2020 -- H 7767

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LC004222

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2020

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A N   A C T

RELATING TO HEALTH AND SAFETY -- CONSUMER PROTECTION IN EYE CARE ACT

     

     Introduced By: Representatives Jacquard, Lima, and McNamara

     Date Introduced: February 26, 2020

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 95

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THE CONSUMER PROTECTION EYE CARE ACT

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     23-95-1. Short Title.

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     This act shall be known and may be cited as the “Consumer Protection in Eye Care Act.”

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     23-95-2. Definitions.

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     (a) As used in this chapter:

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     (1) “Assessment mechanism” means automated or virtual equipment, application, or

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technology designed to be used on a telephone, a computer, or an Internet-accessible device that

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may be used either in person or remotely to conduct an eye assessment, and includes artificial

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intelligence devices and any equipment, electronic or nonelectronic, that is used to perform an

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eye assessment.

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     (2) “Contact lens” means any lens placed directly on the surface of the eye, regardless of

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whether or not it is intended to correct a visual defect, including any cosmetic, therapeutic, or

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corrective lens.

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     (3) “Eye assessment” means an assessment of the ocular health and visual status of a

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patient that may include, but is not limited to, objective refractive data or information generated

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by an automated testing device, including an autorefractor, in order to establish a medical

 

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diagnosis for the correction of vision disorders.

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     (4) “Person” means an individual, corporation, trust, partnership, incorporated or

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unincorporated association, and any other legal entity.

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     (5) “Prescription” means a handwritten or electronic order issued by a provider, or an oral

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order issued directly by a provider.

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     (6) “Provider” is a health care professional licensed under chapter 35.1 or 37 of title 5.

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     (7) “Seller” means an individual or entity that sells contact lenses or visual aid glasses

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and dispenses them in Rhode Island in any manner.

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     (8) “Visual aid glasses” means eyeglasses, spectacles, or lenses designed or used to

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correct visual defects, including spectacles that may be adjusted by the wearer to achieve

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different types or levels of visual correction or enhancement. Visual aid glasses do not include

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optical instrument or devices that are:

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     (i) Not intended to correct or enhance vision;

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     (ii) Sold without consideration of the visual status of the individual who will use the

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optical instrument or device, including nonprescription sunglasses, plano lenses that are clear,

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colored or tinted, or lenses that are designed and used solely to filter out light; or

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     (iii) Completely assembled eyeglasses or spectacles designed and used solely to magnify.

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     23-95-3. Prescriptions - Content; release.

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     (a) A contact lens prescription shall include the following:

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     (1) The ophthalmic information necessary to accurately fabricate or dispense the lenses,

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including the lens manufacturer, lens series, and the lens material if applicable;

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     (2) Power and base curve;

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     (3) Name, license number, telephone number, and for written orders, the signature of the

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prescribing provider;

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     (4) Patient’s name and address, expiration date of the prescription, and number of refills

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or lenses permitted; and

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     (5) The date of issuance.

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     (b) A contact lens prescription may also include the diameter, axis, add power, cylinder,

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peripheral curve, optical zone and center thickness.

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     (c) A prescription for visual aid glasses shall include the following:

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     (1) The name, license number, telephone number, and for written orders, the signature of

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the prescribing provider;

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     (2) The patient’s name;

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     (3) The date of issuance; and

 

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     (4) The value of all parameters the provider has deemed necessary to dispense corrective

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lenses appropriate for a patient.

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     (d) A provider shall not refuse to release a prescription for contact lenses or visual aid

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glasses to a patient.

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     23-95-4. Verification of contact lens prescriptions.

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     (a) All contact lens sellers and any person authorized under the general laws to dispense

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contact lenses in the state shall verify the contact lens prescription by the following:

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     (1) Receipt of a written or faxed valid contact lens prescription signed by the prescribing

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provider; or

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     (2) An electronic or oral affirmative communication of the complete contact lens

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prescription from the prescribing provider.

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     (b) If a contact lens seller or any person authorized to dispense contact lenses in the state

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finds it necessary to contact the prescribing provider via telephone in order to verify a contact

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lens prescription, the following protocols shall be followed:

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     (1) Calls shall be made during regular business hours;

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     (2) Any verification requests shall include the name, address, and telephone number of

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the patient;

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     (3) The toll-free telephone number as required by § 23-95-7(a)(7) shall be included in

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voice mail or messages left on answering machines;

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     (4) Contact lens prescriptions shall not be mailed, sent, delivered, or dispensed before

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verification by the provider;

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     (5) Touch-tone telephone options offered by a contact lens seller or any person

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authorized to dispense contact lenses in the state shall not constitute verification; and

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     (6) Response-time options stated by a contact lens seller or any person authorized to

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dispense contact lenses in the state shall not constitute verification.

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     (c) In the absence of a prescription as defined and described in this chapter, it shall be a

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violation of this chapter to dispense contact lenses in Rhode Island in any manner.

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     23-95-5. Dispensing.

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     (a) Any contact lens seller or any person authorized to dispense contact lenses or visual

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aid glasses in the state who fills a prescription bears the full responsibility for the accurate

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dispensing of the contact lenses or visual aid glasses provided under the prescription. At no time

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shall any changes or substitutions be made including brand, type of lenses, or ophthalmic

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parameters without the direction of the provider who issued the contact lens or visual aid glasses

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prescription.

 

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     (b) The provider shall not be liable for any damages for injury resulting from the

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packaging, manufacturing, or dispensing of the contact lenses or visual aid glasses.

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     23-95-6. Prerequisites for writing contact lens prescriptions.

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     (a) A contact lens fitting shall be complete and a contact lens prescription may be written

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when:

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     (1) The provider has completed all measurements, tests, and examinations necessary to

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satisfy his or her professional judgment that the patient is a viable candidate to wear contact

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lenses, recognizing that more than one visit between the patient and the provider may be required;

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and

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     (2) Contact lenses suitable for the patient’s eyes have been evaluated and fitted by the

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provider to the patient’s eyes and the provider is satisfied with the fitting based on ocular health

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and the visual needs of the patient.

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     (b) The patient shall be entitled to receive a copy of the contact lens prescription until its

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expiration date.

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     23-95-7. Registration of nonresident contact lens sellers.

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     (a) The department of health shall require and provide for the annual registration of all

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contact lens sellers located outside of the state that dispense contact lenses in Rhode Island

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including those providing contact lenses via the Internet. A contact lens seller's registration shall

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be granted upon the disclosure and certification by the seller of all of the following:

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     (1) The seller is licensed or registered to distribute contact lenses in the state in which the

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dispensing facility is located and from which the contact lenses are dispensed;

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     (2) The location, names, and titles of all owners, partners, corporate officers, and the

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person who is responsible for overseeing the dispensing of contact lenses to persons in this state;

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     (3) The seller has complied with and shall continue to comply with all lawful directives

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and appropriate requests for information from the appropriate agency of each state in which the

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seller is licensed or registered;

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     (4) The seller shall respond to all requests for information from the department of health

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within thirty (30) days from receipt of the request;

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     (5) The seller shall maintain records of contact lenses dispensed to persons in this state

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for a period of ten (10) years, and that the records shall be readily available for inspection by the

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department of health upon demand;

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     (6) The seller shall provide a toll-free telephone service during its regular hours of

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operation for the sole purpose of responding to the patients in this state concerning questions and

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complaints. All questions relating to eye care shall be referred to the doctor prescribing the

 

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contact lenses;

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     (7) The seller shall provide a toll-free telephone service during its regular hours of

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operation solely for providers.

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     (8) The seller shall provide the following or a substantially equivalent written notification

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to the patient whenever contact lenses are supplied: WARNING: IF YOU ARE HAVING ANY

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OF THE FOLLOWING SYMPTOMS REMOVE YOUR CONTACT LENSES IMMEDIATELY

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AND CONSULT YOUR EYE CARE PRACTITIONER BEFORE WEARING YOUR LENSES

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AGAIN: UNEXPLAINED EYE DISCOMFORT, WATERING, VISION CHANGE, OR

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REDNESS; and

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     (9) The seller's license or registration, in the state in which the seller is licensed or

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registered, has not been suspended or revoked, but should the seller be the subject of any

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investigation undertaken by the licensing or registering state, or should the seller's license or

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registration be suspended or revoked, then the seller shall immediately notify the department of

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health of such actions.

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     23-95-8. Assessment Mechanisms.

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     (a) An assessment mechanism to conduct an eye assessment or to generate a prescription

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for contact lenses or visual aid glasses in Rhode Island shall:

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     (1) Provide synchronous or asynchronous interaction between the patient and the

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provider;

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     (2) Collect the patient’s medical history, previous prescription for corrective eyewear,

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and length of time since the patient’s most recent in-person comprehensive eye health

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examination;

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     (3) Provide any applicable accommodation required by the federal Americans with

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Disabilities Act, 42 U.S.C. sec. 12101 et seq., as amended;

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     (4) Gather and transmit protected health information in compliance with the federal

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Health Insurance Portability and Accountability Act of 1996 as amended;

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     (5) Be used to perform a procedure with a recognized Current Procedural Terminology

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code maintained by the American Medical Association, if applicable; and

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     (6) Maintain liability insurance, through its owner or lessee, in an amount adequate to

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cover claims made by individuals diagnosed or treated based on information and data, including

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any photographs and scans, generated by the assessment mechanism.

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     (b) A provider shall:

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     (1) Read and interpret the diagnostic information and data, including any photographs

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and scans, gathered by the assessment mechanism;

 

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     (2) Verify the identity of the patient requesting treatment via the assessment mechanism;

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     (3) Create and maintain a medical record for each patient, which is for use during the

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ongoing treatment of a patient, and complies with all state and federal laws regarding

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maintenance and accessibility;

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     (4) Provide a handwritten or electronic signature, along with their Rhode Island state

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license number, certifying their diagnosis, evaluation, treatment, prescription, or consultation

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recommendations of the patient;

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     (5) Utilize an assessment mechanism for an eye assessment or to generate a prescription

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for visual aid glasses only if:

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     (i) The patient is at least eighteen (18) years of age; and

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     (ii) The patient has received an in-person comprehensive eye examination by a provider

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within the previous twenty-four (24) months.

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     (6) Utilize an assessment mechanism to generate a prescription for contact lenses only if:

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     (i) The patient is at least eighteen (18) years of age; and

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     (ii) The patient has received an in-person comprehensive eye health examination by a

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provider:

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     (A) For the initial prescription and one follow-up or first renewal of the initial

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prescription; or

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     (B) Within twenty-four (24) months after the follow-up or first renewal of the initial

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prescription, and every twenty-four (24) months thereafter.

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     (c) Prior to using an assessment mechanism, each Rhode Island patient shall be provided

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with and shall accept as a term of use a disclosure that includes the following information:

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     (1) This assessment is not a replacement for an in-person comprehensive eye health

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examination;

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     (2) This assessment cannot be used to generate an initial prescription for contact lenses or

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a follow-up or first renewal of the initial prescription;

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     (3) This assessment may only be used if the patient has had an in-person comprehensive

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eye health examination within the previous twenty-four (24) months if the patient is conducting

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an eye assessment or receiving a prescription for visual aid glasses; and

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     (4) The United States Centers for Disease Control and Prevention (CDC) advises contact

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lens wearers to visit an eye doctor one time a year or more often if needed.

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     (d) Evaluation, treatment, and consultation recommendations by a provider utilizing an

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assessment mechanism as requested in this chapter, including issuing a prescription via electronic

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means, shall be held to the same standards of appropriate practice as those in traditional in-person

 

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clinical settings.

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     (e) This section shall not:

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     (1) Limit the discretion of a provider to direct a patient to utilize any tele-health service

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deemed appropriate for any treatment and care of the patient;

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     (2) Limit the sharing of patient information, in whatever form, between providers; or

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     (3) Apply beyond ocular health and eye care.

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     23-95-9. Fees.

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     The department of health shall charge a fee for investigation and registration of

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nonresident dispensers of contact lenses and visual aid glasses.

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     23-95-10. Penalties.

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     (a) Any person who dispenses, offers to dispense, or attempts to dispense contact lenses

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or visual aid glasses in violation of this chapter or the rules or regulations promulgated by the

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department of health concerning the dispensing of contact lenses or visual aid glasses shall, in

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addition to any other penalty provided by law, pay a civil penalty to the department of health in

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an amount not to exceed ten thousand dollars ($10,000) for each violation.

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     (b) Any person charged in a complaint filed by the department of health with violating

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any of the provisions of this chapter shall be entitled to an administrative hearing conducted in

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accordance with § 42-35-1, et seq.

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     (c) Any person aggrieved by a final order issued under the authority of this chapter shall

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have the right of an appeal by filing a petition in the state superior court.

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     (d) Nothing in this chapter shall restrict the department of health from enforcing

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disciplinary action against a provider pursuant to chapters 35.1 and 37 of title 5, and any rules or

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regulations promulgated thereunder.

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     23-95-11. Rules and Regulations.

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     The department of health may adopt and promulgate reasonable rules and regulations to

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carry out the provisions of this chapter.

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     23-95-12. Severability.

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     If any provision of this chapter, or of any rule or regulation made under this chapter, or

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the application of this chapter to any person or circumstances is held invalid by a court of

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competent jurisdiction, the remainder of the chapter, rule, or regulation, and the application of

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this provision to other persons or circumstances, shall not be affected.

 

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     SECTION 2. This act shall take effect upon passage.

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LC004222

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- CONSUMER PROTECTION IN EYE CARE ACT

***

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     This act would create the Consumer Protection in Eye Care Act which establishes

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standards for eyeglass prescriptions, verification of contact lens prescriptions, dispensing of

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contact lenses and glasses, prerequisites for writing prescriptions, registration of nonresident

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contact lens sellers, and assessment mechanisms to conduct an eye assessment test.

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     This act would take effect upon passage.

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