Virginia Approves New Telemedicine Regulations for ‘Ophthalmic Prescriptions’

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RICHMOND, Va.—The state of Virginia in February approved legislation that amends the state code and clarifies and adds to the requirements for ophthalmic prescriptions, including via a telemedicine approach. The new legislation, which takes effect July 1, breaks new ground in the area of telemedicine and ophthalmic prescriptions in that it has drawn endorsement from parties that are typically on opposite sides of this increasingly divisive eyecare issue.

Notably, the legislation received support from the Virginia Optometric Association (VOA),  as well as online eye exam companies such as Opternative  and Simple Contacts, which are often on the opposite side of any debate with the more established entities in the optical business.

The new technology-driven companies see the regulation as opening the door to the use of telemedicine in creating ophthalmic prescriptions, even though the new requirements lay out a stringent set of standards that eyecare providers must meet to prescribe in the state.

VOA chief legislative counsel Bruce Keeney Sr. told VMail the new regulations set appropriate standards for ophthalmic prescribing and that the legislation “accomplished all of our goals.” He said the association believes that online refractive exams, as currently conducted, “wouldn’t meet the provisions of the new law.”

In the new regulations, a provider must “establish a bona fide provider-patient relationship” before writing the ophthalmic prescription, and the prescription must include the provider's name, physical address at which the provider practices, and a telephone number, according to the new legislation. The “provider” also must be either an ophthalmologist licensed by the state’s Board of Medicine or an optometrist licensed by the state Board of Optometry.

In addition, while an exam can be conducted via “face-to-face interactive, two-way, real-time communication or store-and-forward technologies,” there are several conditions that have to be met as part of the prescribing process. They include: the provider obtaining an updated medical history at the time of prescribing; the provider conforming to “the standard of care expected of in-person care as appropriate to the patient’s age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination; and the ophthalmic prescription is “not determined solely by use of an online questionnaire.”

After the new legislation was signed by Virginia Gov. Terry McAuliffe, Opternative issued a statement commending the state for enacting the legislation, which the company says “clears the way for online contact lens and glasses prescription services to continue to be offered in Virginia.”

“Opternative was founded with a sincere belief that contact lens prescriptions should be accessible and affordable to everyone,” Peter Horkan, leader of U.S. government affairs for Opternative, said in a statement. “As a result of this legislation, every Virginian will have the right to innovative and affordable vision testing options. We applaud the efforts of Senator Carrico and Delegate Farrell to architect this piece of legislation that continues to make Virginia a leader in access to remote health care services.”