Update: InMay 2021, the amendment to the Fairness to Contact Lens Consumers Act was reintroduced in the House of Representatives. See O.D. Notebook for details.
In February 2004, the Fairness to Contact Lens Consumers Act passed into law. Part of the act put certain responsibilities on prescribers. It also called on the U.S. Federal Trade Commission (FTC) to develop and enforce this new set of rules. In July 2004, the FTC released the ‘Contact Lens Rule,’ and on Oct. 16, 2020, it released amendments to the rule, which put certain responsibilities on us, as prescribers, and can cost $42,530 per violation. This article highlights what optometrists need to know about the rule.
Editor’s note: As this issue goes to press, here is the latest update on the new Contact Lens Rule: The Consolidated Appropriations Act, signed into law in the final days of 2020, directed the FTC to cease enforcement of the new rule until March 31, 2021 (see p.65 at bit.ly/359EvFi ). Also, see OM’s Jan. 6 online “O.D. Notebook” for a news item on the postponement.
TAKING THE EXAMINATION A STEP FURTHER
As optometrists, we know the value of the doctor-patient relationship. We spend time understanding our patients’ visual and ocular demands, and, using that information, we make the appropriate recommendations.
With the new changes in place, we must take our examination a step further. We now are required to give the patient a copy of their contact lens prescription at the end of their exam, even if they do not ask for it.
REQUESTS FOR PRESCRIPTIONS
Prescription confirmations from third parties have also been adjusted. We not only are required to provide a contact lens prescription to anyone who is designated to act on behalf of the patient, including contact lens sellers, but this verification must take place within a new timeline: Whereas there was no previous time constraint, now we have 40 business hours to comply. These requests could include fixes in inaccuracies in the prescription, informing the seller if the prescription is expired and providing a reason if the prescription is invalid. (Read more about requirements for sellers at “Final Rule for Sellers” p.18)
OBTAINING THE PATIENT’S SIGNATURE
It is not enough that we provide the prescription. We must also make sure we obtain a signature from the patient acknowledging receipt of the prescription. After receiving that signature, we must keep it on file for no less than three years. Obtaining the signature can be done in numerous ways. Practices will have to figure out what works best for them.
Acceptable ways to document are as follows:
- Patients can sign a separate form: This form must acknowledge receipt of the prescription to the patient. Attached to this article you will see the form that we use in our office. There is no specific wording required on this form. The FTC was clear in stating that practitioners can use whatever language is appropriate, and they have the ability to include additional information, if desired.
- Patients can sign their sales receipt: After examination and lens fitting is complete, the patient can sign their exam receipt, which must include wording indicating that their prescription was received.
- Patients can sign their prescription: The patient can sign the prescription, which must include language that it was given to the patient.
- Patients can esign: The patient can sign digitally to receive a copy of the prescription electronically. The FTC clarifies that consent to provide the prescription electronically can be through the standard intake form process.
In situations in which a patient is unwilling to sign, we should document this, and make sure to keep that documentation for our records. This documentation also should contain our signature and the date of the patient interaction.
There are a few scenarios in which we may be exempt from this mandate. Specifically, the FTC indicates “doctors who do not have a direct or indirect financial interest in the sale of contact lenses do not need to request that a patient acknowledge receipt of a contact lens prescription and need not maintain records associated with patient acknowledgments.” Examples of this would include military, VA hospitals or Public Health Service on tribal reservations.
PRESCRIBING TRIAL LENSES
As we know, not every contact lens prescription is finalized at the initial date of service. Unfortunately, this does not relieve us of this new rule. To ensure we remain compliant, we have these options:
- Email the prescription.
- Make it available via a patient portal.
- Sign the final version of the contact lens prescription when the patient arrives at the office to pick it up.
When sending emails, we must keep in mind another regulation, HIPAA. Remember, email communications containing health information are required to be sent securely or via encrypted email. If we do not have access to these options, that is OK, as the U.S. Department of Health and Human Services clarifies that, “covered entities are permitted to send individuals unencrypted emails if they have advised the individual of the risk, and the individual still prefers the unencrypted email.”
If we are going to be using non-HIPAA regulated email, it might be in our best interest to document that the patient understands the situation. A good place for this would be a patient intake form, according to the FTC. Patients could indicate on these forms how they would like to receive their contact lens prescription: On paper? Electronic? If electronic, non-HIPAA-regulated email or portal?
PRESCRIBING SPECIALTY LENSES
When prescribing GP, hybrid or even some specialty soft lenses, a lot goes into determining the final prescription. Unfortunately, The FTC clearly states there is not an exemption for these types of lenses. As noted in the initial rulemaking: “The Act thus does not permit the Commission by rule to grant an exception to the release requirement for custom-designed soft and rigid gas permeable lenses.”
This does make things a bit challenging because, whether fitting empirically or using diagnostic lenses, a lens needs to be ordered to finalize a prescription. The FTC clarifies that if a lens order is required to complete the fitting process, prescribers may charge for the lenses as part of the overall cost of the fitting process: ‘“Specialty” or custom-made lenses are sometimes necessary to complete the fitting process. To the extent these lenses are necessary to complete the fitting process, prescribers may charge patients for such lenses as part of the cost of the fitting process, and as such may condition the release of a contact lens prescription on payment of the fitting fee.”
OPTOMETRY CONTINUES TO FIGHT
While we must comply to this new mandate, the American Optometric Association (AOA) has fought and continues to fight on our behalf. Specifically, counter legislation called the Contact Lens Rule Modernization Act (S. 4613) has been introduced that would replace the signed patient acknowledgment with a requirement to post “conspicuous” signage in practices notifying patients of their right to a copy of their contact lens prescription, as is current law in California. (We can urge our representatives to co-sponsor the Contact Lens Rule Verification Modernization Act by visiting aoa.org/advocacy/federal/action-center .)
Final Rule for Sellers
The final Contact Lens Rule includes several new requirements that address the seller’s prescription verification practices. According to the FTC website, the following action steps and definitions for sellers include:
→ Record the entire call and preserve the recording.
→ Start the call by identifying it as a prescription-verification request made in accordance with the Contact Lens Rule.
→ Deliver the verification message in a slow and deliberate manner and at a volume that the prescriber can understand.
→ Make the message repeatable at the prescriber’s request.
→ Make prominently available a way for consumers to present their prescriptions to the sellers, and clearly disclose that method.
→ Defines “alteration” of a prescription, which is prohibited, to include a brand or manufacturer other than what is prescribed to the consumer. This information must be provided as part of the verification process. The exception being if the consumer inputs information other than what is on the prescription.
→ Clarifies that the only permissible substitution involves private label lenses; private label and brand name lenses can be substituted when they are identical lenses by the same manufacturer.
This information is available via the FTC website, at bit.ly/3oiioE8 , and via the Federal Register at bit.ly/3hJ4N6u .
As stated by current AOA President William T. Reynolds, O.D.: “For nearly five years, we’ve fought together against the Federal Trade Commission’s baseless and costly contact lens paperwork and record-retention mandate, which unfairly targets us, our patients, practices, staff and communities.”
This is not over. OM
*Excerpts of this article appeared in the January issue of Contact Lens Spectrum.
DR. COMPTON owns two private practices, Compton Eye Associates in the New York City area. He is the president/founder of TheRightContact.com , a contact lens resource used by eye care professionals. He reports no financial disclosures.
FAQs
Does 1800contacts really verify prescription? ›
Our staff of amazing people verify the Rx is valid and matches your order. Once that's verified, they give the OK for your order to be shipped. If you still have questions, feel free to reach out 24/7 via chat, email, or by calling 1-800-266-8228.
What is the FTC contact lens rule? ›The FTC's Contact Lens Rule ensures that patients receive a copy of their contact lens prescription when they complete a contact lens fitting with their eyecare professional.
How can I get contacts without an eye exam? ›+ Can you order contact lenses without a prescription? All contact lenses require a valid prescription as they are are classified as medical devices. Please only order contact lenses that have been prescribed by an eye doctor, even in the case of colored contacts.
How to buy contact lenses with an expired prescription? ›You can't legally order contacts with an expired prescription either. Contact lenses are classified as medical devices in the U.S., so your prescription needs to be current to have it filled. These guidelines apply to both physical locations and online retailers.
Why won't my eye doctor give me my PD? ›Lots of optometrists will give you a copy of your prescription but not include your PD. That's because they know that, armed with both, you can order your glasses online.
How do contact lens companies verify prescriptions? ›The verification process works like this: the patient gives information about her prescription (e.g., the manufacturer or brand, power, diameter) to the seller, who then submits it to the prescriber in a request to verify that information. Upon receiving the request, the prescriber has eight business hours to respond.
Does Costco verify contact lens prescription? ›To get your lenses faster, Costco recommends that you upload your prescription instead of having customer service call and verify it with your eye doctor's office. You can upload your prescription from the Costco.com page that I linked above.
What contact lens number is legally blind? ›Legal blindness is defined as 20/200 vision. 14 The prescription equivalent is -2.5. It is important to note that prescriptions for corrective lenses are different for each person, and measurements can be different for each eye.
What are the codes for contact lens exam? ›Contact Lens Examination
In addition to the basic eye examination, a contact lens fitting is reimbursable with CPT® codes 92071, 92072 and 92310 thru 92312 for recipients with medically necessary conditions.
To buy contacts online, you will need to obtain a prescription, locate the brand prescribed to you on your preferred website, enter your prescription information, choose the number of lenses you want to order, select your shipping option, and pay for your order.
Who Cannot have contact lenses? ›
Eye conditions, such as dry eye disease or blepharitis, may make wearing contacts uncomfortable and risky. A severe refractive error, allergies, or contact lens intolerance can also make wearing contact lenses difficult. Fortunately, some treatments can allow you to wear contacts comfortably.
How much is a contact lens exam? ›The cost for a contact lens exam varies, depending on certain conditions and where you go to get the exam. The NHS provides free eye tests for those who qualify. Otherwise, the average cost of a contact lens exam is £25.
How expired is too expired for contact lenses? ›Yes, all contact lenses have an expiration date, usually between one and four years from the date of manufacture. It's important not to use expired contacts, even if the package has never been opened.
Why can't I order contacts with an expired prescription? ›In the United States, the FTC (Federal Trade Commission) dictates the rules for the sales of contact lenses. All contact lens purchases must be verified (aka: have a valid prescription) before the lenses are sold.
How many years is a contact lens prescription typically valid for? ›Generally, contact lens prescriptions are valid from 1 to 2 years following the date of your last eye exam and contact lens fitting. Once your prescription expires, it's time for your contacts prescription renewal.
Can you order contacts without doctor's approval? ›Anyone selling you contact lenses must get your prescription and verify it with your doctor. They should request not only the prescription, but the name of your doctor and their phone number. If they don't ask for this information they are breaking federal law and could be selling you illegal contact lenses.
Can you wear fake contacts with prescription glasses? ›Yes! It may be surprising but you can wear contact lenses while wearing glasses. Not many people do, but it's more common now that people wear coloured contacts with glasses.
Do I need a current prescription to buy contacts online? ›How to buy contacts online. Buying contacts online can be easy. You'll need a current prescription with the brand prescribed to you. Once you find your brand of lenses, you will enter your prescription information, choose the number of boxes you want, and select your shipping preference.
How do I verify my eye prescription? ›Just remember that you can request your prescription details from the office where you last had an eye exam. They're required to share a copy with you. If you're looking for other options to find out your prescription based on existing glasses, there are other scanning apps like the one GlassesUSA offers.