Contact Lens Prescriptions
Federal Law: The Fairness to Contact Lens Consumers Act, effective February 2004, applies to licensees of the Texas Optometry Board and governs the release of contact lens prescriptions. FTC 16 CFR Part 315 implements the Fairness to Contact Lens Consumers Act which requires that rules be issued to address the release, verification, and sale of contact lens prescriptions. This part specifically governs contact lens prescriptions and related issues.
State Law: The Contact Lens Prescription Act sets out the requirements for a contact lens prescription and release. Board Rule 279.2 incorporates these requirements by defining the requirements for a contact lens prescription, release and verification.
Questions: The 2014, 2011 and 2007 Newsletters answer the most frequent questions regarding contact lens prescription release.
Spectacle Prescriptions
Federal Law: FTC 16 Part 456 governs the availability of eyeglass prescriptions and related issues (the Ophthalmic Practice Rules (Eyeglass Rule)
State Law: Section 351.365 of the Texas Optometry Act sets out the requirements for the release of a prescription for spectacles. Board Rule 279.4 defines the requirements for a spectacle prescription.
Questions: See also discussion of the FTC Rule in the August 2002 Newsletter.
E-Prescribing
House Bill 2174 (86th R) requires Texas prescribers to electronically prescribe all controlled substances (Schedules II-V) unless an exception applies or a waiver is granted.
Topical Prescription Drugs (Therapeutic Optometrist)
Board Rule 280.5 sets out the requirements for the prescribing of topical prescription drugs. The rule also sets out the procedure to prohibit substitution of generic drugs (see subsection (b)).
Requirements for writing a prescription are found in Subsection (c).
Oral Prescription Drugs and Anti-Glaucomas (Optometric Glaucoma Specialist)
NOTE: See important information below concerning the Prescription Monitoring Program.
Controlled Substances: Prescriptions for Schedule III Controlled Substances must contain the following information:
- Quantity of the substance prescribed (written as both a number and as a word)
- Date of issue (can not be postdated)
- Name, address, and date of birth or age of the patient (if the patient is an animal, the species and the name and address of the owner)
- Name and strength of the controlled substance prescribed
- Directions for use of the controlled substance
- Intended use of the substance prescribed unless the practitioner determines the furnishing of this information is not in the best interest of the patient
- Printed or stamped name, address, Federal Drug Enforcement Administration (DEA) registration number, and telephone number of the practitioner’s usual place of business
- The signature of the prescribing practitioner, unless the prescription is called in to the pharmacy
Prescription Monitoring Program
State law imposes duties on health professionals, including Optometric Glaucoma Specialists, to combat the abuse of opioids. One duty is to query the Prescription Monitoring Program (PMP) before prescribing an analgesic that is a controlled substance (an Optometric Glaucoma Specialist may prescribe one three-day supply of any analgesic identified in Schedules III, IV, and V).
Licensees must register and query the PMP when prescribing an opioid. Only registered users can query. This requirement is set out in Board Rule 280.10
See the August 2019 Newsletter for detailed information.
MEDICAID: Tamper Resistant Requirements
Effective April 1, 2008, Medicaid requires all written prescriptions to be on tamper-resistant prescription pads. Prescriptions submitted via fax, e-prescribing, or telephone are exempt from the requirements, as are prescriptions in long-term care facilities and hospitals.
CMS’ guidance on the tamper-resistant law, set forth in an August 17, 2007 State Medicaid Director letter, contains two phases. For the first, a prescription must contain at least one of the three tamper-resistant characteristics in order to be considered “tamper resistant.” For the second, prescriptions must contain all three characteristics.
Tamper Resistant FAQ (pdf)
More information is available at http://www.cms.hhs.gov/center/intergovernmental.asp
DEA Controlled Substance Registration
A DEA Controlled Substance Registration is only required if the licensee prescribes or administers controlled substances. See Board Rules 280.5 and 280.10. To obtain a DEA number, apply to the DEA online. If you are currently licensed as an optometric glaucoma specialist, an authorized schedule is available.
There are fees and record keeping requirements involved. DEA Numbers should be protected from misuse.
Computerized Signatures
Computer generated signatures are permissible, but only if the guidelines in Board Rules 279.2, 279.4 and 280.5 are followed. The rules do not authorize the use of rubber stamped signatures. See page 7 of the August 2013 Newsletter.
