WASHINGTON D.C. and ST. LOUIS—The Federal Trade Commission said on Dec. 9 that after previously requesting and receiving hundreds of public comments, based on its regular review of current rules, that it would now recommend implementation to several new elements of its Ophthalmic Practice Rules, also known as the Eyeglass Rule in the U.S. In its "Proposed 16 CFR 456 Ophthalmic Practice Rules Eyeglass Rule, Request for Public Comment," the FTC stated that its new proposal would "ensure ophthalmologists and optometrists provide patients with a copy of their prescription immediately after the completion of a refractive eye exam, get a signed statement from the patient confirming that they have received their prescription, and keep a record of that confirmation for at least three years."

The FTC said it made the proposal after considering more than 800 public comments. “This rule is made to protect consumer choice by empowering them to decide where they fill their eyeglass prescriptions, yet too many prescribers are failing to give patients their prescriptions automatically,” said Samuel Levine, director of the Bureau of Consumer Protection. “To remedy that and enforce the law we are proposing that prescribers now get a signed confirmation when they release prescriptions to their patients.”

Originally issued in 1978, the FTC’s Eyeglass Rule helps facilitate consumer choice and promote competition in the eyeglass market by requiring prescribers to provide patients with a copy of their eyeglass prescription immediately after an eye exam that includes a refraction, even if the patient does not request it. Under the rule, prescribers also cannot require that patients buy eyeglasses as a condition of providing them with a copy of their prescription, place a liability waiver on the prescription, require patients to sign a waiver, or require patients to pay an additional fee in exchange for a copy of their prescription.

Prescribers further cannot refuse to perform an eye exam unless the patient buys eyeglasses, contact lenses, or other ophthalmic goods from them. In response to consumer complaints over the past several years, the FTC has sent warning letters to prescribers, as VMAIL reported in December 2020, reminding them that they must provide patients with prescriptions at the end of an exam; cannot charge a fee or require eyeglass purchase for prescription release.

In total, the Commission said it is seeking comment on proposed measures that would:

  • Require prescribers to request that each patient sign an acknowledgement confirming they have received their eyeglass prescription, and to retain such confirmation for three years.

  • Allow prescribers, with a patient’s verifiable affirmative consent, to provide the patient with a digital copy of a prescription in lieu of a paper copy.

  • Clarify that a patient’s proof of insurance coverage will be deemed to be a payment for the purpose of determining when a prescription must be provided.

  • Change the term “eye examination” to “refractive eye examination” throughout the rule.
A link to a PDF of the FTC's full proposal is posted here.

The FTC said its notice includes a preliminary regulatory analysis concluding that despite some increased costs from the confirmation retention requirement, the overall burden of the rule on prescribers would remain relatively small in the context of the total market for eyeglasses and refractive examinations. The Commission also made a preliminary finding that the potential benefits of increasing the number of patients in possession of their eyeglass prescriptions are substantial. After the Commission reviews the comments received, it will decide whether to issue a final rule.

Just after the FTC's Dec. 9 communication, the American Optometric Association (AOA) sent a letter to its state leaders, signed by AOA president Robert C. Layman, D and president-elect Ronald L. Benner, OD. The letter stated, "independent doctors and small- to mid-sized health care practices deliver essential care and make our communities healthier every day. Despite this, we too often see—and have to work to defeat—proposals in Washington, D.C., to impose costly new burdens that threaten practices and quality care. Today’s Federal Trade Commission (FTC) public announcement marks the beginning of the government’s once-per-decade update of regulations connected to eye health and vision care.

"Already, the AOA’s concerns—we have been active on this for months—about harmful new mandates involving pupillary distance, prescription verification and duplicative paperwork have been accepted. These important wins must now be held. At the same time, we immediately see that the agency needs to hear more from our profession about our compliance with prescription release requirements.

"Together, with our affiliates and in close consultation with our supporters on Capitol Hill and federal health agencies, the AOA will ensure that doctors of optometry and our patients continue to be listened to and heeded. Stay tuned to aoa.org for updates on our efforts and contact president@aoa.org to join our advocacy movement."

The Commission vote approving publication of the notice in the Federal Register was 4-0. It will be published in the Register in early January 2023, after which consumers can submit comments electronically or in writing for 60 days for Commission consideration.