AOA: Patient safety paramount in contact lens legislation

Arizona successfully fended off anti-unilateral pricing policy (UPP) legislation, but optometry's ability to treat patients in the state continues to come under fire as AOA makes a stand.

Introduced, in part, by state Rep. Heather Carter on Feb. 2, 2015, Arizona S.B. 1444 sought to eliminate UPP and allow for contact lens substitution in a piece of legislation that included possible loopholes and violations of the Fairness to Contact Lens Consumers Act (FCLCA).

Annette Hanian, O.D., Arizona Optometric Association (AZOA) Legislation Committee chair, says once amendments were made to protect patients and reinforce FCLCA guidelines, the bill was pulled and reintroduced in the House without those amendments. The bill ultimately stagnated in committee and died with conclusion of the legislative session.

Nonetheless, Rep. Carter created an Ad Hoc study committee to explore all aspects of the contact lens market in Arizona. This committee was comprised of supporters of the UPP bill—including 1-800 CONTACTS, Costco and others—as well as those against the bill—AZOA and Johnson & Johnson. The committee reviewed laws and trends, including optometry's scope of practice, components of an eye exam, the FCLCA, Federal Trade Commission investigations, brands of contact lenses and online or mobile refractive services.

"The original premise for the committee, that there is a lack of affordable and available eye care, was never discussed or proven to be viable," Dr. Hanian says. "The committee seems to be trying to find a problem to fix."

Although the committee did not formally reach any decisions, at its conclusion, Dr. Hanian expects possible legislation in the next session (January 2016) to address areas including:

1. Eliminating expiration dates on contact lens prescriptions.
2. Eliminating notation of brands on contact lens prescriptions.
3. Preventing doctors of optometry from selling the products they prescribe.
4. Legitimizing prescriptions generated from online refraction and vision kiosks without the necessity for a health assessment from an eye care provider.

"These measures would cause enormous harm to the public and delay treatment to a point that would be much harder to treat and require more extensive care," Dr. Hanian says. "Enforcement of the current FCLCA rules that are being violated by online retailers would go a long way to protect our patients' ocular health."

Lilien Vogl, O.D., AZOA president, commends the work Dr. Hanian has done to educate those on the committee about optometry and protect the right of Arizona citizens to receive great vision and health care.

"Unfortunately there is considerable pressure by some motivated by self-interest and by some of our elected officials to consider 'care' that is unproven or may not be in the best interests of the uninformed public," Dr. Vogl says.

UPP legislation, then and now

In every state in which 1-800 CONTACTS-backed legislation has been introduced, the AOA has taken a firm stand for patient safety and safeguarding the doctor-patient relationship, and holding unscrupulous Internet contact lens sellers accountable for illegal sales and deceptive tactics. Overall, in 2015, anti-UPP legislation was defeated by determined advocacy responses by state associations in seven targeted states—Arizona, Florida, Idaho, Louisiana, Mississippi, Tennessee and Washington.

Several states have anti-UPP legislation pending—California, Illinois, Minnesota, New York, Oregon and Rhode Island—and more states could see further action as 2016 nears. But the AOA stands ready to help affiliates battle such harmful legislation.

The goal of optometry, on this issue, is to protect the profession's role in guiding proper contact lens usage. Doctors of optometry play a critical role in helping their patients avoid issues that might arise from improper contact lens care. Steven A. Loomis, O.D., AOA president, says this fight against UPP legislation goes beyond a simple debate about pricing on contact lenses—it's about patients.

"While opponents attempt to reduce the issue to the cheapest way to acquire a commodity, the truth of the matter is that only the AOA and state associations are actually advocating for patient care," Dr. Loomis says. "Contact lenses are regulated medical devices for a reason; they physically rest on the human cornea and affect that delicate ocular tissue in myriad ways. Unfortunately, those behind these misguided proposals are seeking to draw the focus away from where it should be—on contact lenses as a medical device. That's why the AOA and state associations are working every day to educate and inform policy makers and make patient health and safety the highest priority, and that's exactly what we'll continue doing."