The Federal Trade Commission (FTC) has put in place the Eyeglass Rule, a critical regulation designed to protect consumers and ensure transparency in the eyeglass prescription process. For anyone working as an Eyeglasses Doctor, whether an ophthalmologist or optometrist, understanding and adhering to this rule is not just a matter of best practice—it’s the law. This article breaks down the key aspects of the Eyeglass Rule, providing essential questions and answers to help both eye care professionals and patients navigate their rights and responsibilities.
Understanding What Constitutes an Eyeglass Prescription
According to the Eyeglass Rule, a prescription for eyeglasses is defined as “the written specifications for lenses for eyeglasses which are derived from a refractive eye examination.” This definition is broad, but it essentially means any documentation that provides the necessary lens specifications after an eye exam. The rule also respects state laws, meaning that if your state has specific requirements for what must be included on a prescription, those must also be followed.
Many states mandate that a valid eyeglass prescription includes several key pieces of information:
- Patient’s Name: Clearly identifying who the prescription is for.
- Date of Examination and/or Issue Date: Providing a timeline for the prescription’s validity.
- Prescription Expiration Date: Indicating how long the prescription is valid, as per state or professional guidelines.
- Doctor’s Information: Including your name, contact details, and signature, ensuring accountability and legitimacy.
For eyeglasses doctors, it’s crucial to ensure that every prescription you issue is not only legible and complete but also compliant with both federal and state regulations. Another important element, though not mandated by all states, is the pupillary distance (PD). This measurement is vital if a patient intends to purchase eyeglasses online. While not always required on the prescription itself, the FTC encourages eyeglasses doctors to provide the PD measurement to patients, as they are likely entitled to it under record-keeping requirements, and obtaining it separately can be inconvenient for both the doctor and the patient.
When Must an Eyeglasses Doctor Provide the Prescription?
Timing is everything when it comes to the Eyeglass Rule. You, as an eyeglasses doctor, are obligated to provide the patient with a copy of their prescription in specific instances:
- Immediately After Refractive Eye Exam: As soon as you complete any refractive eye examination, regardless of why the exam was conducted or whether you charged specifically for the refraction, the prescription must be provided.
- Automatic Provision: You must provide the prescription whether the patient asks for it or not. The rule is designed to be proactive, ensuring patients receive their prescriptions without needing to request them.
- Before Offering to Sell Eyeglasses: Critically, the prescription must be given to the patient before any offer to sell eyeglasses is made. This sequence is in place to allow patients to consider their options and potentially shop elsewhere for their eyewear.
A refractive eye examination, as defined by the Rule, is “the process of determining the refractive condition of a person’s eyes or the presence of any visual anomaly by the use of objective or subjective tests.” This is a standard part of most routine eye exams conducted by eyeglasses doctors.
For practices with front desk staff handling prescription distribution, proper training is essential. Staff should be well-versed in the Eyeglass Rule, ensuring they provide prescriptions automatically at the end of the exam, without the patient having to ask and without any additional fees for the prescription itself. Simply asking a patient if they want their prescription is not compliant. The prescription must be offered proactively unless the patient explicitly refuses it. In cases of refusal, it’s a good practice to document this refusal in the patient’s file. Furthermore, ensure your staff understands that prescriptions must be provided before any discussion or offer to sell eyeglasses within your practice.
Digital Prescriptions: A Modern Approach for Eyeglasses Doctors
In today’s digital age, the Eyeglass Rule accommodates electronic delivery of prescriptions, offering flexibility for both eyeglasses doctors and patients. However, this digital delivery is contingent on meeting specific conditions:
- Affirmative Patient Agreement: The patient must explicitly agree, either in writing or electronically, to receive their prescription digitally instead of on paper. Digital delivery cannot be the default option. Patients who prefer a paper prescription must have their preference honored.
- Agreement to Specific Digital Method: The patient must also agree to the specific method of digital delivery you intend to use, whether it’s email, text message, or an online portal.
- Accessibility and Printability: The chosen digital method must allow the patient to easily access, download, and print their prescription. For online portals, access should be maintained for the entire validity period of the prescription.
It’s important to note that digital delivery does not alter the timing requirements. Whether delivered digitally or on paper, the prescription must be provided immediately after the eye exam and before any offer to sell eyeglasses.
For eyeglasses doctors opting for digital prescriptions, maintaining proper records of patient consent is vital. You must keep records for at least three years, demonstrating each patient’s agreement to digital delivery. Furthermore, it’s crucial to ensure patients are clearly informed about how to access and retrieve their digital prescriptions.
Patient Consent for Digital Prescriptions: Recurring or One-Time?
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The Eyeglass Rule provides some flexibility regarding how often you need to obtain consent for digital prescriptions. It does not mandate obtaining consent at every appointment. If you clearly define the digital delivery method and provide patients with a choice to consent, a one-time authorization can be sufficient, provided you continue using the same method.
However, any changes to your delivery policies, such as switching from email to an online portal, necessitate obtaining new consent for the updated method. Patients must also have the option to revoke their digital delivery consent at any time, reverting to paper prescriptions.
Record-keeping for digital consent is also important over time. If you plan to use a patient’s digital consent for more than three years, retain the consent record for the duration of its use plus an additional three years. For instance, if a patient consents to email delivery in September 2024 and you use this method until their September 2028 appointment, you should retain the consent record until at least September 2031. If you switch to portal delivery in 2029 and obtain new consent, the original email consent record should still be kept until September 2031, and the portal consent record for at least three years from 2029, or longer if portal delivery continues.
Verifying Prescription Receipt: Confirmation Requirements for Eyeglasses Doctors
For eyeglasses doctors who sell eyeglasses or have a financial interest in their sale, there’s an additional requirement: confirming prescription receipt. After providing the prescription, you must ask patients to confirm in writing that they have received it. This confirmation should not be part of pre-appointment paperwork; any confirmation obtained before the patient receives the prescription is not compliant.
Records of these confirmations must be kept for at least three years.
An alternative to written confirmation is providing a digital copy of the prescription (via email, text, or portal). If you choose this route, you must first obtain the patient’s affirmative written consent for the specific digital method and keep a record of this consent. You also need to maintain records for at least three years showing that the prescription was sent, received, or made accessible, downloadable, and printable. You can ask for digital consent before the exam. If the patient declines digital delivery, you must provide a paper prescription and obtain written confirmation of receipt.
The confirmation requirement is waived only if you have no direct or indirect financial interest in the sale of eyeglasses. In such cases, you are not obligated to obtain confirmation of prescription receipt.
Handling Patient Refusal to Sign Confirmation
What happens if a patient refuses to sign a confirmation of receipt? In such situations, as an eyeglasses doctor, you should note the patient’s refusal on the receipt itself, sign it yourself, and retain it for at least three years. This documented refusal serves as proof of your compliance with the rule, even in the absence of patient signature.
Defining Financial Interest in Eyeglass Sales
Understanding what constitutes a “direct or indirect financial interest” in eyeglass sales is crucial for eyeglasses doctors to determine if the confirmation of receipt requirement applies. If you are associated, affiliated, or co-located with an eyeglass seller, it is considered a financial interest. Other scenarios might also qualify as a financial interest if you receive financial benefits from a seller due to your association. If there’s any uncertainty about whether your situation constitutes a financial interest, it’s best to err on the side of caution and request confirmation of receipt from your patients.
Combining Eyeglass and Contact Lens Prescription Confirmations
To streamline processes and reduce paperwork, the FTC allows for the use of a single document to confirm receipt for both eyeglass and contact lens prescriptions, provided both are finalized at the same appointment. This combined document is acceptable under both the Eyeglass Rule and the Contact Lens Rule, as long as it clearly indicates to the patient what they are signing and that the signature confirms receipt of both types of prescriptions. Similarly, a single document can be used for consent to digital delivery for both eyeglass and contact lens prescriptions, with the same clarity requirement.
Fees for Eye Exams and Prescriptions: What’s Permitted?
As an eyeglasses doctor, you are entitled to charge for the eye examination itself. The only condition for requiring payment before providing the prescription is if you have a policy of always requiring immediate payment from all eye exam patients. Acceptance of insurance coverage is considered payment in terms of when you must provide the prescription.
However, you cannot charge an additional fee specifically for the prescription itself. Nor can you mandate that patients purchase eyeglasses or contact lenses from you as a condition for receiving their prescription.
While the Eyeglass Rule does not prevent you from charging for your services, it explicitly prohibits charging for a copy of the prescription following a refractive exam. If a refractive exam is part of the overall eye exam, the prescription must be provided, regardless of whether you bill separately for the refraction. You cannot selectively charge only those patients who request their prescriptions. If you bill separately for eye health and refractive examinations, patient education on this billing structure may be necessary.
You are permitted to charge a fee for verifying eyeglasses dispensed by another seller, but this fee can only be charged when the verification service is actually performed.
Advertising Bundled Services: Eye Exams and Eyeglasses
Advertising a single price for an eye exam combined with eyeglasses, or offering a “free exam” with eyeglass purchase, is permissible. However, the critical point remains: you must still provide the prescription to the patient before offering to sell eyeglasses. This ensures the patient has the freedom to either take advantage of bundled offers or simply pay for the exam and leave with their prescription, without any obligation to purchase eyeglasses from you. The eye exam cannot be made contingent upon purchasing eyeglasses.
Liability Waivers: Not Permitted Under the Eyeglass Rule
You cannot require patients to sign any waiver or disclaimer of liability as a prerequisite for releasing their prescription. Such waivers are not allowed under the Eyeglass Rule.
Exceptions to the Eyeglass Rule
It’s important to note that the Eyeglass Rule does not apply to ophthalmologists or optometrists who are employed by any federal, state, or local government entity. For those in private practice, however, compliance is mandatory.
Reporting Rule Violations
If you suspect a violation of the Eyeglass Rule or the Contact Lens Rule, you can report it online at ReportFraud.ftc.gov. Reports filed through this portal are used by the FTC and other law enforcement agencies to take action against companies and individuals violating these regulations.
For Further Information
The FTC is committed to preventing deceptive, unfair, and fraudulent practices affecting businesses and consumers alike. For more information or to report business practices, visit ReportFraud.ftc.gov. Business guidance is available at business.ftc.gov. Stay updated on FTC initiatives by subscribing to the FTC’s Business Blog: Subscribe to the FTC’s Business Blog.
Opportunity for Small Business Comment
Small businesses have the opportunity to provide feedback on federal compliance and enforcement activities through the National Small Business Ombudsman and 10 Regional Fairness Boards. To comment, call toll-free 1-888-REGFAIR (1-888-734-3247) or visit www.sba.gov/ombudsman.
