Indiana navigates telehealth bill, exempts ophthalmic devices

Legislation granting providers' telemedical prescribing clears the Indiana General Assembly with provisions protecting patients against ophthalmic device prescriptions, an allowance that online "vision tests" could have exploited.

Currently awaiting Gov. Mike Pence's signature, H.B. 1263 would permit providers with prescriptive authority the ability to write patients prescriptions for non-controlled substances via telemedical counseling after first establishing a provider-patient relationship. If enacted, the legislation would reportedly place Indiana among the leaders in telemedicine access for prescription services.

Originally introduced on behalf of major insurance companies, the bill gained sweeping support for its stated intent to provide telemedical services for the most common conditions that typically backlog doctors' offices, such as colds, urinary tract infections or conjunctivitis. However, the bill's language raised flags with the Indiana Optometric Association (IOA).

"The bill was intended to be for the prescribing of medications through telemedicine, but it was written so broadly that it would allow for the prescribing of devices, including glasses, contact lenses and low-vision devices," says Jim Zieba IOA executive director.  When efforts to amend the bill to exclude ophthalmic devices failed in committee, " we went to our grassroots, and it worked out perfectly. It was a scenario where literally every discussion on the House floor then dealt with optometry's concerns because our grassroots mobilized so well."

Marjorie Knotts, O.D., IOA Legislative Committee chair, says immediately a House member introduced an amendment to remove vision services from the bill, and though not necessarily their intent, it worked to get IOA-backed language introduced into the bill. Additionally, this move gained the interest of the American Academy of Ophthalmology who—not wanting to be left out—ultimately supported the new language.

Through this effort, not only did IOA's members successfully ensure that ophthalmic devices cannot be prescribed through telemedicine, but they also ensured optometry could diagnose and treat using telemedicine should the bill pass, Dr. Knotts says.

"We accomplished both of our objectives, and learned that our strong grassroots organization really works," Dr. Knotts says.

Adds Zieba: "This really shows how grassroots support can work. People may think legislators don't listen, but they really do—people just have to make that phone call."