Contact lens safety legislation proposes banning robocalls

Calls to ban problematic, automated robocalls for contact lens prescription verifications prompted federal legislation aimed at restoring commonsense health and safety protections in the marketplace.

Introduced April 20 in the U.S. House by Reps. Michael Burgess, M.D., R-Texas, and Lisa Blunt Rochester, D-Del., H.R. 2748, the Contact Lens Prescription Modernization Act, would ensure a safer, simpler contact lens prescription verification process for the millions of contact lens-wearing Americans by prohibiting online retailers’ use of automated robocalls to verify prescriptions. The legislation, jointly backed by the AOA and Health Care Alliance for Patient Safety, is a priority issue for optometry’s advocates heading to Washington, D.C., in June, for the AOA’s single-largest federal advocacy event, AOA on Capitol Hill.

“I would like to thank Reps. Burgess and Blunt Rochester for reintroducing this important legislation,” says David Cockrell, O.D., chair of the Health Care Alliance for Patient Safety, a collaboration of patient safety advocates, eye doctors and contact lens manufacturers who advocate for eye health and safety, as well as elevating the doctor-patient relationship.

“This is a major step to protect contact lens patients from potentially harmful practices currently utilized in the contact lens marketplace.”

The Contact Lens Prescription Modernization Act would address patient safety concerns brought about by online retailers’ use of automated robocalls and manipulation of verification requirements outlined by the Contact Lens Rule and under the Fairness to Contact Lens Consumers Act (FCLCA). The legislation would establish a paper trail by requiring retailers to use direct communication, such as email, live phone calls or fax, to confirm prescription accuracy. Further, the bill requires retailers to offer a HIPAA-compliant method for allowing patients to upload an electronic copy of their prescription thereby deprioritizing the use of verification robocalls.

In a joint statement, the members of Congress note a need to overhaul the verification system in a way that ensures Americans receive accurate prescriptions without compromising their personal medical information.

“Today, Americans know the benefits and expect the convenience of modern technology,” Rep. Burgess notes. “Patients deserve the choice to safely purchase contact lenses without the risk of receiving the incorrect prescription. Unfortunately, online contact lens sellers are still allowed to verify prescriptions using an automated voice message or robocall. This can result in incorrect prescriptions and sometimes permanent eye damage or blindness. The Contact Lens Prescription Verification Modernization Act prohibits robocalls for contact lens prescription verifications and extends HIPAA protections to correspondence between a patient and an online seller. This bill will maintain consumers’ freedom while ensuring that physicians can safely verify their patients’ prescriptions.”

Adds Rep. Blunt Rochester: “Since coming to Congress, one of my top priorities in Congress has been ensuring that consumers are protected from malicious and intentionally deceptive business practices. Given the damage that unregulated and unprescribed contact lenses can cause, it only makes sense to ensure that there is proper oversight and protection for American consumers. The Contact Lens Prescription Verification Modernization Act will do just that.”

Introduced in both the 116th and 117th sessions of Congress, the Contact Lens Prescription Modernization Act has previously garnered bipartisan support and represents a long-term priority of both the AOA and Health Care Alliance for Patient Safety as a way to preserve the doctor-patient relationship and further reduce risks of preventable vision loss.

Problems with the current prescription verification system

Popular with more than 45 million Americans, contact lenses are a safe and effective vision-correction option when worn and cared for properly. However, poor-fitting or improperly used contact lenses can result in serious eye and vision harm, which is why the U.S. Food and Drug Administration (FDA) regulates contact lenses as Class II and III medical devices that require an eye doctor’s prescription and oversight. Both the FDA and Centers for Disease Control and Prevention (CDC) advise consumers that contact lenses are not “one size fits all” and that regular comprehensive eye examinations are necessary for ensuring optimal eye health.

Despite these health and safety concerns, some online contact lens retailers not only permit consumers to purchase these medical devices using expired prescriptions but also sell altogether different brands or types of contact lenses than were prescribed by the patient’s doctor. Although these kinds of practices are outlawed by the FCLCA and Contact Lens Rule, retailers commonly take advantage of the law’s interpretation to subvert its intent.

While the FCLCA clearly allows telephone, fax or email for prescription verification, the FTC interpreted the law to also permit robocalls. However, these automated calls to eye care providers are often difficult to understand, do not include all the necessary information for confirmation, and create barriers for doctors’ real-time feedback about prescription corrections. In some cases, doctors are unable to immediately provide critical health and safety feedback if a request is being made for an incorrect device or for an individual who is not a patient of the doctor.

Some retailers also use robocalls to take advantage of the current “passive verification” provision of the FCLCA and Contact Lens Rule that doctors have only an 8-hour window to respond before a prescription is automatically verified. By exploiting such loopholes, retailers push products not prescribed by the patient’s eye doctor.

In fact, a report from the AOA Health Policy Institute found that among doctors of optometry who provide contact lens services:

• 89% received prescription verification calls for invalid prescriptions
• 54% received prescription verification calls for an altogether wrong patient
• 43% received prescription verification calls for someone who wasn’t their patient

As many Americans choose to purchase their contact lenses through direct-to-consumer (DTC) internet mass retailers, the AOA and Health Care Alliance for Patient Safety continue to speak out against these patient safety problems.

Already, optometry’s advocates’ efforts to bring federal scrutiny down on unscrupulous retailers resulted in not only a $3.5 million penalty levied against a DTC contact lens seller by the FTC and Department of Justice but also Congressional inquiries on potential loopholes in regulatory oversight of DTC contact lens retailers.

Here’s how you can get involved

The AOA urges the profession’s support of the Contact Lens Prescription Modernization Act to close loopholes in the verification system and restore commonsense health and safety considerations. Here’s how you can help:

• Join optometry’s advocates for AOA on Capitol Hill.
  A cornerstone of the AOA’s federal advocacy efforts, AOA on Capitol Hill is taking place in conjunction with Optometry’s Meeting®, June 21-24, in Washington, D.C. This legislation and other key issues will be among the priorities championed by doctors of optometry and students across scores of meetings with members of Congress.
  
• Report illegal or unsafe contact lenses or business practices.
  Suspect an FCLCA or Contact Lens Rule violation? Use the link above to complete a form that helps the AOA better advocate for improved laws and regulations that better protect patients. Although the AOA is not a regulatory or enforcement agency, the AOA can help build a case with these federal entities.

Learn more about the Health Care Alliance for Patient Safety and sign up for their news and policy updates newsletter.