PRINTER'S NO. 374
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
391
Session of
2019
INTRODUCED BY GORDNER, SCARNATI, FOLMER, BAKER, WHITE,
HUTCHINSON AND YUDICHAK, MARCH 5, 2019
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
MARCH 5, 2019
AN ACT
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; and providing
for insurance billing codes.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. 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:
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
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
professional competence. The term shall encompass the use of
pharmaceutical agents approved by the Food and Drug
Administration and published in the Code of Federal Regulations
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.
* * *
"Optometrist." Any person who, following formal and
recognized training in the art and science of optometry has
received a doctor of optometry degree from an accredited
institution and is qualified to seek or has acquired a license
to practice the profession of optometry. 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
and all kinds and types of lenses including contact lenses.],
including all conditions of the human eye and adnexa
20190SB0391PN0374 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
applicable to this act . The term shall include:
(i) The examination for, and adapting and fitting
of, any and all kinds and types of lenses, including
contact lenses.
(ii) The administration and prescription of all
legend and nonlegend drugs, by any means, methods or
delivery systems, approved by the board in section 4.3
for the treatment of diseases and conditions affecting
the eye and adnexa, including codeine and hydrocodone
combinations which were reclassified from Schedule III to
Schedule II prior to the effective date of this
subparagraph. 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.
(iv) The draining of superficial cysts.
(v) Epinephrine auto-injectors for anaphylaxis.
(vi) The ordering and interpretation of angiography
via noninvasive imaging, including, but not limited to,
light wave imaging and other imaging tests.
(vii) The treatment of glaucoma.
[(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
this paragraph shall not continue beyond six weeks from the
initiation of treatment unless the prescribing optometrist
20190SB0391PN0374 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
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:
(i) Surgery with a scalpel or scissors, refractive
or therapeutic surgery with a laser and surgery with a
CryoProbe.
(ii) Injection into the globe.
(iii) The use of Schedule I and Schedule II
controlled substances, except for the use of codeine and
hydrocodone combinations which were reclassified from
Schedule III to Schedule II prior to the effective date
of this subparagraph and any drugs approved by the board
in section 4.3 for the treatment of ocular disease.
* * *
Section 2. Sections 4.3 and 6(b) of the act are amended to
read:
Section 4.3. Approval of drugs.
20190SB0391PN0374 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Drugs shall be approved as follows:
(1) All drugs currently approved by the Secretary of
Health and in use in the practice of optometry on the
effective date of this section shall be deemed approved under
this section.
[(2) Within 90 days of the effective date of this
section, the board shall submit a list of drugs authorized
under this act to the Secretary of Health, who, in
consultation with the Physician General, shall approve or
disapprove for good cause each drug. Upon failure of the
Secretary of Health to act within 90 days of receipt of the
list of drugs, the drugs shall be deemed approved for use
under this act.
(3) The State Board of Optometry shall provide the
Secretary of Health with lists of additional drugs for use
under this act after such drugs are approved by the Food and
Drug Administration, as published in the Code of Federal
Regulations. The Secretary of Health, in consultation with
the Physician General, shall approve or disapprove for good
cause any such drug within 90 days of the receipt of the
list. Upon failure of the Secretary of Health to act within
90 days, the drugs shall be deemed approved for use under
this act.]
(4) On and after the effective date of this paragraph,
the board may approve drugs for use in the practice of
optometry after the drugs are approved by the Food and Drug
Administration, as published in the Code of Federal
Regulations.
Section 6. Exemptions and exceptions.
* * *
20190SB0391PN0374 - 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(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. Nothing contained in this act shall be construed
to entitle an extern to practice optometry.
* * *
Section 3. Section 8(a) of the act is amended by adding a
paragraph to read:
Section 8. Violations and penalties.
(a) * * *
(4) It is unlawful for an optometrist to advertise a
service prohibited under this act. A person convicted of
violating this paragraph commits a summary offense and shall,
for a first offense, be subject to a fine of not more than
$500. For a second or subsequent violation, the board may
impose a suspension of the person's license for up to 30
days, in addition to the fine.
* * *
Section 4. The act is amended by adding a section to read:
Section 10.1. Insurance billing codes.
An insurance billing code may not be used to define or
interpret a procedure performed by an optometrist as surgery.
Section 5. This act shall take effect in 60 days.
20190SB0391PN0374 - 6 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24