The Texas Optometry Board (TOB) is the state agency that handles licensing and disciplinary matters for optometrists in Texas. Unfortunately, optometrists, like all professionals, may be subject to complaints by patients, colleagues, and other members of the public. Complaints can involve any of the rules and laws that govern optometrists, including the requirements for prescriptions issued by optometrists, both in terms of prescriptions for contact lenses and glasses, and prescriptions for medications.
Even if the complaint has no merit, receiving a complaint from the TOB can be stressful and overwhelming. The possibility that one complaint could upend the career that you have worked so hard for can be devastating, and you may be unsure where to turn first. Fortunately, your Texas optometrist license defense attorneys are here to help with the defensive tactics that you need in any disciplinary license proceedings.
Contact Lens Prescriptions
Both federal and state laws apply to the issuance of contact lens prescriptions by optometrists. The Fairness to Contact Lens Consumer Act (“the Act”), which is a federal law, governs the release of contact lens prescriptions by licensed optometrists in Texas. 16 CFR §315 implements the Act, in that it requires the issuance of rules to address the release, verification, and sale of contact lens prescriptions.
Under state law, the Contact Lens Prescription Act establishes the requirements for a contact lens prescription and its release. TOB Rule 279.2 implements those requirements for contact lens prescriptions, as well as their release and verification.
Prescriptions for Eyeglasses
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16 CFR §456 contains the federal regulations concerning the availability of eyeglass prescriptions and related issues. Tex. Occ. Code §351.365 outlines the requirements to release a prescription for eyeglasses. TOB Rule 279.4 defines the requirements for a prescription for eyeglasses.
Optometrists and Prescription Drugs
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Various federal and state laws govern the ability of optometrists to prescribe drugs, especially controlled substances. Generally, therapeutic optometrists may administer and prescribe all ophthalmic devices, over-the-counter medications (including oral and other treatments), and appropriate topical pharmaceutical agents for diagnosing and treating visual defects, abnormal conditions, and diseases of the human eye and adnexa, including cocaine eye drops of no greater than 10 percent solution in prepackaged liquid form for diagnostic purposes. An optometric glaucoma specialist may prescribe antiglaucoma drugs, as defined in Tex. Occ. Code §351.3581.
Topical Prescription Drugs
TOB Rule 280.5 outlines the requirements for prescribing topical prescription drugs. This rule also contains the procedure for prohibiting the substitution of a generic drug for a brand-name drug, which is to write “brand necessary” or “brand medically necessary” in the prescriber’s own handwriting across the prescription. They must clearly communicate the words “brand necessary” or “brand medically necessary” if issuing a prescription electronically or verbally.
This rule contains the general requirements for writing a prescription, which include:
- The date of issuance;
- The name and address of the patient for whom the drug is prescribed;
- The name, strength, and quantity of the drug, medicine, or device prescribed;
- The direction for use of the drug, medicine, or device prescribed;
- The name and address of the therapeutic optometrist;
- The manually written signature of the prescribing therapeutic optometrist; or an electronic signature provided that the prescription is electronically signed by the practitioner using a system which electronically replicates the practitioner’s manual signature on the written prescription, and provided:
- that security features of the system require the practitioner to authorize each use; and
- the prescription is printed on paper that is designed to prevent unauthorized copying of a completed prescription and to prevent the erasure or modification of information written on the prescription by the prescribing practitioner; and
- The license number of the prescribing therapeutic optometrist including the therapeutic designation.
A prescribing optometrist who issues a prescription electronically or verbally must meet all these requirements, except for that of a written signature.
Controlled Substances
Under Texas law, prescribers, including optometrists, must electronically prescribe all controlled substances, unless an exception applies or the prescriber receives a waiver. Under federal law, Medicaid requires that all written prescriptions for controlled substances be on tamper-resistant prescription pads. Prescriptions that are faxed, sent electronically, or sent via telephone are exempt from this requirement, as are prescriptions in long-term care facilities and hospitals.
Prescribers may use computer-generated signatures, but only if they follow the guidelines in TOB Rules 279.2, 279.4, and 280.5. Rubber-stamped signatures are impermissible.
Under TOB Rules 280.5 and 280.10, an optometrist must have a DEA Controlled Substance Registration only if they prescribe or administer controlled substances.
Schedule III Controlled Substances
Prescriptions for Schedule III Controlled Substances must contain the following information:
- Quantity of the substance prescribed (written as both a number and as a word);
- Date of issue (may not be postdated);
- Name, address, and date of birth or age of the patient);
- Name and strength of the controlled substance prescribed;
- Directions for use of the controlled substance;
- Intended use of the substance prescribed unless the practitioner determines the furnishing of this information is not in the best interest of the patient;
- Printed or stamped name, address, Federal Drug Enforcement Administration (DEA) registration number, and telephone number of the practitioner’s usual place of business; and
- The signature of the prescribing practitioner, unless the prescription is called in to the pharmacy.
The Texas Prescription Monitoring Program
The Texas Prescription Monitoring Program (PMP) is a database of all Schedule II through V controlled substances that Texas pharmacies dispense and that out-of-state pharmacies dispense to Texas residents. All healthcare professionals, including optometrists, have certain duties to check a patient’s PMP history before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. For Optometrist Glaucoma Specialists, this duty means that they must check the PMP before prescribing any analgesic that is a controlled substance. Optometrist Glaucoma Specialists may prescribe one three-day supply of any analgesic identified in Schedules III, IV, or V. Likewise, registering with and querying the PMP is required before prescribing any opioids.
Get the Advice You Need About Your Optometrist License
When you face the potential loss of your optometrist license, you risk losing the ability to support yourself and your family. Don’t try to handle such a critical situation on your own. The optometrist license defense lawyers at Bertolino LLP, can look at your circumstances and help you determine the best strategy for protecting your license. Call us today at (512) 980-3751 or get more information about us online.
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