subdivision 4 of section 7101-a of the education law and 48 other educational materials and to assist in ensuring patient safety. 49 Upon finding evidence of non-compliance by any optometrist, the commit- 50 tee shall refer such information to the commissioner and to the office 51 of professions within the department for investigation and, if applica- 52 ble, disciplinary action. Nothing in this subdivision is intended to 53 modify or otherwise limit the department's authority or discretion to 54 review, investigate and refer matters related to the professional 55 conduct of a licensed provider.S. 5235--A 7 1 § 14. This act shall take effect eighteen months after it shall have 2 become a law; provided that: 3 (a) section thirteen of this act shall expire and be deemed repealed 4 five years following the approval by the department of education of the 5 initial certification course or the initial examination, whichever is 6 later, pursuant to paragraph (c) of subdivision 4 of section 7101-a of 7 the education law as added by section six of this act; 8 (b) the commissioner of education shall notify the legislative bill 9 drafting commission upon approval of the initial certification course 10 and examination required in section six of this act in order that the 11 commission may maintain an accurate and timely effective data base of 12 the official text of the laws of the state of New York in furtherance of 13 effectuating the provisions of section 44 of the legislative law and 14 section 70-b of the public officers law; and 15 (c) any rule or regulation necessary for the timely implementation of 16 this act on its effective date shall be promulgated on or before such 17 effective date.
