FTC, DOJ weigh in on Massachusetts’ glaucoma care expansion

February 25, 2016
Legislators considering bill to expand scope of practice.

Federal antitrust authorities encourage legislators in Massachusetts to consider expanding optometry's scope of practice, allowing for treatment of glaucoma.

Introduced by Rep. Patricia Haddad (D-5 th Dist. Bristol), H. 1973, referred to as "an act relative to the modernization of optometric patient care," could do just that in the last remaining state where doctors' of optometry legal scope of practice falls short of glaucoma care.

Currently under consideration, H. 1973 would allow doctors of optometry in Massachusetts to "utilize and prescribe topical and oral therapeutic pharmaceutical agents" to diagnose, prevent, correct, manage or treat the disease. If caught early enough, glaucoma—the second leading cause of blindness worldwide—not only can be managed to mitigate vision loss risk, but also at a lower cost to the patient.

In December 2015, Rep. Bradley Jones Jr. (R-20 th Dist. Middlesex)—who also introduced H. 1983, "an act relative to optometrists" to show bipartisan support for expanding doctors' of optometry scope of practice—requested both the U.S. Federal Trade Commission's (FTC's) Office of Policy Planning, Bureau of Competition and Bureau of Economics, and the Department of Justice's (DOJ's) Antitrust Division to comment on the possible competitive impact from such legislation.

In that joint response, released Feb. 18, 2016, the federal agencies noted how doctors of optometry "serve as a first line of defense" to "facilitate earlier diagnosis and less costly treatment of glaucoma," and excluding doctors of optometry from offering such glaucoma care "may limit price competition to serve these patients."

The response continues: "Under current law, however, Massachusetts prohibits optometrists from treating glaucoma. Unwarranted restrictions may be reducing patient access, raising costs and foreclosing opportunities for early treatment. For these reasons, we encourage the legislature to consider whether patient welfare can be appropriately served by loosening this restriction."

Michael Stokes, AOA general counsel, says it's notable that the federal government has decided to speak out so directly about this legislation.

"The expressed views of the Federal Trade Commission and the Department of Justice's Antitrust Division reflect a great deal of expertise, authoritative research and deliberation, and carry a great deal of weight in policy discussions," Stokes says.

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