Bill Text: NY A06751 | 2017-2018 | General Assembly | Amended
Bill Title: Relates to the use of oral medications by optometrists.
Spectrum: Slight Partisan Bill (Democrat 64-27)
Status: (Introduced - Dead) 2018-04-18 - print number 6751a [A06751 Detail]
Download: New_York-2017-A06751-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 6751--A 2017-2018 Regular Sessions IN ASSEMBLY March 16, 2017 ___________ Introduced by M. of A. PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER, WEPRIN, HEVESI, RYAN, TITUS, STIRPE, SKOUFIS, BUCHWALD, DiPIETRO, BRABENEC, BLAKE, FAHY, ORTIZ, COLTON, WALTER, NORRIS, McDONALD, BARRETT, PHEFFER AMATO, DINOWITZ, OAKS, LALOR, ZEBROWSKI, STECK, JENNE, HUNTER, BRONSON, SOLAGES, PEOPLES-STOKES, DE LA ROSA, B. MILL- ER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICKENS, MAGNARELLI, PICHARDO, SANTABARBARA, GIGLIO, PELLEGRINO, D. ROSENTHAL, KIM, RODRI- GUEZ, ABBATE, JONES -- Multi-Sponsored by -- M. of A. BARCLAY, BLANK- ENBUSH, BUTLER, CAHILL, CROUCH, CUSICK, ERRIGO, FRIEND, GALEF, GOODELL, GOTTFRIED, HAWLEY, HIKIND, LENTOL, LUPARDO, MAGEE, PALMESANO, RIVERA, SKARTADOS, STEC, THIELE, WALSH, WOERNER, WRIGHT -- read once and referred to the Committee on Higher Education -- recommitted to the Committee on Higher Education in accordance with Assembly Rule 3, sec. 2 -- 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; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04288-12-7A. 6751--A 2 1 (v) antiviral agents; 2 (vi) hyperosmotic/hypertonic agents; 3 (vii) cycloplegics; 4 (viii) artificial tears and lubricants; and 5 (ix) immunosuppressive agents. 6 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education 7 law, as added by chapter 517 of the laws of 1995, is amended to read as 8 follows: 9 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 10 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 11 pharmaceutical agents for treatment of glaucoma and ocular hypertension 12 shall mean those drugs which shall be limited to topical application to 13 the surface of the eye and shall be limited to: 14 (i) beta blockers; 15 (ii) alpha agonists; 16 (iii) direct acting cholinergic agents; 17 (iv) prostaglandin analogs; and 18 (v) carbonic anhydrase inhibitors. 19 § 3. Subdivision 1 of section 7101-a of the education law is amended 20 by adding a new paragraph (g) to read as follows: 21 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 22 ceutical agents shall mean those orally administered drugs used for 23 therapeutic purposes solely for the treatment of diseases of the eye and 24 adnexa and shall be limited to: 25 (i) the following antibiotics, including, where applicable, the gener- 26 ic equivalent of any of the listed drugs: 27 (1) augmentin; 28 (2) keflex; 29 (3) azithromycin; 30 (4) bactrim; 31 (5) doxycycline; and 32 (6) tetracycline; 33 (ii) the following decongestants/anti-allergenic/antihistamines, 34 including the generic equivalents of the listed drugs: 35 (1) clarinex; 36 (2) xyzal; and 37 (3) singulair; 38 (iii) the following antiglaucoma agents, including the generic equiv- 39 alents of such agents, used for the management of acute increases in 40 intraocular pressure; provided, however, an optometrist may use or 41 prescribe a maximum of one twenty-four hour prescription and shall imme- 42 diately refer the patient to a licensed physician specializing in 43 diseases of the eye: 44 (1) diamox; and 45 (2) neptazane; 46 (iv) the following antiviral agents, including the generic equivalents 47 of such agents, used for herpes zoster ophthalmicus; provided an optome- 48 trist shall use or prescribe in maximum, seven-day prescriptions; 49 provided, however, if a patient is diagnosed with herpes zoster ophthal- 50 micus and has not already been examined by a primary care physician or 51 other appropriate physician for such viral condition, an optometrist 52 shall refer the patient to a licensed primary care physician, licensed 53 physician specializing in diseases of the eye, or other appropriate 54 physician within three days of such diagnosis: 55 (1) valacyclovir; and 56 (2) acyclovir; andA. 6751--A 3 1 (v) the following non-steroidal anti-inflammatory agents: 2 (1) cox-2 inhibitors; 3 (2) ibuprofen; and 4 (3) naproxen. 5 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 6 section 7101-a of the education law, as added by chapter 517 of the laws 7 of 1995, are amended to read as follows: 8 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 9 using or prescribing [phase one] topical therapeutic pharmaceutical 10 agents, each optometrist shall have completed at least three hundred 11 hours of clinical training in the diagnosis, treatment and management of 12 patients with ocular disease other than glaucoma and ocular hyperten- 13 sion, not fewer than twenty-five hours of such training shall have been 14 completed subsequent to June thirtieth, nineteen hundred ninety-three 15 and additionally shall either have taken and successfully passed the 16 treatment and management of ocular diseases portion of the National 17 Board of Examiners in Optometry test or have taken and successfully 18 passed an examination acceptable to the board. 19 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 20 law, as added by chapter 517 of the laws of 1995, is amended to read as 21 follows: 22 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 23 agents for treatment of glaucoma and ocular hypertension, an optometrist 24 must be certified for diagnostic and [phase one] topical therapeutic 25 agents and have completed an additional one hundred hours of clinical 26 training in the diagnosis, treatment and management of patients with 27 glaucoma and ocular hypertension, not fewer than twenty-five hours of 28 such training shall have been completed subsequent to July first, nine- 29 teen hundred ninety-four, and shall have taken and successfully passed 30 an oral or written examination acceptable by the board. 31 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 32 education law are relettered paragraphs (d) and (e) and a new paragraph 33 (c) is added to read as follows: 34 (c) Before using or prescribing oral therapeutic pharmaceutical 35 agents, an optometrist must be certified to prescribe diagnostic pharma- 36 ceutical agents and topical therapeutic and therapeutic pharmaceutical 37 agents for treatment of glaucoma and ocular hypertension, have completed 38 an oral therapeutic pharmaceutical agent certification course and have 39 passed an examination within five years of the department's approval of 40 the initial certification course or the initial examination, whichever 41 is later. 42 (i) The curriculum for the course shall include, but not be limited 43 to, instruction in pharmacology and drug interaction in treating ocular 44 disease and be taught through clinical case scenarios and emphasize 45 clinical decision making and shall be no less than forty hours, of which 46 no less than twenty-four hours shall be live instruction. 47 (ii) Such course shall qualify towards meeting the continuing educa- 48 tion per triennial registration requirement pursuant to subdivision 49 seven of this section. 50 (iii) The examination shall test the knowledge of materials in the 51 curriculum and reflect the provisions of paragraph (g) of subdivision 52 one of this section, and shall be acceptable to the department. If an 53 optometrist fails to pass the examination, such optometrist may retake 54 the examination; provided, however, that if an optometrist fails to pass 55 the examination after three attempts, such optometrist must again 56 complete the certification course in order to retake the examination. AnA. 6751--A 4 1 optometrist shall be required to complete the certification course after 2 each subsequent failure to pass the examination three times. If an opto- 3 metrist requires more time to pass the examination and to become certi- 4 fied than the five-year period provided for in this paragraph, such 5 optometrist may be authorized to retake the examination and to become 6 certified beyond such period upon application by the optometrist and a 7 showing of good cause as may be acceptable to the commissioner. 8 (iv) The initial, and any subsequent, curriculum and examination shall 9 be subject to review and approval by the department. 10 (v) The requirement for the oral therapeutic pharmaceutical agent 11 certification course and examination shall not apply to those optome- 12 trists who graduated from an accredited college of optometry subsequent 13 to January first, two thousand seven and have taken and successfully 14 passed the National Board of Examiners in Optometry test or an examina- 15 tion acceptable to the department. 16 § 7. Subdivision 5 of section 7101-a of the education law, as added by 17 chapter 517 of the laws of 1995, is amended to read as follows: 18 5. Suspension of certification. The department shall suspend the 19 certification for the use and prescribing of [phase one] topical thera- 20 peutic agents of any optometrist who fails to receive certification for 21 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 22 and ocular hypertension within three years of having been certified for 23 [phase one] topical therapeutic pharmaceutical agents. 24 § 8. The subdivision heading of subdivision 6 of section 7101-a of the 25 education law, as added by chapter 517 of the laws of 1995, is amended 26 to read as follows: 27 Consultation with use of certain topical therapeutic pharmaceutical 28 agents for treatment of glaucoma and ocular hypertension. 29 § 9. Subdivision 7 of section 7101-a of the education law, as added by 30 chapter 517 of the laws of 1995, is amended to read as follows: 31 7. Continuing education. Each optometrist certified to use [phase one32or phase two] topical therapeutic pharmaceutical agents and therapeutic 33 pharmaceutical agents for treatment of glaucoma and ocular hypertension, 34 shall complete a minimum of thirty-six hours of continuing education in 35 the area of ocular disease and pharmacology per triennial registration 36 period. [The education shall be in the area of ocular disease and phar-37macology and may include both didactic and clinical components.] Each 38 optometrist certified to use oral therapeutic pharmaceutical agents 39 shall, in addition to the minimum thirty-six hours of continuing educa- 40 tion provided for in this subdivision, complete an additional minimum of 41 thirty-nine hours of continuing education related to systemic disease 42 and therapeutic treatment per triennial registration period. Such educa- 43 tional programs may include both didactic and clinical components and 44 shall be approved in advance by the department and evidence of the 45 completion of this requirement shall be submitted with each application 46 for license renewal as required by section sixty-five hundred two of 47 this chapter. 48 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 49 subdivision 8 of section 7101-a of the education law, as added by chap- 50 ter 517 of the laws of 1995, are amended to read as follows: 51 Notice to patient with the use or prescription of topical therapeutic 52 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 53 ment of glaucoma and ocular hypertension. 54 (i) An optometrist prescribing topical steroids or antiviral medica- 55 tion shall inform each patient that in the event the condition does notA. 6751--A 5 1 improve within five days, a physician of the patient's choice will be 2 notified. 3 § 11. Subdivision 10 of section 7101-a of the education law, as added 4 by chapter 517 of the laws of 1995, is amended to read as follows: 5 10. Pharmaceutical agents. Optometrists who have been approved and 6 certified by the department shall be permitted to use the following 7 drugs: 8 (a) Diagnostic pharmaceuticals. 9 (b) Those optometrists having been certified for [phase one] topical 10 therapeutic pharmaceutical agents shall be authorized [(i) to use and11recommend all nonprescription medications appropriate for ocular disease12whether intended for topical or oral use; and (ii)] to use and prescribe 13 all [phase one] topical therapeutic pharmaceutical agents specified in 14 paragraph (e) of subdivision one of this section, which are FDA approved 15 and commercially available for topical use. 16 In the event an optometrist treats a patient with topical antiviral or 17 steroidal drugs and the patient's condition either fails to improve or 18 worsens within five days, the optometrist shall notify a physician 19 designated by the patient or, if none, by the treating optometrist. 20 (c) Those optometrists having been certified for [phase two] therapeu- 21 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 22 sion shall be authorized to use and prescribe [phase two] therapeutic 23 pharmaceutical agents for treatment of glaucoma and ocular hypertension 24 specified in paragraph (f) of subdivision one of this section, which are 25 FDA approved and commercially available. 26 (d) Those optometrists having been certified for oral therapeutic 27 pharmaceutical agents shall be authorized to use and prescribe oral 28 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 29 sion one of this section, which are FDA approved and commercially avail- 30 able and shall comply with all safety information and side-effect and 31 warning advisories contained in the most current physicians' desk refer- 32 ence. 33 (e) Those optometrists having been certified for topical therapeutic 34 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 35 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 36 agents shall be authorized to use and recommend all nonprescription 37 medications, whether intended for topical or oral use, appropriate for 38 the treatment of the eye and adnexa. 39 § 12. Subdivision 8 of section 7104 of the education law, as amended 40 by chapter 517 of the laws of 1995, is amended to read as follows: 41 (8) Fees: pay a fee of two hundred twenty dollars to the department 42 for admission to a department conducted examination and for an initial 43 license, a fee of one hundred fifteen dollars for each reexamination, a 44 fee of one hundred thirty-five dollars for an initial license for 45 persons not requiring admission to a department conducted examination, 46 [and] a fee of two hundred ten dollars for each triennial registration 47 period, [and] for additional authorization for the purpose of utilizing 48 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 49 certification to use or prescribe oral therapeutic pharmaceutical 50 agents, a fee of two hundred fifty dollars. 51 § 13. Oral therapeutic pharmaceutical agent implementation review. 1. 52 For purposes of this section, the term "commissioner" shall mean the 53 commissioner of the state education department; and the term "depart- 54 ment" shall mean the state education department. 55 2. Each optometrist certified to use oral therapeutic pharmaceutical 56 agents pursuant to paragraph (c) of subdivision four of section 7101-aA. 6751--A 6 1 of the education law shall provide the department with information, on a 2 form prescribed by the commissioner, related to the prescription or use 3 of oral therapeutic pharmaceutical agents provided for in section 7101-a 4 of the education law. Such information shall include the optometrist's 5 license number and the national provider identifier as established by 6 the centers for medicare and medicaid services, whether no oral 7 prescriptions have been issued and in the event that oral prescriptions 8 have been issued, then the following information shall be required: the 9 prescribed or used oral therapeutic pharmaceutical agent, the dosage of 10 such agent, the date of the prescription, the diagnosis of the patient 11 for which the agent was prescribed or used, and whether a referral was 12 made in accordance with paragraph (g) of subdivision one of section 13 7101-a of the education law. Such information shall not include any 14 patient identifying information and must otherwise be in compliance with 15 all state and federal requirements related to protected health informa- 16 tion. Each form shall be submitted by mail or electronic means to the 17 department on a quarterly basis. If a database of all oral therapeutic 18 pharmaceutical agents prescribed or used by optometrists is, or becomes, 19 available to the committee provided for in this act, then optometrists 20 shall be advised by the commissioner that quarterly reporting forms will 21 no longer be required. The requirements of this section shall remain in 22 effect for five years following approval by the department of the 23 initial oral therapeutic pharmaceutical agent certification course and 24 examination pursuant to paragraph (c) of subdivision four of section 25 7101-a of the education law, after which time these requirements shall 26 expire and no longer have effect. 27 3. The commissioner shall appoint a committee to advise and assist the 28 commissioner in evaluating compliance with the provisions of section 29 7101-a of the education law and to identify any necessary enhancements 30 to the curriculum provided for in such section and other educational 31 materials and to assist in ensuring patient safety. The committee shall 32 consist of one pharmacist, one optometrist upon the recommendation of a 33 statewide professional organization consisting of optometrists, one 34 ophthalmologist upon the recommendation of a statewide professional 35 organization consisting of ophthalmologists, and one expert in the field 36 of public health who shall be designated as chair by the commissioner in 37 consultation with the commissioner of the department of health and who 38 shall be neither an ophthalmologist nor an optometrist. 39 4. The commissioner shall submit each form received pursuant to this 40 section to the committee, except as otherwise provided in this subdivi- 41 sion. The committee shall review the forms and shall randomly cross- 42 check such submissions with a publicly available or other database 43 containing electronic prescriber information. Should a database of all 44 oral therapeutic pharmaceutical agents prescribed or used by optome- 45 trists pursuant to section 7101-a of the education law become available, 46 and the commissioner determines and advises optometrists that quarterly 47 reports are no longer necessary, then the committee shall review the 48 database and ascertain the prescribing information for all optometrists 49 consistent with section 7101-a of the education law. The committee 50 shall advise the commissioner as to compliance with the provisions of 51 section 7101-a of the education law for the purpose of evaluating 52 compliance with the provisions of section 7101-a of the education law 53 including the applicable referrals and dosing limitations and to identi- 54 fy any necessary enhancements to the curriculum provided for in para- 55 graph (c) of subdivision 4 of section 7101-a of the education law and 56 other educational materials and to assist in ensuring patient safety.A. 6751--A 7 1 Upon finding evidence of non-compliance by any optometrist, the commit- 2 tee shall refer such information to the commissioner and to the office 3 of professions within the department for investigation and, if applica- 4 ble, disciplinary action. Nothing in this subdivision is intended to 5 modify or otherwise limit the department's authority or discretion to 6 review, investigate and refer matters related to the professional 7 conduct of a licensed provider. 8 § 14. This act shall take effect eighteen months after it shall have 9 become a law; provided that: 10 (a) section thirteen of this act shall expire and be deemed repealed 11 five years following the approval by the department of education of the 12 initial certification course or the initial examination, whichever is 13 later, pursuant to paragraph (c) of subdivision 4 of section 7101-a of 14 the education law as added by section six of this act; 15 (b) the commissioner of education shall notify the legislative bill 16 drafting commission upon approval of the initial certification course 17 and examination required in section six of this act in order that the 18 commission may maintain an accurate and timely effective data base of 19 the official text of the laws of the state of New York in furtherance of 20 effectuating the provisions of section 44 of the legislative law and 21 section 70-b of the public officers law; and 22 (c) any rule or regulation necessary for the timely implementation of 23 this act on its effective date shall be promulgated on or before such 24 effective date.