SB 391 — An Act amending the act of June 6, 1980 (P.L.197, No.57), known as the Optometric Practice and Licensure Act, further providing for definitions, for approval of drugs, for exemptions and exceptions and for violations and penalties.

PRIOR PRINTER'S NO.

374 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA SENATE BILL Session of No.

2009391 THE2019 GENERALINTRODUCED ASSEMBLYBY OFGORDNER, PENNSYLVANIASCARNATI, SENATEFOLMER, BILLBAKER, SessionWHITE, HUTCHINSON AND YUDICHAK, MARCH 5, 2019 REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE, MARCH 5, 2019 AN ACT Amending the act of No.June 6, 1980 (P.L.197, No.57), entitled "An act regulating the licensure and practice of optometry, making repeals and providing penalties," further providing for definitions, for approval of drugs, for exemptions and for insurance billing codes.s and penalties;

391and 2019providing INTRODUCEDThe BYGeneral GORDNER,Assembly SCARNATI, FOLMER, BAKER, HUTCHINSON, YUDICHAK, HAYWOOD AND PITTMAN, MARCH 5, 2019 SENATOR TOMLINSON, CONSUMER PROTECTION AND PROFESSIONAL LICENSURE, AS AMENDED, SEPTEMBER 22, 2020 AN ACT Amending the act of June 6, 1980 (P.L.197, No.57), entitled "An <-- act regulating the licensureCommonwealth and practice of optometry,Pennsylvania makinghereby repealsenacts andas providingfollows: penalties," further providing exceptions and for violations and penalties;

and providing for insurance billing codes.

AMENDING THE ACT OF JUNE 6, 1980 (P.L.197, NO.57), ENTITLED "AN <-- ACT REGULATING THE LICENSURE AND PRACTICE OF OPTOMETRY, MAKING REPEALS AND PROVIDING PENALTIES," FURTHER PROVIDING FOR DEFINITIONS, FOR APPROVAL OF DRUGS, FOR EXEMPTIONS AND EXCEPTIONS AND FOR VIOLATIONS AND PENALTIES.

The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:

The definitions of "examination and diagnosis," <-- "optometrist" and "practice of optometry" in section 2 of the act of June 6, 1980 (P.L.197, No.57), known as the Optometric Practice and Licensure Act, are amended to read:

An optometrist shall be identified either by "Doctor of Optometry," ["O.D.," or "Dr." followed by "Optometrist."] "O.D." or "Doctor." "Practice of optometry." (1) The use of any and all means or methods for the examination, diagnosis, prevention and treatment of all conditions [of] affecting the human visual system [and shall include the examination for, and adapting and fitting of, any 20190SB0391PN2009 - 2 - and all kinds and types of lenses including contact lenses.], including all conditions of the human eye and adnexa 20190SB0391PN0374 - 2 - applicable to this act.

[(2) The administration and prescription of legend and nonlegend drugs as approved by the Secretary of Health as provided in section 4.3 for treatment of the eye, the eyelids, the lacrimal system and the conjunctiva and the removal of superficial foreign bodies from the ocular surface and adnexa so long as treatment of diseases or conditions of the visual system, other than glaucoma, as authorized under 20190SB0391PN2009 - 3 - this paragraph shall not continue beyond six weeks from the initiation of treatment unless the prescribing optometrist 20190SB0391PN0374 - 3 - documents consultation with a licensed physician.

Sections 4.3 and 6(b) of the act are amended to 20190SB0391PN2009 - 4 - read:

20190SB0391PN0374 - 4 - Drugs shall be approved as follows:

20190SB0391PN2009 - 5 - Section 6.

* * * 20190SB0391PN0374 - 5 - (b) The board shall permit externs, who are [fourth year] optometric students, to perform procedures and tests for the sole purpose of instruction and experience under the direct supervision and control of an optometrist licensed in this Commonwealth.

SECTION20190SB0391PN0374 1.- 6 -

THE DEFINITIONS OF "EXAMINATION AND DIAGNOSIS" <-- AND "PRACTICE OF OPTOMETRY" IN SECTION 2 OF THE ACT OF JUNE 6, 1980 (P.L.197, NO.57), KNOWN AS THE OPTOMETRIC PRACTICE AND LICENSURE ACT, ARE AMENDED TO READ:

20190SB0391PN2009 - 6 - SECTION 2.

DEFINITIONS.

THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS ACT SHALL HAVE, UNLESS THE CONTEXT CLEARLY INDICATES OTHERWISE, THE MEANINGS GIVEN TO THEM IN THIS SECTION:

* * * "EXAMINATION AND DIAGNOSIS." ANY EXAMINATION OR DIAGNOSTIC MEANS OR METHOD COMPATIBLE WITH OPTOMETRIC EDUCATION AND PROFESSIONAL COMPETENCE.

THE TERM SHALL ENCOMPASS THE USE OF TOPICAL AND ORAL PHARMACEUTICAL AGENTS APPROVED BY THE BOARD AS PROVIDED IN SECTION 4.3 FOR DIAGNOSTIC PURPOSES [CLASSIFIED AS], INCLUDING MIOTICS, MYDRIATICS, CYCLOPLEGICS, TOPICAL ANESTHETICS AND DYES WHEN APPLIED TOPICALLY TO THE EYE, [WHICH PHARMACEUTICAL AGENTS SHALL BE APPROVED BY THE SECRETARY OF HEALTH AS PROVIDED IN SECTION 4.3 AND,] SUBJECT TO THE RULES AND REGULATIONS OF THE BOARD, PROVIDED HOWEVER THAT WITH RESPECT TO OPTOMETRISTS LICENSED BEFORE MARCH 1, 1974, ONLY SUCH OPTOMETRISTS WHO HAVE SATISFACTORILY COMPLETED A COURSE IN PHARMACOLOGY AS IT APPLIES TO OPTOMETRY, WITH PARTICULAR EMPHASIS ON THE TOPICAL APPLICATION OF DIAGNOSTIC PHARMACEUTICAL AGENTS TO THE EYE, APPROVED BY THE BOARD SHALL BE PERMITTED TO USE DIAGNOSTIC PHARMACEUTICAL AGENTS TOPICALLY IN THE PRACTICE OF OPTOMETRY.

* * * "PRACTICE OF OPTOMETRY." (1) THE USE OF ANY AND ALL MEANS OR METHODS FOR THE EXAMINATION, DIAGNOSIS AND TREATMENT OF ALL CONDITIONS OF THE HUMAN VISUAL SYSTEM [AND SHALL INCLUDE THE EXAMINATION FOR, AND ADAPTING AND FITTING OF, ANY AND ALL KINDS AND TYPES OF LENSES INCLUDING CONTACT LENSES].

THE TERM SHALL INCLUDE:

(I) THE EXAMINATION FOR, AND ADAPTING AND FITTING 20190SB0391PN2009 - 7 - OF, ANY AND ALL KINDS AND TYPES OF LENSES, INCLUDING CONTACT LENSES.

(II) THE ADMINISTRATION AND PRESCRIPTION OF ALL LEGEND AND NONLEGEND DRUGS, EITHER BY TOPICAL OR ORAL ROUTES OF ADMINISTRATION, APPROVED BY THE BOARD IN SECTION 4.3 FOR THE TREATMENT OF THE EYE, THE EYELIDS, THE LACRIMAL SYSTEM AND THE CONJUNCTIVA, INCLUDING CODEINE AND HYDROCODONE COMBINATIONS, SO LONG AS THE TREATMENT OF DISEASES OR CONDITIONS OF THE VISUAL SYSTEM, OTHER THAN GLAUCOMA, DRY EYES OR ALLERGIES, AS AUTHORIZED UNDER THIS PARAGRAPH SHALL NOT CONTINUE BEYOND SIX WEEKS FROM THE INITIATION OF TREATMENT UNLESS THE PRESCRIBING OPTOMETRIST DOCUMENTS CONSULTATION WITH A LICENSED PHYSICIAN.

AS USED IN THIS PARAGRAPH, THE INITIATION OF TREATMENT MAY, BUT NEED NOT, INCLUDE THE PRESCRIPTION OR ADMINISTRATION OF PHARMACEUTICAL AGENTS FOR THERAPEUTIC PURPOSES.

THE PRESCRIPTION OF SCHEDULE II CONTROLLED SUBSTANCES CONTAINING CODEINE AND HYDROCODONE COMBINATIONS MAY NOT EXCEED A 72-HOUR SUPPLY.

(III) THE REMOVAL OF SUPERFICIAL FOREIGN BODIES FROM THE OCULAR SURFACE OR ADNEXA.

(IV) EPINEPHRINE AUTO-INJECTORS FOR ANAPHYLAXIS.

(V) THE ORDERING AND INTERPRETATION OF ANGIOGRAPHY VIA NONINVASIVE IMAGING, WHICH SHALL ONLY INCLUDE OPTICAL COHERENCE TOMOGRAPHY.

(VI) THE ADMINISTRATION AND PRESCRIPTION OF ALL LEGEND AND NONLEGEND DRUGS APPROVED BY THE BOARD UNDER SECTION 4.3 FOR THE TREATMENT OF GLAUCOMA.

[(2) THE ADMINISTRATION AND PRESCRIPTION OF LEGEND AND NONLEGEND DRUGS AS APPROVED BY THE SECRETARY OF HEALTH AS 20190SB0391PN2009 - 8 - PROVIDED IN SECTION 4.3 FOR TREATMENT OF THE EYE, THE EYELIDS, THE LACRIMAL SYSTEM AND THE CONJUNCTIVA AND THE REMOVAL OF SUPERFICIAL FOREIGN BODIES FROM THE OCULAR SURFACE AND ADNEXA SO LONG AS TREATMENT OF DISEASES OR CONDITIONS OF THE VISUAL SYSTEM, OTHER THAN GLAUCOMA, AS AUTHORIZED UNDER THIS PARAGRAPH SHALL NOT CONTINUE BEYOND SIX WEEKS FROM THE INITIATION OF TREATMENT UNLESS THE PRESCRIBING OPTOMETRIST DOCUMENTS CONSULTATION WITH A LICENSED PHYSICIAN.

AS USED IN THIS PARAGRAPH, THE INITIATION OF TREATMENT MAY, BUT NEED NOT, INCLUDE THE PRESCRIPTION OR ADMINISTRATION OF PHARMACEUTICAL AGENTS FOR THERAPEUTIC PURPOSES.

(3) THE TERM SHALL NOT INCLUDE:

(I) SURGERY, INCLUDING, BUT NOT LIMITED TO, LASER SURGERY;

THE USE OF LASERS FOR THERAPEUTIC PURPOSES;

AND THE USE OF INJECTIONS IN THE TREATMENT OF OCULAR DISEASE;

(II) THE USE OF SCHEDULE I AND SCHEDULE II CONTROLLED SUBSTANCES;

(III) TREATMENT OF SYSTEMIC DISEASE;

AND (IV) THE TREATMENT OF GLAUCOMA, EXCEPT THAT OPTOMETRISTS MAY USE ALL TOPICAL PHARMACEUTICAL AGENTS IN THE TREATMENT OF PRIMARY OPEN ANGLE GLAUCOMA, EXFOLIATION GLAUCOMA AND PIGMENTARY GLAUCOMA.] (4) THE TERM SHALL NOT INCLUDE: