An Rx for compliance with the Contact Lens Rule

April 7, 2016

Today, we’re turning the table on some healthcare professionals. Don’t worry. We’re not asking an anesthesiologist to count back from ten, or even telling an ENT to say “ah.” We’re offering an eye exam for eye doctors:

Unfortunately, some eye doctors and eye care professionals aren’t passing the exam. In fact, FTC staff recently sent more than 50 letters to contact lens prescribers and sellers, warning they are potentially breaking the agency’s Contact Lens Rule. The rule, and the Fairness to Contact Lens Consumers Act, require prescribers to provide a copy of the prescription to the patient at the end of the contact lens fitting, even if the patient doesn’t request it.

Here’s what should be in the prescription:

  • The patient’s name
  • The date of the exam
  • When the prescription was issued, and when it expires
  • The name, postal address, and phone number of the eye care prescriber (it’s a good idea to include your fax number, too)
  • The power, material and/or manufacturer of the prescribed lens
  • The base curve or appropriate designation of the lens
  • The diameter of the lens, when appropriate

If you’re prescribing private label lenses, the prescription should include the name of the manufacturer, the brand name, and the equivalent brand name, if that applies.

Specific no-no’s under the rule include requiring a patient to buy lenses, pay a fee, or sign a form or waiver before providing or verifying a prescription. Those practices were cited in the FTC’s warning letters as potential rule violations. Breaking the rule could result in civil penalties of up to $16,000 per violation.

You have to give the prescription at the end of the fitting, but doctors often point out that a contact lens fitting may take more than one session. So how do you know when it’s over? If you’re ready to sell the patient contacts, the fitting is over and the patient should have the prescription.

Of course, it’s fine to charge for an eye exam or contact lens fitting. However, the only way you can require a patient to pay for the eye exam or fitting before giving a copy of the prescription is if you require immediate payment from all eye exam patients.

By the way, here’s the answer to a common question: HIPAA does not prohibit the release of a contact lens prescription to a patient.

The rule offers guidance for sellers, too. Sellers may provide contact lenses to a buyer only after either obtaining a copy of a valid prescription or, alternatively, verifying the prescription with the prescriber. Sellers may not dispense lenses using an expired prescription, and may only substitute lenses under certain conditions specified in the rule.

If you have more questions, check out The Contact Lens Rule: A Guide for Prescribers and Sellers and Complying with the Contact Lens Rule. We also have information for consumers about Prescription Glasses and Contact Lenses.

 

Comments

It seems that Optometrists and Ophthalmologists have now started to charge $70 or more for a contact lens "fitting" over and above the exam copay, Even if the individual being seen is already wearing contact lenses. I've worn contact lenses for over 20 years (10 years wearing Accuvue and 10 years wearing CIBA Night & Day) The Rx is just being updated, twice the lens strength wasn't even changing, but they still insist on a "fitting fee" I believe this is waste and a way to get money in addition to insurance payment and copays. Often vision insurance indicates it pays for a contact lens exam but the prescribers allege that the copay is only for the exam and does not include a "fitting" my complaint is I don't need fit, I've been fit for 20 years now I just need a new Rx without paying $70+ over my $15 vision insurance copay! Sorry, but this is something that when you don't have a lot of money to start with and insurance is supposed to cover a contact lens exam just feels like consumers are being given one line from the insurance and another from the prescriber and both are taking our hard earned money.

I had a contact eye exam on Monday 4/25/16. I was told I could not have my prescription until the lenses were fitted however, they did not have loaners in stock. It is now Friday, 4/29/16 and I have just picked up my sample supply. I was told I had to wait a full week before the doctor would see me. So, I scheduled an appointment on my lunch hour next Friday. If I choose to order with them, it will be another week or two before my order is in. When it is all said and done, I will have made four visits to their office. This is absurd! I have worn contacts for years, my prescription has not changed nor am I switching brands. I tried to avoid the whole uh-oh I am down to my last pair of contacts scenario but, with all these hoops, that will not be the case. I did pay for my exam at the end as well. What can I do?

All this trouble is bring caused by increased regulation. I order to get contacts my daughter will have to make 3 visits to the doctor. That is 3 missed days if school. Please stop pretending to protect consumers. The only ones being protected are the companies charging the consumer more on top of the increased time to get something that used to be hassle free.

I had my eye exam in dec. due to work, I missed my follow up appt to check the lenses they gave me. Now, I am being told that due to HIPPA, they can’t give me my prescription until I have another exam because it has been 90 days. I know HIPPA has nothing to die with this, but seems like they just want to charge me for a new exam

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