florida laws and rules for optometric physicians-2014€¦ · · 2014-01-11florida laws and rules...

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Florida Laws and Rules for Optometric Physicians-2014Robert M Easton Jr OD FAAOFlorida Board of Optometry 1999-2008ARBO President 2006-2007AOA-PAC Chair 1999-2000FOA President 1993-1994BCOA President 1986-1987Florida Board Certified Optometric Physician 1982-Diplomate, American Board of Optometry 2011-2021I have no financial interest in any eye related companies.

The Florida Board of Optometry Logo

The Florida Board of Optometry

The Florida Board of Optometry is composed of seven members appointed by the Governor and confirmed by the Senate. Five members of the board must be licensed practitioners actively practicing in this state. The remaining two members must be citizens of the state who are not, and have never been, licensed practitioners. Additionally, the consumer members may not be connected with the practice of optometry or with any other vision-related profession or business. At least one member of the board must be 60 years of age or older.

2014 Optometry Board and Staff Composition

Timothy Underhill, OD, Chair, Fort MyersStuart Kaplan, OD, Cape Coral, Vice Chair

Terrance Naberhaus, OD, Merritt Island

Christopher King, OD, Englewood

Tamara Maule, OD, Lake Worth

Rosa McNaughton, Esq, Tallahassee

Rod Presnell, RPh, Tallahassee

Bill Miller, Executive Director

Rachel Clark, Board Counsel, Assistant Attorney General

Lawrence Harris, Board Counsel, Assistant Attorney General

Elana Jones, ESQ, Prosecuting Counsel, DOH

If you have board questions please call

(850) 245-4355FAX: 850-922-8876

http://www.floridasoptometry.gov/

2014 Meeting DatesMarch 21, OrlandoJuly 23, Boca Raton

November 14, Orlando

The 2014 Florida Board of OptometryDepartment of HealthBoard of Optometry4052 Bald Cypress WayBin C-07Tallahassee, FL 32399-3257

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2014 Optometry Board Committee Structure

Budget-Rod Presnell, RPhComplaints, Investigations- Stuart Kaplan, ODContinuing Education- Tamara Maule, ODCorporate Practice- ???Disciplinary/Compliance- Rosa McNaughton. ESQExamination- Chris King, ODFOA- Tim Underhill, ODLegislation- Tim Underhill, ODProbable Cause- Rod Presnell, RPh, Alan Fisher, OD, John Lewis, ODRules- Terry Naberhaus, ODULA- Stuart Kaplan, OD

DOH/MQA/Bureau of Health Care Practitioner Regulation

Mission: Promote, protect and improve the health of all people in Florida.

Vision: A healthier future for the people of Florida.

Purpose: To protect the public through health care licensure, enforcement and information.

Focus: To be the nation's leader in quality health care regulation.

Values Include: Integrity, Commitment, Respect, Excellence, Accountability, Teamwork, & Empowerment.

Lucy Gee, Division Director-Medical Quality AssuranceSusie Love, Chief, Bureau of Enforcement-ComplaintsJulie Forrester, Chief Legal Counsel, Prosecution Services Unit

Organizational Structure of the Board

The Department of Health's Division of Medical Quality Assurance serves as the principle administrative support unit for the board. The board is supported by a full-time professional staff based in Tallahassee, and its regulatory functions are funded in full by fees paid by its licensees. Board members are appointed by the Governor and subject to confirmation by the Senate. Members of the board can serve two four-year terms. Despite the expiration of a term, board members can continue to serve until they have been either replaced or reappointed.

Florida Board of Optometry Executive Director

William MillerExecutive Director

Responsibilities: Coordination of Budget; Analyzes & Tracks Legislation; Interaction with

Board Members

Florida Board of Optometry StaffKeri MeanyRegulatory Specialist IIResponsibilities: Responsible for continuing education provider/course approval, and reactivation of optometry licenses

Martha GoldRegulatory Specialist IResponsibilities: Receptionist and various administrative functions

Samantha ThompsonRegulatory Specialist IIResponsibilities: Initial licensure of optometrists, branch offices, and faculty certificates for last names beginning with P through Z

Sherra MearsRegulatory Specialist IIResponsibilities: Board and Committee Meeting agendas, assists Executive Director

Savada KnightRegulatory Specialist IIResponsibilities: Initial licensure of optometrists, branch offices, and faculty certificates for last names beginning with I through O

Jose MontalvanSupervisor/ConsultantResponsibilities: Supervisor of the Optometry licensure section

Kenneth SmithRegulatory Specialist IIResponsibilities: Initial licensure of optometrists, branch offices, and faculty certificates for last names beginning with A through H

Sharon GuilfordProgram Operations AdministratorResponsibilities: Administrative Issues, New Legislation and Rules, Overseeing the Licensing Processes, assist Executive Director

Go to http://www.floridasoptometry.gov/resources/If you wish to get updates from the board

Subscribe & Receive Updates via Email!Don’t have time to check the board’s website for new information? Subscribe to receive an email when new posts are added to the website. Examples of the types of updates provided by the subscription system includes changes in the law and board rules, reminders about legal requirements and updates that impact professionals and consumers in Florida.*Your email address will be used for the sole purpose of receiving further correspondence from the Florida Board of Optometry, and will not be publicly displayed or posted to the Board’s website.

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Follow the Optometry Board on twitter

Board of Optometry @FLOptometry

A Resource for Optometrists, Optometry Branch Offices and Faculty Certificate Holders Licensing, Renewals and Information

Florida Department of Health · FloridasOptometry.gov https://twitter.com/FLOptometry

COPE APPROVED36545-EJ

36545EJ - Florida Laws and Rules for Optometric Physicians

Format: Live Category: Ethics/Jurisprudence Total CE Hours: 2

Description: The Optometric Practice Act defines the limits of optometric physicians in the state of Florida. The Rules and Regulations are in place to protect the citizens of the state of Florida. Unlicensed activity is the practice of optometry without a valid Florida license and comes under the purview of the Attorney General.

CEE: No Expires: Course Expires: 01/28/2016

Instructor: Robert Easton Jr, O.D.

31009-EJ - JurisprudenceThe goal of this course is to provide a review of the laws (463) and

rules (64B13) regarding the practice of optometry in the state of Florida. The Optometric Practice Act defines the limits of optometric physicians within the state of Florida. The Rules are further definitions of the Optometric Practice Act to educate the optometrist to ensure protection of the citizens of the state of Florida. Unlicensed activity is the practice of optometry without a valid Florida license and comes under the purview of the Attorney General.

NSU College of Optometry Sponsored Course Expires: 04/01/2014

Florida Statutes and Rules that regulate the profession of OptometryChapters 463, 456 and Chapter 64B13 are most important

� Chapter 463: Optometry Practice Act� Chapter 456: Health Professions and

Occupations: General Provisions� Chapter 408: Health Care Administration� Chapter 120: Administrative Procedure Act� Chapter 119: Public Records� Chapter 112: Public Officers and Employees:

General Provisions� Rules: Chapter 64B13 (Board of Optometry Rules)

Chapter 463.002 Optometry463.002 Definitions.

(3)(a) "Licensed practitioner" means a person who is a primary health care provider licensed to engage in the practice of optometry under the authority of this chapter.

(b) A licensed practitioner who is not a certified optometrist shall be required to display at her or his place of practice a sign which states, "I am a Licensed Practitioner, not a Certified Optometrist, and I am not able to prescribe topical ocular pharmaceutical agents." (The font size is being worked on)

(c) All practitioners initially licensed after July 1, 1993, must be certified. In 2012, of the active licenses; 106 Non-certified OD’s exist; 64 out-of-state and 42 in-state. This number continues to drop. There was a 94% Renewal Rate of Licensees in 2013. 7 OD’s retired.

TMODThe Treatment and Management of Ocular Disease (TMOD) examination will continue to be administered as an embedded subtest within the overall Part II -Patient Assessment and Management (PAM) examination. If a candidate is taking the Part II - PAM examination for the purpose of obtaining an embedded TMOD score, the entire Part II examination must be taken. However,candidates who desire a TMOD-only score may select this TMOD-only score option during registration. They will be charged with the same TMOD-only feeof $450.

The Part II - PAM exam is comprised of 2 testing sessions. Each PAM exam session will be 3½ hours in length, and will consist of 30 cases for a total of 60 cases. The cases will be of variable length and will include 5 or 6 multiple choice items. For those PAM exam cases that pertain to the embedded TMOD exam, the multiple choice items pertaining to the treatment and management of ocular disease will comprise the TMOD score.”

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CS/CS/HB239 Orals Bill 2013

An act relating to the practice of optometry; amending s. 463.002, F.S.; revising and providing definitions; authorizing a certified optometrist to administer and prescribe ocular pharmaceutical agents; This act shall take effect July 1, 2013!

(4) "Certified optometrist" means a licensed practitioner authorized by the board to administer and prescribe ocular pharmaceutical agents.

(5) "Ocular pharmaceutical agent" means a pharmaceutical agent that is administered topically or orally for the diagnosis or treatment of ocular conditions of the human eye and its appendages without the use of surgery or other invasive techniques.

(6) "Surgery" means a procedure using an instrument, including a laser, scalpel, or needle, in which human tissue is cut, burned, scraped except as provided in s. 463.014(4), or vaporized, by incision, injection, ultrasound, laser, infusion, cryotherapy, or radiation. The term includes a procedure using an instrument which requires the closure of human tissue by suture, clamp, or other such device.

Chapter 463.002 Optometry

2013 Legislative Update – Prescription Authority

The 2013 legislative session brought very important changes for the practice of optometry. On April 19, 2013, Governor Rick Scott signed HB-239 into law, which significantly increased the scope of practice of optometry. The law now includes prescription authority for certain certified optometrists.

Orals Board Certification

Any certified optometrist that completes a 20 hour course and passes a subsequent examination on general and ocular pharmaceutical agents and their side effects may prescribe certain oral drugs to treat injuries and diseases of the eye. To register for the course and examination, please visit http://optometristonlinece.com for additional information. Specifically, a certified optometrist who completes the course and passes the examination mentioned above may administer or prescribe specific oral medications in the next slide. The FMA and FPA worked with the American Safety Council to develop the 20 hour course. The FMA defined the 32 questions on the test.

Test to become Certified in Orals

Test Questions are based upon the specific medications used only for systemic ocular conditions including General and Ocular Pharmacology, Side Effects, Pharmacological Description, Mechanism of Action, Indication for Usage, Maximum Dosage, Contraindications, Adverse reactions and Specific Ocular use. To pass, you must score 70%. (23 right) There is one free re-take.

The Orals FormularyTramadol hydrochlorideAcetaminophen 300 mg with No. 3 codeine phosphate 30 mgAmoxicillin with or without clavulanic acid.AzithromycinErythromycinDicloxacillinDoxycycline/TetracyclineKeflexMinocyclineAcyclovirFamciclovirValacyclovirAcetazolamideMethazolamide

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Oral Prescriptive RestrictionsCertified optometrists may not provide a prescription for more than a 72 hour supply of tramadol hydrochloride, acetaminophen 300 mg with no. 3 codeine phosphate 30 mg, acetazolamide, or methazolamide without consulting a licensed medical or osteopathic physician.

Certified optometrists are strictly prohibited from administering or prescribing any controlled substances that are not specifically listed above. Moreover, certified optometrists may not administer or prescribe any controlled substance for the treatment of chronic nonmalignant pain as defined in Section 456.44(1)(e), Florida Statutes.

Additionally, certified optometrists are prohibited from prescribing, ordering, dispensing, administering, selling, or giving any drug for the purpose of treating a systemic disease. However, the law provides a single exception, which allows certified optometrist to utilize commonly accepted means and methods to immediately address anaphylaxis.

Anaphylaxis

Because the symptoms of anaphylaxis may progress rapidly and become life-threatening, it is important that treatment be initiated promptly. Immediate intervention tactics involve assessing airway, breathing, circulation and level of consciousness, as well as administering epinephrine.

Anaphylaxis

During anaphylaxis, epinephrine works through its impact on Į- and ȕ-adrenergic receptors.Į1-receptors: potent vasoconstriction, relieving airway obstruction, mucosal edema and angioedemaĮ2-receptors: decreased insulin resistanceȕ1-receptors: increased force of cardiac contractions and heart rateȕ2-receptors: decreased release of inflammatory mediators (including histamine and tryptase) and increased Broncho-dilation and vasodilationSee Figure 1.

Anaphylaxis

Criteria for Diagnosing AnaphylaxisTable 3. Clinical criteria for diagnosing anaphylaxis10

Anaphylaxis is highly likely when any one of the following 3 criteria is fulfilled:Because the majority of anaphylactic reactions (>80%) include skin symptoms, it was judged that at least 80% of anaphylactic reactions should be identified by criterion 1 — even when the allergic status of the patient and potential cause of the reaction are unknown. However, cutaneous symptoms might be absent in up to 20% of anaphylacticreactions in children with food or insect sting allergy.Criterion 1. Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue or both (eg, generalized hives, pruritus or flushing, swollen lips/tongue/uvula)AND AT LEAST ONE OF THE FOLLOWING:1.Respiratory compromise (eg, dyspnea, wheeze-bronchospasm, stridor, reduced peak expiratory function [PEF], hypoxemia)2.Reduced blood pressure (BP) or associated symptoms of end-organ dysfunction (eg, hypotonia [collapse], syncope, incontinence)In patients with a known allergic history and possible exposure, criterion 2 should provide ample evidence that an anaphylactic reaction is occurring.Criterion 2. Two or more of the following that occur rapidly after exposure to a likely allergen for that patient (minutes to several hours):1.Involvement of the skin-mucosal tissue (eg, generalized hives, itch-flush, swollen lips/tongue/uvula)2.Respiratory compromise (eg, dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)3.Reduced BP or associated symptoms (eg, hypotonia [collapse], syncope, incontinence)4.Persistent GI symptoms (eg, cramping abdominal pain, vomiting)Criterion 3 should identify the rare patients who experience an acute hypotensive episode after exposure to a known allergen.Criterion 3. Reduced BP after exposure to known allergen for that patient (minutes to several hours):1.Infants and children: low systolic BP* (age-specific) or greater than 30% decrease in systolic BP2.Adults: systolic BP of less than 90 mm Hg or greater than 30% decrease from that person’s baseline

How to administer an Epipen

For a video go to:http://www.epipen.com/How-to-use-EpiPen

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After Emergency Treatment Refer to Allergy Specialist

Because the evaluation and diagnosis of anaphylaxis, as well as its long-term management, can be complex, patients with a history of anaphylaxis should be considered for referral to an allergy-immunology specialist. Such specialists can obtain a detailed allergy history, coordinate laboratory and allergy tests, evaluate the benefits and risks of therapeutic options and counsel the patient on avoidance measures.

DEA Application Required for Controlled Substances

Once the course has been taken and the examination has been passed, a certified optometrist must register under form 224 with the DEA for the purpose of prescribing the controlled substances. Additionally, certified optometrists have been added to the list of health care practitioners that may access the Prescription Drug Monitoring Program (PDMP) when prescribing controlled substances.https://www.deadiversion.usdoj.gov/webforms/jsp/regapps/common/newAppLogin.jsp

Adverse Reaction ReportingEffective January 1, 2014, certified optometrists will be required to report to the Department of Health any adverse incidents in the practice of optometry. An adverse incident is defined to mean, “any of the following events when it is reasonable to believe that the event is attributable to the prescription of an oral ocular pharmaceutical agent” by a certified optometrist:Any condition requiring a patient’s transfer to a hospital;Any condition that requires care and treatment from a physician, other than a referral or consultation;Permanent physical injury to the patient;Partial or complete permanent loss of sight by the patient; orDeath of the patient.The reports must be sent by certified mail; and postmarked within 15 days after the adverse incident occurs.

Post Operative Care LawThe law added several requirements for co-management between an ophthalmologist who performed a surgical procedure and an optometrist who will provide at least part of the postoperative care. The terms of the co-management agreement will be governed by a transfer of care letter between the two health care practitioners, as well as any other legal requirements that may exist.The patient must be fully informed of, and consent in writing to, the co-management of postoperative care. The transfer of care letter must state that:It is not medically necessary for the operating ophthalmologist to deliver postoperative care; andIt is clinically appropriate for the optometrist to provide the postoperative care.Prior to the commencement of postoperative care, the patient must be informed, in writing, that:The patient has the right to have all postoperative care delivered by the operating ophthalmologist;The patient must also be informed of the fees being charged by the physician that performed the surgery and the optometrist for providing postoperative care; andThe patient must be provided with an accurate and comprehensive itemized statement of the specific postoperative care being provided by the physician that performed the surgery and the optometrist, along with the charge(s) for each service.

Lab Testing by Certified OD’s

Specifically, the 2013 law amended Section 483.035, F.S., to allow certified optometrists to own and operate a clinical laboratory by modifying the definition of “licensed practitioner,” to include practitioners licensed under Chapter 463, F.S. Additionally, Section 483.181, F.S., was amended to allow certified optometrists to order clinical laboratory testing.

Certified OD’s can certify Boxers Vision and Retina Health

One of those changes amended Section 463.0135, Florida Statutes, expanding the scope of practice to allow a certified optometrist to perform any eye examination, including a dilated examination, as required or authorized by law for boxing exhibitions.

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Supervision Definitions"Direct supervision" means supervision to an extent that the licensee

remains on the premises while all procedures are being done and gives final approval to any procedures performed by an employee.

"General supervision" means the responsible supervision of supportive personnel by a licensee who need not be present when such procedures are performed, but who assumes legal liability therefore. Except in cases of emergency, "general supervision" shall require the easy availability or physical presence of the licensee for consultation with and direction of the supportive personnel.

Definition of Optometry� (7) "Optometry" means the diagnosis of conditions of the human eye

and its appendages; the employment of any objective or subjective means or methods, including the administration of ocular pharmaceutical agents, for the purpose of determining the refractive powers of the human eyes, or any visual, muscular, neurological, or anatomic anomalies of the human eyes and their appendages; and the prescribing and employment of lenses, prisms, frames, mountings, contact lenses, orthoptic exercises, light frequencies, and any other means or methods, including ocular pharmaceutical agents, for the correction, remedy, or relief of any insufficiencies or abnormal conditions of the human eyes and their appendages

American Board of Optometry Certification ProcessBased upon 2.5 year equal input from multiple stakeholders such as AAO, AOA, AOSA, ARBO, ASCO and NBEO. Passed AOA house of Delegates 6/26/09.

Board Certification and Maintenance of Certification for optometry will become a means of demonstrating ongoing clinical competence independent of established licensing and state regulatory boards. Board Certification will not confer legal qualification, privilege or license to practice optometry.

American Board of Optometry Certification ProcessComplete Initial ApplicationSupply demographic information. Submit Application Fee of $300.00. Identify Qualifying Requirements: Graduation from School or College of Optometry accredited by the

Accreditation Council on Optometric Education (ACOE). Active License to practice therapeutic optometry in a State,

District of Columbia, U.S. Commonwealth or Territory. State adherence to principles of the Optometric Oath. Affirm that all supplied information is true and correct. Grant permission to the American Board of Optometry to verify all

credentials. Authorize search of National Practitioner Data Bank (NPDB) and

Health Integrity and Protection Data Bank (HIPDB).

American Board of Optometry Board Certification Process� Active Candidates should pass the

Examination within 12 months of submitting the Examination Application

� Take the ABO Exam involving patient assessment and management in three subject areas of interest

� A passing score on the ABO exam makes you American Board Certified for 10 years

� Exam fee $1500

American Board of Optometry “Fully Qualified”by Centers for Medicare & Medicaid Services

ST. LOUIS, Mo., September 22, 2011 ʊ The Centers for Medicare & Medicaid Services (CMS) announced that the American Board of Optometry (ABO) has qualified for purposes of the 2011 Physician Quality Reporting System (PQRS) Maintenance of Certification (MOC) Program Incentive. The ABO successfully completed the vetting process to ensure that the ABO MOC program meets the requirements for participation in this incentive. In this program, physicians will have the opportunity to earn the

PQRS incentive, and an additional incentive of 0.5%, by participating in additional activities of a qualified MOC program including a practice assessment module.

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AAO Maintenance of FellowshipMaintenance of Fellowship (MOF) was approved by the membership as a bylaws

amendment at the business meeting in 2009 at Orlando. All new Fellows and those reactivating Fellowship on or after November 2010 must meet the MOF requirements. All other Fellows are encouraged to participate in the MOF program as well.

Fellows of the Academy are required to renew their Fellowship status every 10 years starting after the annual Academy meeting in 2010. The program is required for any new or reactivated Fellow admitted in 2010 and subsequent years. The program is voluntary for Fellows admitted prior to 2010. Each Fellow is responsible for acquiring 15 points during a consecutive 10 year period. Points are awarded in the following manner:

I. Attendance at an AAO Annual Meeting pointsii. Attendance at any CE-qualifying event at AAO annual meeting 1 point/2 hrs of CEiii. Present a one hour lecture or any workshop at AAO 2 pointsiv. Present a scientific paper, poster, or symposium speaker at AAO AM1 pointv. Serve as an AAO Volunteervi. Author article in an accepted peer-reviewed journal 2 pointsvii. Author a book chapter 2 points / chapter

Optometrists classified as "physicians" by Joint Commission

Effective July 1, 2009, the Joint Commission has changed the definition of "physician" in its hospital accreditation program to match the Medicare definition (Section 1861(r) of the Social Security Act, which includes optometrists). The Joint Commission, formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), accredits 88 percent of the nation's hospitals.

Physician under Medicare

r) The term “physician”, when used in connection with the performance of any function or action, means (4) a doctor of optometry, but only for purposes of subsection (p)(1) with respect to the provision of items or services described in subsection (s) which he is legally authorized to perform as a doctor of optometry by the State in which he performs them.

Federal False Claims Act, Title 31

1. Submitting a false claim for payment.2. Making or using a false record or statement to obtain payment.3.Conspiring to make a false claim or get one paid.4. Making or using a false record to void payments owed to the US Government.(Whistleblowers are protected.)

The Florida False Claims Act is within F.S. 112.3187, 409.9201, 409.913, 414.39, 812.035, 817.155 and 837.06 .

The Florida False Claims Act prohibits similar conduct as the Federal False Claims Act as it relates to claims made to Florida agencies involving governmental healthcare programs.

Penalties $5000-$11000/claim, Treble Damages, and removal from the provider panel(s).

Chapter 463.005 Optometry

463.005 Authority of the board.(1) The Board of Optometry has authority to adopt rules pursuant to ss. 120.536(1) and 120.54 to implement the provisions of this chapter conferring duties upon it. Such rules shall include, but not be limited to, rules relating to:

(a) Standards of practice, including, but not limited to, those provided for in s. 463.0135.

(b) Minimum equipment which a licensed practitioner shall at all times possess to engage in the practice of optometry.

(c) Minimum procedures which shall constitute a visual examination.

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Chapter463.005 Optometry

(d) Procedures for the safekeeping and transfer of prescription files or case records upon the discontinuance of practice. (e) Supervision of supportive personnel. (f) Courses and procedures for continuing education.(g) Administration and prescription of ocularpharmaceutical agents. (2) The board is authorized to disseminate information, the sole purpose of which is to inform licensed practitioners and the public of regulations regarding the practice of optometry.

Chapter 463.0055 Administration and prescription of ocular pharmaceutical agents

(1) (a) Certified optometrists may administer and prescribe ocular pharmaceutical agents as provided in this section for the diagnosis and treatment of ocular conditions of the human eye and its appendages without the use of surgery or other invasive techniques. However, a licensed practitioner who is not certified may use topically applied anesthetics solely for the purpose of glaucoma examinations, but is otherwise prohibited from administering or prescribing ocular pharmaceutical agents.

Chapter 463.0055 Administration and prescription of ocular pharmaceutical agents(b) Before a certified optometrist may administer or prescribe oral ocular pharmaceutical agents, the certified optometrist must provide proof to the department of successful completion of a course and subsequent examination, approved by the board, on general and ocular pharmaceutical agents and the side effects of those agents. The course shall consist of 20 contact hours, all of which may be web-based. The first course and examination shall be presented by October 1, 2013, and shall be administered at least annually thereafter. The course and examination shall be developed and offered jointly by a statewide professional association of physicians in this state accredited to provide educational activities designated for the American Medical Association Physician's Recognition Award (AMA 143 PRA) Category 1 credit and a statewide professional association of licensed practitioners which provides board-approved continuing education on an annual basis. The board shall review and approve the content of the initial course and examination if the board determines that the course and examination adequately and reliably satisfy the criteria set forth in this section. The board shall thereafter annually review and approve the course and examination if the board determines that the content continues to adequately and reliably satisfy the criteria set forth in this section. Successful completion of the board-approved course and examination may be used by a certified optometrist to satisfy 20 hours of the continuing education requirements in s. 463.007(3), only for the biennial period in which the board-approved course and examination are taken. If a certified optometrist does not complete a board-approved course and examination under this section, the certified optometrist is only authorized to administer and prescribe topical ocular pharmaceutical agents.

To be Certified in Orals

Certified optometrists can administer and prescribe oral pharmaceutical agents upon passing a 20 hour on-line course and test approved by the Board of Optometry.Furthermore, the 20 hour course and test will count one time towards the 30 hour biennial CE requirement.


(2)(a) The board shall establish a formulary of topical ocular pharmaceutical agents that may be prescribed and administered by a certified optometrist. The formulary shall consist of those topical ocular pharmaceutical agents that are appropriate to treat or diagnose ocular diseases and disorders and that the certified optometrist is qualified to use in the practice of optometry. The board shall establish, add to, delete from, or modify the topical formulary by rule. Notwithstanding any provision of chapter 120 to the contrary, the topical formulary rule becomes effective 60 days from the date it is filed with the Secretary of State.

The State Board of Optometry will decide Topical Ocular FormularyThe burden of the Topical Ocular Pharmaceutical Committee (TOPA) no longer exists as the bill abolishes that entity. The formulary of topical pharmaceutical agents will now be determined solely by the Board Of Optometry. The potential scope of the formulary has been clarified to include topical agents that are "appropriate to treat or diagnose ocular diseases and disorders". This change will greatly expedite our ability to timely add any new topically applied ocular medications approved by our Board to our list of useable drugs.

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(3) In addition to the formulary of topical ocular pharmaceutical agents established by rule of the board, there is created a statutory formulary of oral ocular pharmaceutical agents, which includes the following agents: (a) The following analgesics or their generic or therapeutic equivalents, which may not be administered or prescribed for more than 72 hours without consultation with a physician licensed under chapter 458 or chapter 459 who is skilled in diseases of the eye: 1. Tramadol hydrochloride. 2. Acetaminophen 300 mg with No. 3 codeine phosphate 30 mg. (b) The following antibiotics or their generic or therapeutic equivalents: 1. Amoxicillin with or without clavulanic acid. 2. Azithromycin. 3. Erythromycin. 4. Dicloxacillin. 5. Doxycycline/Tetracycline. 6. Keflex. 7. Minocycline.


(c) The following antivirals or their generic or therapeutic equivalents: 1. Acyclovir. 2. Famciclovir. 3. Valacyclovir. (d) The following oral anti-glaucoma agents or their generic or therapeutic equivalents, which may not be administered or prescribed for more than 72 hours: 1. Acetazolamide. 2. Methazolamide. Any oral ocular pharmaceutical agent that is listed in the statutory formulary set forth in this subsection and that is subsequently determined by the United States Food and Drug Administration to be unsafe for administration or prescription shall be considered to have been deleted from the formulary of oral ocular pharmaceutical agents. The oral ocular pharmaceutical agents on the statutory formulary set forth in this subsection may not otherwise be deleted by the board, the department, or the State Surgeon General.

Oral Med ListPain Management

Tramadol HCL- (Ultram) An opiate agonist for the management of moderate to moderately severe ocular pain. (3 day limit) (Schedule IV in some states)Tylenol #3- An opioid pain medication used to relieve moderate to severe ocular pain. (3 day limit) (Schedule V)

Antibiotics

Amoxicillin- A penicillin antibiotic used to treat bacterial ocular infection.Erythromycin- a macrolide antibiotic that slows the growth of or sometimes kill sensitive ocular bacterial infection.Dicloxacillin- is a penicillin antibiotic used treat bacterial ocular infection.Doxycycline- is a tetracycline antibiotic used to treat bacterial ocular infection.Tetracycline- is an antibiotic used to treat bacterial ocular infection.Keflex- is a cephalosporin antibiotic used in the treatment of bacteria ocular infection.Minocycline- is a tetracycline antibiotic used to treat bacterial ocular infection.

Oral Med List (Continued)Antivirals

Acyclovir is an antiviral drug that slows the growth and spread of the herpes virus.Famciclovir is an antiviral drug that slows the growth and spread of the herpes virus.Valacyclovir is an antiviral drug that slows the growth and spread of the herpes virus.

Anti-Glaucoma

Acetazolamide- is a carbonic anhydrase inhibitor used to treat glaucoma.

Methazolamide is a carbonic anhydrase inhibitor used to treat glaucoma.


(4) A certified optometrist shall be issued a prescriber number by the board. Any prescription written by a certified optometrist for an ocularpharmaceutical agent pursuant to this section shall have the prescriber number printed thereon. A certified optometrist may not administer or prescribe: (a) A controlled substance listed in Schedule III, Schedule IV, or Schedule V of s. 893.03, except for an oral analgesic placed on the formulary pursuant to this section for the relief of pain due to ocular conditions of the eye and its appendages. (b) A controlled substance for the treatment of chronic nonmalignant pain as defined in s. 456.44(1)(e).

893.03 DRUG ABUSE PREVENTION AND CONTROL

Standards and schedules.—The substances enumerated in this section are controlled by this chapter. The controlled substances listed or to be listed in Schedules I, II, III, IV, and V are included by whatever official, common, usual, chemical, or trade name designated.SCHEDULE V.—A substance, compound, mixture, or preparation of a substance in Schedule V has a low potential for abuse relative to the substances in Schedule IV

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Oral Ocular Medications

Certified optometrists have, for the first time, received express statutory authority to use and prescribe oral pharmaceutical agents which makes it clear that optometrists are authorized to diagnose and treat the human eye and its appendages. This includes the ability for Florida Certified Optometrists to apply for and receive a DEA number. These oral medications and their generic or therapeutic equivalents include specific antibiotics, antiviral's, analgesics (72 hr limit then consultation required), and carbonic anhydrase inhibitors (72 hr limit). The use of an injecting “EpiPen" was also authorized for the treatment of anaphylaxis.

EpiPenEpinephrine autoinjectorAn epinephrine autoinjector is a medical device used to deliver a measured dose of epinephrine using autoinjector technology, most frequently for the treatment of acute allergic reactions to avoid or treat the onset of anaphylactic shock.

Oral Ocular Pain Meds

Certified optometrists are for the first time permitted to administer and prescribe those controlled substances (oral analgesics) which have been placed on the legislated formulary. Certified optometrists have also been added to the list of medical practitioners authorized to administer and prescribe controlled substances, provided those agents are approved and listed on the legislated formulary. To help curtail pain medication abuse in Florida, certified optometrists are now included in the list of health care practitioners who have access to the Florida prescription drug monitoring program.

DEA Number Registrationhttps://www.deadiversion.usdoj.gov/webforms/

Section 1. Personal/Business Information If you are applying for an Individual Registration (Practitioner, MLP, Researcher) you are required to provide your Full Name, Address, Social Security Number, and Phone Number. If you are applying for a Business Registration, you are required to provide the Name of the Business, Address, Tax ID, and Phone Number. Section 2. Activity Business Activity and Drug Schedule information. In addition - Certain registrants for forms 225 and 510 will need to provide specific drug codes and/or chemical codes related to their operations.Section 3. State License(s) Information pertaining to current State medical and/or controlled substance licenses/registrations.Section 4. Background Information pertaining to controlled substances in the applicant's background.Section 5. Payment $731 for 3 years via this on-line application, must be made with a Visa or MasterCard, American Express, or Discover. Application fees are not refundable.Section 6. Confirmation Applicants will confirm the entered information, make corrections if needed, and electronically submit the application and a submission confirmation will be presented. Applicants will be able to print copies for their records. WARNING: 21 USC 843(d), states that any person who knowingly or intentionally furnishes false or fraudulent information in the application is subject to a term of imprisonment of not more than 4 years, and a fine under Title 18 of not more than $250,000, or both.Select Your Business Category Form 224 - Practitioners(MD,DO,DDS,DMD,DVM,DPM), Mid Level Practitioners(NP, PA, OD, etc.), Pharmacies, Hospitals/Clinics, Teaching Institutions

463.0057 Optometric faculty certificate

(3) The holder of a faculty certificate may engage in the practice of optometry as permitted by this section, but may not administer or prescribe topical ocular pharmaceutical agents unless the certificate holder has satisfied the requirements of s. 463.006(1)(b)4. and 5. If a certificate holder wishes to administer or prescribe oral ocular pharmaceutical agents, the certificate holder must also satisfy the requirements of s. 463.0055(1)(b).

(d) Upon adoption of the formulary required by this section, and upon each addition, deletion, or modification to the formulary, the board shall mail a copy of the amended formulary to each certified optometrist and to each pharmacy licensed by the state. (DOH website)(3) A certified optometrist shall be issued a prescriber number by the board. Any prescription written by a certified optometrist for a topical ocular pharmaceutical agent pursuant to this section shall have the prescriber number printed thereon. ( Your License number OPC00XXXX is now your prescriber number. DEA numbers are not to be used by insurance companies or pharmacies to verify prescribing authority)


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Practitioners Authorized to Write Prescriptions

"Prescription claims filed by practitioners such as optometrists 463.0055(1), F.S. and nurse practitioners Section 464.003(3), F.S. who are fully authorized to write all non-controlled substance prescriptions must not require a DEA number."

464.003 Nursing Practice Act

(3) “Advanced registered nurse practitioner” means any person licensed in this state to practice professional nursing and certified in advanced or specialized nursing practice, including certified registered nurse anesthetists, certified nurse midwives, and nurse practitioners.

Misuse of DEA Number Complaint Form

Date of Denial________________________________________Doctor’s Last Name, First Name_________________________City, State___________________________________________Prescription Denied by (Circle) Pharmacy, Carrier, Employer.Retail Pharmacy name_________________________________Mail Order/Internet Pharmacy Name______________________Insurance Company Name______________________________Location (State) of Insurance Co ________________________Name of Employer which Benefits Originate_______________Comments___________________________________________

Fax to David Danielson, at the AOA: 703-739-9497

Chapter 463.007 Renewal of license; continuing education(1) The department shall renew a license upon receipt of the renewal application and the fee set by the board not to exceed $300. ($5 added fee is assessed to fight ULA that’s why it is $305)

(3) Unless otherwise provided by law, the board shall require licensees to periodically demonstrate their professional competence, as a condition of renewal of a license, by completing up to 30 hours of continuing education during the 2-year period preceding license renewal. For certified optometrists, the 30-hour continuing education requirement shall include 6 or more hours of approved transcript-quality (CEE) coursework in ocular and systemic pharmacology and the diagnosis, treatment, and management of ocular and systemic conditions and diseases during the 2-year period preceding application for license renewal.

www.CEatRenewal.com

� The Department of Health, Division of Medical Quality Assurance (MQA), will now review your continuing education records in the electronic tracking system at the time of renewal. It will happen automatically when you renew your license and it is important that you understand this simple change. To Renew your License:

� https://ww2.doh.state.fl.us/mqaservices/login.asp?mult=&pass=Y

� 3146 OD’s 54% have processed as of Jan 30,2013.

Renewal will require you to meet the correct amount of CE before your license is issued.

� Beginning with Professions expiring May 31, 2013, MQA will now verify a practitioner’s continuing education record in the electronic tracking system at the time of renewal. If the practitioner’s continuing education records are complete, they will continue the renewal process without interruption. If the practitioner’s continuing education records are not complete, they will be prompted to enter their remaining continuing education hours before proceeding with their license renewal. Practitioners can report continuing education and view courses in the electronic tracking system free of charge. CE Broker offers additional paid services to help licensees understand and manage renewal requirements and make sure that all hours have been met before license renewal. Many practitioners benefit from and appreciate CE Broker's subscription services, however, subscribing is not a requirement for licensure.

� Visit the below website to learn more about CE Broker. Cost $29/year. https://www.cebroker.com/public/pb_healthcare_professionals.aspx?state=1

� By the next biennium (2015) you will be able to upload your CME to MQA.

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456.0635(2), Florida Statutes requires you to answer these questions before renewing your license.� On or after July 1, 2009, have you been convicted of, or entered a plea of guilty

or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S. (relating to social and economic assistance), Chapter 817, F.S. (relating to fraudulent practices), Chapter 893, F.S. (relating to drug abuse prevention and control) or a similar offense(s) in another state or jurisdiction?

� Are you currently enrolled in a drug court program for a felony offense that allows the withdrawal of the plea or the dismissal of the charges?

� On or after July 1, 2009, have you been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues)?

� On or after July 1, 2009, have you been terminated for cause from the Florida Medicaid Program pursuant to Section 409.913, Florida Statutes?

� On or after July 1, 2009, have you been terminated for cause, pursuant to the appeals procedures established by the state, from any other state Medicaid program?

� Are you currently listed on the United States Department of Health and Human Services Office of Inspector General's List of Excluded Individuals and Entities?

License Renewal Notification

� Log on to www.FLHealthsource.com� Click Renew License� Renew on Line or Submit by mail� 456.0635 may affect your ability to renew� Next Biennium renewals have to be

submitted by 2/28/2015 to avoid delinquent fees.

INTERNET PRESCRIBINGINTERNET PRESCRIBINGPrescribing without a history and physicalis both a standard of care violation and aviolation of board rulePhysicians have been disciplined for thiswith penalties ranging from revocation tosuspension, reprimands and fines.DO NOT JEOPARDIZE YOUR LICENSE-DON’TPRESCRIBE ON THE INTERNET![Rule 64B8-9.014, FAC] Board of Medicine

LEGIBLE PRESCRIPTION LAW

Written prescription must be legibly printed or typed, must contain the name of the prescribing practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed in both textual and numerical formats, and the directions for use of the drug, must be dated with the month written out in textual letters, and must be signed by the prescribing practitioner on the day when issued.

Chapter 463.007 Renewal of license; continuing education

(4) Criteria or course content of continuing education must be approved by the board and must be regularly reviewed by the board to assure that the programs adequately and reliably contribute to the professional competence of the licensee. (COPE numbered courses for regular CE must go through CE Broker to be approved by the Florida Board of Optometry, COPE CEE (TQ) must be submitted to CE Broker prior to the date of the course.)

Chapter 463.009 Supportive personnelNo person other than a licensed practitioner may engage in the practice of optometry as defined in s. 463.002(7) . Except as provided in this section, under no circumstances shall non-licensed supportive personnel be delegated diagnosis or treatment duties; however, such personnel may perform data gathering, preliminary testing, prescribed visual therapy, and related duties under the direct supervision of the licensed practitioner. Non-licensed personnel, who need not be employees of the licensed practitioner, may perform ministerial duties, tasks, and functions assigned to them by and performed under the general supervision of a licensed practitioner, including obtaining information from consumers for making appointments for the licensed practitioner. The licensed practitioner shall be responsible for all delegated acts performed by persons under her or his direct and general supervision.

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Chapter 463.011 Exhibition of license

Each person to whom a license or branch office license is issued by the department shall keep said license conspicuously displayed in the appropriate office and shall, whenever required, exhibit said license to any authorized representative of the department.

If you practice at different locations you must have a branch office license for each location. A Branch office license is not required for the occasional fill-in position.

Chapter 463.012 Prescriptions; filing; release; duplication

(1) A licensed practitioner shall keep on file for a period of at least 2years any prescription she or he writes.

(2)(a) A licensed practitioner shall make available to the patient or her or his agent any spectacle prescription or duplicate copy determined for that patient. Such prescription shall be considered a valid prescription to be filled for a period of 5 years.

(b) A licensed practitioner shall make available to the patient or her or his agent any daily wear soft contact lens prescription (modality) or duplicate copy determined for that patient. Such prescription shall be considered a valid prescription to be filled for a period of 2 years.

Chapter 463.0135 Standards of practice

(1) A licensed practitioner shall provide that degree of care which conforms to that level of care provided by medical practitioners in the same or similar communities. A licensed practitioner shall advise or assist her or his patient in obtaining further care when the service of another health care practitioner is required.

(2) A licensed practitioner diagnosing angle closure, infantile, or congenital forms of glaucoma shall refer the patient to a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459.

(3) When an infectious corneal disease condition has not responded to standard methods of treatment within the scope of optometric practice, the certified optometrist shall consult with a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459.


(4) A licensed practitioner shall promptly advise a patient to seek evaluation by a physician skilled in diseases of the eye and licensed under chapter 458 or chapter 459 for diagnosis and possible treatment whenever the licensed practitioner is informed by the patient of the sudden onset of spots or "floaters" with loss of all or part of the visual field.

(5) The licensed practitioner shall routinely advise a patient to immediately contact the licensed practitioner if the patient experiences an adverse drug reaction.

(6) The licensed practitioner shall, when appropriate, refer to medical specialists or facilities patients who notify a licensed practitioner of an adverse drug reaction.

Adverse Reactions

Practitioners, Hospitals, and Ambulatory Surgery Centers must personally notify the patient who was the subject of an adverse incident that resulted in serious harmto the patient. 395.0197, 395.1051,456.0575, F.S.


(7) The licensed practitioner shall place in a patient's permanent record information describing any adverse drug reaction experienced by the patient, the date of such reaction, and whether any referral was made.

(8) The licensed practitioner shall maintain the names of at least three physicians, physician clinics, or hospitals to whom the licensed practitioner will refer patients who experience an adverse drug reaction. At least one of these physicians shall be a physician skilled in the diagnosis and treatment of diseases of the eye and licensed under chapter 458 or chapter 459.

(9) A licensed practitioner who believes a patient may have glaucoma shall promptly advise the patient of the serious nature of glaucoma. The licensed practitioner shall place in the patient's permanent record that the practitioner provided such advice to the patient.

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463.0135 Standards of practice

(10) A certified optometrist is authorized to perform any eye examination, including a dilated examination, required or authorized by chapter 548 or by rules adopted to implement that chapter. (11) Co-management of postoperative care shall be conducted pursuant to the requirements of this section and a patient-specific transfer of care letter that governs the relationship between the physician who performed the surgery and the licensed practitioner. The patient must be fully informed of, and consent in writing to, the co-management relationship for his or her care. The transfer of care letter shall confirm that it is not medically necessary for the physician who performed the surgery to provide such postoperative care to the patient and that it is clinically appropriate for the licensed practitioner to provide such postoperative care. Before co-management of postoperative care commences, the patient shall be informed in writing that he or she has the right to be seen during the entire postoperative period by the physician who performed the surgery. In addition, the patient must be informed of the fees, if any, to be charged by the licensed practitioner and the physician performing the surgery, and must be provided with an accurate and comprehensive itemized statement of the specific postoperative care services that the physician performing the surgery and the licensed practitioner render, along with the charge for each service.

Chapter 548 PUGILISTIC EXHIBITIONS

"Fighting" License Certification

Certified optometrists are now authorized by statute to perform dilated eye exams for boxing exhibitions and MMA fights necessary for licensure. Previously, this authority had been limited by Florida law to ophthalmologists.

Co-Management

Florida Optometrists’ ability to provide co-management of post-operative care is, for the first time, codified in the Florida Statutes under identical documentation requirements and rules established previously under CMS/ Medicare.

Chapter 463.014 Certain acts prohibited(1)(a) No corporation, lay body, organization, or individual other than a licensed practitioner shall engage in the practice of optometry through the means of engaging the services, upon a salary, commission, or other means or inducement, of any person licensed to practice optometry in this state. Nothing in this section shall be deemed to prohibit the association of a licensed practitioner with a multidisciplinary group of licensed health care professionals, the primary objective of which is the diagnosis and treatment of the human body.

(The FOA and Corporate Optometry have met since 2006 to resolve issues within this act and rules that pertain to corporate practice. After 7 years of discussion I have yet to see the final white paper )

Chapter 463.014 Certain acts prohibited

(b) No licensed practitioner shall engage in the practice of optometry with any corporation, organization, group, or lay individual. This provision shall not prohibit licensed practitioners from employing, or from forming partnerships or professional associations with, licensed practitioners licensed in this state or with other licensed health care professionals, the primary objective of whom is the diagnosis and treatment of the human body. (You can only be employed by and OD, MD or DO not a Corporation.)

(c) No rule of the board shall forbid the practice of optometry in or on the premises of a commercial or mercantile establishment. (OD must retain independence)


(d) No licensed practitioner may practice under practice identification names, trade names, or service names, unless any dissemination of information by the practitioner to consumers contains the name under which the practitioner is licensed or that of the professional association in which the practitioner participates. Any advertisement or other dissemination of information to consumers may contain factual information as to the geographic location of licensed practitioners or of the availability of optometric services. (You must ensure the public realizes you are an OD, Optometrist, Optometric Physician, or Doctor of Optometry within the advertisement)

(e) No licensed practitioner shall adopt and publish or cause to be published any practice identification name, trade name, or service name which is, contains, or is intended to serve as an affirmation of the quality or competitive value of the optometric services provided at the identified practice.

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463.014 Certain acts prohibited3) Prescribing, ordering, dispensing, administering, supplying, selling, or giving any drug for treating a systemic disease by a licensed practitioner is prohibited. However, a certified optometrist is permitted to use commonly accepted means or methods to immediately address incidents of anaphylaxis. (4) Surgery of any kind is expressly prohibited. Certified optometrists may remove superficial foreign bodies. For the purposes of this subsection, the term "superficial foreign bodies" means any foreign matter that is embedded in the conjunctiva or cornea but that which has not penetrated the globe. Notwithstanding the definition of surgery as provided in s. 463.002(6), a certified optometrist is not prohibited from providing any optometric care within the practice of optometry as defined in s. 463.002(7), such as removing an eyelash by epilation, probing an uninflamed tear duct in a patient 18 years of age or older, blocking the puncta by plug, or superficial scraping for the purpose of removing damaged epithelial tissue or superficial foreign bodies or taking a culture of the surface of the cornea or conjunctiva.

Eye Surgery DefinedThe definition of "surgery" was clarified. However, the following specific acts, as described in statute, are expressly recognized as being withinthe scope of optometric care:- removing eyelashes by epilation- probing un-inflamed naso-lacrimal ducts in patients 18 years of age or older- blocking the puncta by plug- superficial scraping for the purpose of removing damaged epithelial tissue or foreign bodies- superficial scraping for the purpose of taking a culture of the cornea or conjunctiva.- removal of foreign bodies that have not penetrated the globe

PRE-APPROVE ANY ADVERTISEMENT OFYOUR SERVICES

Why?: Because yourcompetitors read them.They check for:Accuracy,board specialty credentials,and statutory disclaimers.

Texas Optometry’s Bill of Rights Upheld in Court Decision vs. Walmart

On August 24, 2010 a federal court jury returned a unanimous verdict in favor of Doris Forte, O.D., David Wiggins, O.D., Bridget Lee Sang, O.D., and John Boldan, O.D., four Texas licensed optometrists, for the total sum of $3.953 million against Wal-Mart Stores, Inc. Mark Burgess of Boyd, Poff & Burgess from Texarkana, Texas and Hector Canales of Canales & Simonson from Corpus Christi, Texas represented the four optometrists in a one week trial held in the United States District Court, Southern District of Texas, Corpus Christi Division, from August 16-24, 2010.

Texas Optometry’s Bill of Rights UpheldThe optometrists filed suit against Wal-Mart for

violation of the Texas Optometry Act. The Act makes it illegal for commercial optical companies like Wal-Mart / Sam’s Club who lease office space to optometrists next door to their optical stores to control or attempt to control the professional judgment and manner of practice of optometrists. The unanimous verdict found the optometrists’ complaint that Wal-Mart’s lease and business practices in Texas violate the Texas Optometry Act was valid.

Texas Optometry’s Bill of Rights UpheldThe Texas Optometry Act provides that an optometrist

whose rights are violated by prohibited actions is entitled to a statutory penalty of up to $1000 per day for each day of a violation. The purpose of the Texas Optometry Act, as established by the Texas Legislature, is to safeguard the visual welfare of the public and the doctor patient relationship, and to prevent optical companies from interfering and damaging those important interests by interfering with the independent judgment of optometrists.

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Texas Optometry’s Bill of Rights UpheldThe evidence introduced during trial established Wal-Mart

required all optometrists in the State of Texas leasing from Wal-Mart to list their days and hours of operation as a term of the lease and as a condition of obtaining and renewing their leases. Wal-Mart’s Texas Form lease contained a provision which provided Wal-Mart with the option to terminate the optometrists’ lease if the doctor deviated from the listed hours of operation. The four optometrists alleged that Wal-Mart violated the Act each day their days and hours of operation were listed in their leases. The doctors sought a statutory penalty as a means to effectuate the purpose of the Texas Optometry Act.

Texas Optometry’s Bill of Rights Upheld� Evidence was presented to the jury that demonstrated on multiple

occasions Wal-Mart had used its lease terms to control and threaten optometrists. Counsel for Plaintiffs optometrists presented Wal-Mart memos, emails and analysis revealing Wal-Mart’s motive to control and threaten optometrists. Wal-Mart in a memo entitled “Doctor Project” sought to “determine what correlations exist between store sales volume and doctor coverage”. Wal-Mart’s conclusions reflect that an optometrist with “contract hours” of greater than forty hours nearly doubled Wal-Mart’s average weekly sales revenue compared to a doctor “without contracted hours”.

� Legal Counsel for the successful plaintiffs also represent eight other optometrists who have filed a lawsuit against Wal-Mart for the same violations. Questions or comments about the case may be addressed to Mr. Burgess at 903-838-6123

Independency of the OD

� You cannot be forced to see so many patients per hour or per day.

� You cannot be forced to fit certain CL’s, recommend certain solutions, and write any specific RX’s. Do what’s best for the patient not the entity you are working for.

� You need to have 24 hour access to your patients for emergency purposes.

� Be sure to hire an administrative attorney before you sign a lease or agreement.

The Prescription

A prescription creates a Physician Patient relationship.


(4) Surgery of any kind, including the use of lasers, is expressly prohibited. Certified optometrists may remove superficial foreign bodies. For the purposes of this subsection, the term "superficial foreign bodies" means any foreign matter that is embedded in the conjunctiva or cornea but which has not penetrated the globe.

(5) No rule of the board shall prohibit a licensed practitioner from authorizing a board-certified optician to fill, fit, adapt, or dispense a contact lens prescription as authorized under chapter 484. (Opticians cannot Refract)

463.0141 Reports of adverse incidents in the practice of optometry

(1) Effective January 1, 2014, an adverse incident occurring in the practice of optometry must be reported to the department in accordance with this section. (2) The required notification must be in writing and submitted to the department by certified mail. The required notification must be postmarked within 15 days after the adverse incident if the adverse incident occurs when the patient is at the office of the licensed practitioner. If the adverse incident occurs when the patient is not at the office of the licensed practitioner, the required notification must be postmarked within 15 days after the licensed practitioner discovers, or reasonably should have discovered, the occurrence of the adverse incident. (3) For purposes of notification to the department, the term "adverse incident," as used in this section, means any of the following events when it is reasonable to believe that the event is attributable to the prescription of an oral ocular pharmaceutical agent by the licensed practitioner: (a) Any condition that requires the transfer of a patient to a hospital licensed under chapter . (b) Any condition that requires the patient to obtain care from a physician licensed under chapter 458 or chapter 459, other than a referral or a consultation required under this chapter. (c) Permanent physical injury to the patient. (d) Partial or complete permanent loss of sight by the patient. (e) Death of the patient. (4) The department shall review each incident and determine whether it potentially involved conduct by the licensed practitioner who may be subject to disciplinary action, in which event s. 456.073 applies. Disciplinary action, if any, shall be taken by the board.

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Chapter 463.015 Violations and penalties

(1) Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084:

(a) Practicing or attempting to practice optometry without a valid active license issued pursuant to this chapter.

(b) Attempting to obtain or obtaining a license to practice optometry by fraudulent misrepresentation.

(c) Using or attempting to use a license to practice optometry which has been suspended or revoked.

Report Oral Medication Adverse Incidents

The requirement of "adverse incident reporting" that applies to other Florida licensed medical practitioners has been added to Chapter 463, but is limited to adverse incidents stemming from the use/prescription of oral pharmaceutical agents.

Chapter 463.015 Violations and penalties

(2) Each of the following acts constitutes a misdemeanor of the second degree, punishable as provided in s. 775.082

(a) Identifying one's activity by using the name or title "optometrist," "licensed practitioner," "certified optometrist," "Doctor of Optometry," or "O.D." in a manner which represents to the public that the person is a licensed practitioner or certified optometrist when the person has not been licensedor certified pursuant to this chapter.

(b) Knowingly employing unlicensed persons in the practice of optometry, except as specifically authorized by this chapter. (Unlicensed OD’s cannot write Rx’s, be unsupervised, diagnose or treat.)

(c) Knowingly concealing information relating to violations of this chapter.

(d) Willfully making any false oath or affirmation when required to make an oath or affirmation pursuant to this chapter.

Chapter 463.016 Grounds for disciplinary action; action by the board

(1) The following acts constitute grounds for denial of a license or disciplinary action, as specified in s. 456.072(2):

(a) Procuring or attempting to procure a license to practice optometry by bribery, by fraudulent misrepresentations, or through an error of the department or board.

(b) Procuring or attempting to procure a license for any other person by making or causing to be made any false representation.

IMPLICATIONS OF DISCIPLINARYACTION

If you have licenses in multiple states and have had action on a license in one state, you should report that action to the other states.Disciplinary action is reportable to the HealthcareIntegrity Protection Databank. Disciplinary action may have an effect on medicalmalpractice insurance, HMO coverage, staffprivileges and other state licensure.

Chapter 463.016 Grounds for Disciplinary Action

c) Having a license to practice optometry revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of another jurisdiction. (You cannot hide, all states report to a national practitioner data bank. This data is available to all state boards and health departments.)

(d) Being convicted or found guilty, regardless of adjudication, of a crime in any jurisdiction which directly relates to the practice of optometry or to the ability to practice optometry. Any plea of nolo contendere shall be considered a conviction for the purposes of this chapter.(It’s best to disclose your issue to the board as soon as you are found guilty)

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(e) Making or filing a report or record which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, willfully impeding or obstructing such filing, or inducing another person to do so. Such reports or records shall include only those which are signed by the licensee in her or his capacity as a licensed practitioner.

(f) Advertising goods or services in a manner which is fraudulent, false, deceptive, or misleading in form or content. (bait and switch has zero tolerance)

Rule 64B13-3.009 Advertising Rules

Rule 64B13-3.009 identifies the following circumstances when advertisement will be considered fraudulent, false, deceptive, or misleading:Contains a misrepresentation of facts; Has the capacity or tendency to mislead or deceive because in its content or in the context which it is presented makes only a partial disclosure of relevant facts; Has the capacity or tendency to create false or unjustified expectations of beneficial treatment or successful cures; Contains false, fraudulent, deceptive, or misleading representations relating to the quality or quantity of the optometric services offered; Contains any representation or claims which the optometrist referred to in the advertising fails to perform or Contains any other representation, statement, or claim which has the capacity or tendency to mislead or deceive. Rule 64B13-3.009 places an affirmative obligation on the advertising

optometrist to review and proof his or her advertisements prior to publication. The advertising optometrist is fully responsible for the content of the advertisements.


(g) Fraud or deceit, negligence or incompetence, or misconduct in the practice of optometry.

(h) A violation or repeated violations of provisions of this chapter, or of chapter 456, and any rules promulgated pursuant thereto. (456 is DOH’s Law over all health care practitioners)

(i) Conspiring with another licensee or with any person to commit an act, or committing an act, which would coerce, intimidate, or preclude another licensee from lawfully advertising her or his services.

(j) Willfully submitting to any third-party payer a claim for services which were not provided to a patient. (No Tolerance)


(k) Failing to keep written optometric records about the examinations, treatments, and prescriptions for patients.

(l) Willfully failing to report any person who the licensee knows is in violation of this chapter or of rules of the department or the board.

(m) Gross or repeated malpractice.

(n) Practicing with a revoked, suspended, inactive, or delinquent license.


(o) Being unable to practice optometry with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. A licensed practitioner affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that she or he can resume the competent practice of optometry with reasonable skill and safety to patients. (PRN requires 5 year contract with random drug testing, if you violate your 5 year commitment, your license is suspended.)

ELEMENTS OF PROFESSIONALISM

AltruismAccountabilityExcellenceDutyServiceHonorIntegrityRespect for Others

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THREATS TO PROFESSIONALISM

Abuse of powerArroganceGreedMisrepresentationImpairmentLack of PrecisionConflicts of InterestsLack of Independent Thought

PRN 1-800-888-8776, ext. 0The OD must contact PRN for help3 Evaluators are given to the ODAddiction, Mental Health, Sexual Boundary-Priority 1 case OD determines evaluator in problem area Evaluator preliminary report sent to PRNOD’s must pay for evaluations and drug screensTakes 4 weeks for the process to begin treatmentThe 28 day treatment is all confidential (2 OD’s in PRN as of June 2010)Judy Rivenbark, M.D., Medical Director, PRN

PRN Info

OD can enroll in PRN w/o notifying BoardRequired Polygraph & Personal EvaluationPRN determines OD return to practiceBoard can require a PRN EvaluationAll sexual boundary issues require PRN


(p) Having been disciplined by a regulatory agency in another statefor any offense that would constitute a violation of Florida laws or rules regulating optometry. (National Practitioner Data Bank has disciplinary information on all practitioners)

(q) Violating any provision of s. 463.014 or s. 463.015.

(r) Violating any lawful order of the board or department, previously entered in a disciplinary hearing, or failing to comply with a lawfully issued subpoena of the board or department.

(s) Practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities which the licensed practitioner knows or has reason to know she or he is not competent to perform. (i.e. no cyst draining, removing skin tags, yag capsulotomy, or chalazion surgery)


(t) Violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto.

(2) The board may enter an order imposing any of the penalties in s. 456.072(2) against any licensee who is found guilty of violating any provision of subsection (1) of this section or who is found guilty of violating any provision of s. 456.072(1).

(3) The board shall not reinstate the license of a person, or cause a license to be issued to a person it has deemed unqualified, until such time as it is satisfied that she or he has complied with all the terms and conditions set forth in the final order and that such person is capable of safely engaging in the practice of optometry.

ADMINISTRATIVE COMPLAINTS ARE PUBLIC

Administrative Complaints against all licensees will be published online in accordance with the governor’s commitment to transparency and accountability.

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Correspondence from the DOH or the Board of Optometry?

If you receive correspondence from theDepartment of Health and/or the Board of Optometry open it immediately.

It is imperative that you communicate with The Board and/or DOH as requested.

It is your right to obtain representation if needed.

483.035 Clinical laboratories operated by practitioners for exclusive use; licensure and regulation

(1) A clinical laboratory operated by one or more practitioners licensed under chapter 458, chapter 459, chapter 460, chapter 461, chapter 462, chapter 463, or chapter 466, exclusively in connection with the diagnosis and treatment of their own patients, must be licensed under this part and must comply with the provisions of this part, except that the agency shall adopt rules for staffing, for personnel, including education and training of personnel, for proficiency testing, and for construction standards relating to the licensure and operation of the laboratory based upon and not exceeding the same standards contained in the federal Clinical Laboratory Improvement Amendments of 1988 and the federal regulations adopted thereunder.

483.041 Definitions

(7) "Licensed practitioner" means a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461; a certified optometrist licensed under chapter 463; a dentist licensed under chapter 466; a person licensed under chapter 462; or an advanced registered nurse practitioner licensed under part I of chapter 464; or a duly licensed practitioner from another state licensed under similar statutes who orders examinations on materials or specimens for nonresidents of the State of Florida, but who reside in the same state as the requesting licensed practitioner

CLIA Lab Waiver for Optometrists’ Use of Lab Tests

Florida certified optometrists are included in the list of medical practitioners authorized to operate a clinical laboratory, to submit specimens for examination by a clinical laboratory, and to bill for in office cultures and tests.

483.181 Acceptance, collection, identification, and examination of specimens

(5) A clinical laboratory licensed under this part must accept a human specimen submitted for examination by a practitioner licensed under chapter 458, chapter 459, chapter 460, chapter 461, chapter 462, chapter 463, s. 464.012, or chapter 466, if the specimen and test are the type performed by the clinical laboratory. A clinical laboratory may only refuse a specimen based upon a history of nonpayment for services by the practitioner. A clinical laboratory shall not charge different prices for tests based upon the chapter under which a 423 practitioner submitting a specimen for testing is licensed.

641.31 Health maintenance contracts

.(19) Notwithstanding any other provision of law, health maintenance policies or contracts which provide coverage, benefits, or services as described in s. 463.002(7),shall offer to the subscriber the services of an optometrist licensed pursuant to chapter 463.

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893.02 Definitions

(21) "Practitioner" means a physician licensed pursuant to chapter 458, a dentist licensed pursuant to chapter 466, a veterinarian licensed pursuant to chapter 474, an osteopathic physician licensed pursuant to chapter 459, a naturopath licensed pursuant to chapter 462, a certified optometrist licensed pursuant to chapter 463, or a podiatric physician licensed pursuant to chapter 461, provided such practitioner holds a valid federal controlled substance registry number.

893.05 Practitioners and persons administering controlled substances in their absence

(1) A practitioner, in good faith and in the course of his or her professional practice only, may prescribe, administer, dispense, mix, or otherwise prepare a controlled substance, or the practitioner may cause the same to be administered by a licensed nurse or an intern practitioner under his or her direction and supervision only. A veterinarian may so prescribe, administer, dispense, mix, or prepare a controlled substance for use on animals only, and may cause it to be administered by an assistant or orderly under the veterinarian's direction and supervision only. A certified optometrist licensed under chapter 463 may not administer or prescribe a controlled substance listed in Schedule I or Schedule II of s. 893.03

893.055 Prescription drug monitoring program

(1) As used in this section, the term: (d) "Health care practitioner" or "practitioner" means any practitioner who is subject to licensure or regulation by the department under chapter 458, chapter 459, chapter 461, chapter 462, chapter 463, chapter 464, chapter 465, or chapter 466.

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Optometry Rule Changes in 2003

64B13-4.004, F.A.C. – Manner of Application11/3/2003

(5) Applicants are required to complete a 2-hour course relating to prevention of medical errors as part of the licensure process.

64B13-5.001, F.A.C. – Hours Requirement3/20/2003

(d) All licensees are responsible for maintaining appropriate records of completed continuing education for the past two biennium's.


64B13-5.002,F.A.C.- Criteria for Approval 8/19/2003

All non- TQ (non-CEE) COPE approved and COPE numbered courses shall be approved by the board. All TQ (CEE) courses must be approved by the Board prior to the course.


64B13-3.007, F.A.C.-Minimum Procedures for Vision Analysis 4/5/2004- Visual Acuity-at initial presentation unaided and aided acuity's are required, thereafter, unaided or acuity's with present correction are required. ($4000 + your time, attorney)

64B13-3.019, F.A.C.-Address of Record 3/8/2004 - Must provide to DOH written notification by certified mail your current mailing address and place of practice (s) within 10 days of any change.

64B13-4.001, F.A.C.- Examination Requirements 3/8/2004- a candidate must score 84% or better on Laws and Rules to pass, 70% or better on the pharmacology/pathology portion of the state certification exam, and a 80% on the clinical portion of the state certification exam. (For 2008, 86% of the 125 candidates passed the Florida Board of Optometry) ( In 2009, 120 took the Florida Board exam and in 2010, 132 took the exam. The minimum passing score of 80% has passed for pharmacology/path section in 2010)

Optometry Rule changes in 2004

64B13-15.003, F.A.C.- Range of Penalties for Administration Violations 5/13/2004-Minor range from $500-$8000/count and probation, Major range from $1000-$10,000/count and suspension for up to 18 months or revocation of license.

64B13-15.004, F.A.C.- Range of Penalties for Patient Care Violations 5/13/2004- Minor range from$75--$10000/count probation and suspension of 1 year. Major range from $1000-$10000 and suspension up to 24 months or revocation of license.


64B13-3.003- Patient Records: Transfer or Death of Licensed Practitioner (1) The licensed practitioner must legibly sign the entry for each patient encounter. (Records must be available to patients and be noticed 4 weeks when you retire)

64B13-3.004- Minimum Equipment Requirements (4) ophthalmometer, keratometer, or corneal topographer;

64B13-3.010- Standards of Practice (title change)

64B13-3.015-Performance of Delegated Tasks by Non-Licensed Personnel (2) (changed customer to patient )


64B13-16.003-Requirements and Restrictions for Mobile Branch Offices (7) Meet all the requirements of Sections 463.0135 and 463.014, Florida Statutes and Rule Chapter 64B13-3, Florida Administrative Code. (better tracking language)

64B13-18.002-Formulary of Topical Pharmaceutical Agents (update on drugs allowed) go to http://www.doh.state.fl.us/mqa/optometry/lst_form.pdf

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Governor signs two bills in 2007

� House Bill 587 Requires all health care personnel wear a name tag or introduce themselves as what type of health care professional they are. This also includes any advertisements. (No rules defined, yet)

� House Bill 699 HIV/AIDS is a one time, 1hr requirement, to be completed prior to the first renewal of licensure. This is now Rule.

Rule Changes in 2008

� 64B13-4.004 Removed AID’s requirement for candidates sitting for the State Board Exam. Applicants must still have a 2 hour course in medical errors prior to taking the Florida Board Exam. New OD graduates are not required to re-take medical errors in their first biennium.

� Vision Analysis was changed to Comprehensive Eye Examination throughout the rules.


� 64B13-18.002 Azithromycin – 1%, Levofloxacin – 1.5% , Polyvinyl pyrrolidone 2.0% were added.

� 64B13-3.007 supplemental services was changed to consultative services.


� 64B13-3.009 The licensed practitioner has the duty to review and proof all advertisements prior to publication, and is fully responsible for the content therein.


� 64B13-3.010 Engaging or attempting to engage in the possession, sale, or distribution of controlled substances as set forth in Chapter 893, F.S., for any other than legitimate purposes, constitutes grounds for disciplinary action by the Board.

Rule Changes in 2009� Tendering a check payable to the Board of Optometry or

the Department of Health that is dishonored by the institution upon which it is drawn shall result in a fine of $100 and payment of the check within 30 days.

� Durezol and Latisse were up for consideration by the TOPA Committee. They are now approved.

� If a candidate for licensure has committed Medicare or Medicaid fraud the application will be denied. (456.0635)

� Disclaimer for free or discounted services must be at least Times New Roman 6 font or in equivalent size fonts.

� Besivance was recommended by the Board for approval. Besifloxacin Ophthalmic Suspension – 0.6% is now approved.

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2009 Rule Changes Dispensing Practitioner RegistrationDispensing Practitioner Registration 64B13-4.009To register as a dispensing practitioner, the licensee must

submit a Dispensing Practitioner Registration, form number DH-MQA 1137, (8/08) and the fees set forth in Rule 64B13-6.003, F.A.C. The form is incorporated by reference herein and available from the Board office or website: http://www.doh.state.fl.us/mqa/optometry/index.html.

Rulemaking Authority 463.005 FS. Law Implemented 465.0276 FS. History–New 3-31-09.

2009 Rule Changes Prescriptions 64B13-3.012

(1) All prescriptions written by a licensed practitioner shall contain the name, address, telephone number and signature of the licensed practitioner who wrote the prescription and the information shall be kept on file by the licensed practitioner for a period of at least two (2) years. If the licensed practitioner maintains electronic patient records, the practitioner may affix an electronic signature to the prescription only if the electronic signature is generated by using either public key infrastructure or signature dynamics technology, and meets the criteria of paragraphs (1)(a)-(d) of Rule 64B13-3.003, F.A.C.

(2) A spectacle prescription shall be considered valid for a period of five (5) years, and a licensed practitioner shall make available to the patient or his or her agent any spectacle prescription or duplicate copy determined for that patient.

(3) A prescription for daily wear soft contact lens shall be considered valid for a period of two (2) years and a licensed practitioner shall make available to the patient or his or her agent any daily wear soft contact lens prescription or duplicate copy determined for that patient. This subsection applies only to contact lenses determined by the Federal Drug Administration to be daily wear lenses. (Daily Wear Modality 2 Year Rx, Extended Wear Modality 1 Year Rx)

2009 Rule Changes Prescriptions

(4) Spectacle and contact lens prescriptions shall include:

(a) Spectacle prescriptions:1. Sphere power,2. Cylinder power, if necessary,3. Cylinder axis, if necessary,4. Prism amount, if necessary,5. Multifocal add power, if necessary,6. Any other information necessary to accomplish the

objective of the prescription.

2009 Rule Changes Prescriptions

(b) Contact lens prescriptions, including prescriptions for cosmetic, non-corrective lenses, as applicable shall include:

1. Sphere power,2. Cylinder power, if necessary,3. Cylinder axis, if necessary,4. Specific contact lens type/brand,5. Base curve, if not included in type/brand,6. Diameter, if not included in type/brand,7. Follow-up care requirements, if any.(5) Except as provided in Section 463.012, Florida Statutes, and subsection (3)

of this rule, the extent of a contact lens prescription and when a contact lens prescription can safely and accurately be written shall be left to the professional judgment of the licensed practitioner.

2009 Rule Changes Administration and Prescription of Topical Pharmaceutical Agents

64B13-10.002

(1) Only a certified optometrist may administer and prescribe topical ocular pharmaceutical agents. A licensed practitioner who is not certified may use topically applied anesthetics solely for the purpose of glaucoma examinations, but is otherwise prohibited from administering or prescribing topical ocular pharmaceutical agents. Certified optometrists may administer and prescribe only those topical ocular pharmaceutical agents identified by rule of the Board.

(2) Any prescription for a topical pharmaceutical agent written by a certified optometrist shall contain the following information:

(a) Name of the person for whom the pharmaceutical agent is prescribed;(b) Full name and address of the prescribing certified optometrist;(c) Name of the topical pharmaceutical agent prescribed and the strength,

quantity, and directions for use thereof; and(d) Prescriber number and signature of the prescribing certified optometrist.(3) When a topical pharmaceutical agent is either administered or prescribed to

a patient by a certified optometrist, such shall be documented in the patients record.

TOPA Committee Meeting 1/15/10

Jim Watts, OD, ChairMark Dunbar, ODLee Duffner, MD

Emanuel Newmark, MDMagdi Soliman, Pharm.D.

A discussion of adding ZIRGAN to the formulary.

Zirgan(TM) (ganciclovir ophthalmic gel) 0.15% is a treatment for acute herpetic keratitis (dendritic ulcers). The FDA granted orphan

drug designation to Zirgan for this indication in April 2007.PASSED 4-1 Newmark Opposed

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2010 Additions to the Formulary� Acuvail - Allergan, Inc. (ketorolac tromethamine ophthalmic solution) 0.45%, an

advanced, preservative-free formulation of ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) indicated for the treatment of pain and inflammation following cataract surgery. Cataracts are a leading cause of blindness among older adults and cataract surgery is the most frequently performed surgical procedure in the United States, with more than 3 million procedures performed each year.

� Bepreve-ISTA Pharmaceuticals, Inc. (bepotastine besilate ophthalmic solution) 1.5% as a twice-daily prescription eye drop treatment for ocular itching associated with allergic conjunctivitis in patients two years of age and older.

� Zirgan-Sirion Therapeutics, Inc., a privately held ophthalmic-focused biopharmaceutical company, (ganciclovir ophthalmic gel) 0.15% as a treatment for acute herpetic keratitis (dendritic ulcers).

� Zymaxid-Allergan, Inc. Gatifloxacin ophthalmic solution is used to treat bacterial conjunctivitis (pinkeye; infection of the membrane that covers the outside of the eyeballs and the inside of the eyelids). Gatifloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infection ...

Rule changes 201064B-3.008- Board Expert of Technical Advice:Allows the Florida Board of Optometry to contract with an expert OD to help

Consumer Services in the determination of appropriate complaints by consumers. This will ensure consumer complaints are reviewed by an OD prior to dismissal by the department.

64B13-3.009-False, Fraudulent, Deceptive, and Misleading Advertising: Any advertisement for free or discounted services must contain the disclaimer required by Section 456.062, F.S., no less than Times New Roman 6 point font size.

64B13-4.004 Manner of Application changed the Florida Licensing Exam application due date from 60 days prior to the exam to 120 days prior to the exam.

.64B13-4.007 Optometry Faculty Certificate added criminal investigative questions to the applicant history. (F.S. 409, 817, 893)

Rule changes 2010� 64B13-3.001 Confidential Information(1) A licensed practitioner shall

keep in confidence whatever he or she may learn about a patient in the discharge of his or her professional duties. All reports and records relating to the patient, including those records relating to the identity, examination, and treatment of the patient, shall constitute “patient records”. Except upon written authorization of the patient or as otherwise provided by law, such records may not be furnished to and the condition of the patient may not be discussed with any person other than the patient or his or her legal representative or other health care providers licensed under Chapter 463, 458, or 459, Florida Statutes, who are involved in the diagnosis and treatment of that patient. Provided, however, that this shall not prohibit a licensed practitioner from providing copies of a patient prescription in accordance with Section 463.012, Florida Statutes, or Rule 64B13-3.012, F.A.C. The rule adds Nurse Practitioners

Gov Scott’s Moratorium � TALLAHASSEE -- Acting on his anti-regulatory priority,

Gov. Rick Scott's first act in office was to sign a sweeping executive order putting a hold on all pending state government regulations.

In early 2012, this moratorium continued to be in effect.Governor Scott has direct supervision of all rulemaking. All rule filings must go through the Office of Fiscal Accountability and Regulatory Reform (OFARR).

� In late 2012, Rule changes will voluntary go to OFARR and are required to be sent to the Florida Administrative Code. Our board is in compliance.

Formulary Drug Approval in 2011

Allergan’s Lastacaft (Alcaftadine.25%) approved 8/29/2011

July 28, 2010 -- The United States Food and Drug Administration (FDA) has approved Lastacaft (alcaftadine ophthalmic solution) for the prevention of itching associated with allergic conjunctivitis in patients over 2 years of age.

Alcaftadine is an H1 histamine receptor antagonist which also inhibits the release of histamine from mast cells.

The recommended dosage of Lastacaft is one drop to be instilled into each eye once daily.

2011 Rule Changes 64B13-10.001 Application for Certification.

� To be certified to administer and prescribe topical ocular pharmaceutical agents a licensed practitioner must submit a completed application, DPR/OPT/006(A), revised 1/89, hereby incorporated by reference, provided by the Board; remit the application fee for certification specified in subsection 64B13-6.001(9), F.A.C.; and demonstrate compliance with the following requirements:

� (1) Successful completion of at least 110 hours of Board approved transcript quality coursework and clinical training in general and ocular pharmacology conducted by an accredited institution which has facilities for both didactic and clinical instruction in pharmacology. The institution must document the applicant’s successful completion. The Board will accept coursework and clinical training in general and ocular pharmacology received by the applicant during his or her basic optometric curriculum or at post-graduate courses if this coursework and training was provided by a Board approved school of optometry or equivalent educational entity;

� (2) Completion of at least one (1) year of supervised experience in differential diagnosis of eye diseases or disorders. The one year of supervised experience shall be received either during optometric training or in a clinical setting as part of optometric experience. The requisite one year of supervised experience in a clinical setting may be obtained in an academic or non-academic environment. For the purpose of this rule, one year of supervised experience in an academic setting is understood to mean three (3) quarters or two (2) semesters and one (1) year of supervised experience in a non-academic setting is understood to mean a twelve month period;

� (3) Successful completion of part II of the NBEO examination.

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TOPA Update-January 2012Lotemax-loteprednol etabonate ophthalmic suspension, 0.5% has already

been approved in the past. Lotemax Suspension, .5% is indicated for the treatment of steroid responsive

inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitides, when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation.

Lotemax Ointment, .5% was added to the formulary. Lotemax ointment is indicated to treat post-operative inflammation and pain following ocular surgery. Lotemax ointment has proven efficacy in treating in treating inflammation and pain following surgery. Ointment formulation provides additional choice in dosage forms for treating patients with ocular inflammation.

2012 Rule Changes64B13-4.001 Examination Requirements

The 5 year period was increased to 7years for NBEO Parts I and II in order to sit for the Florida Board of Optometry Exam. “Florida licensure examination must be obtained within the 7 year period immediately preceding October 1 of the year that the applicant takes Parts I and II of the Florida licensure examination. “

2012 Rule Changes64B13-3.019 Address of Record� It shall be the duty of each licensee to provide to the Department of

Health written notification by certified mail of the licensee’s current mailing address and place of practice within 10 days upon change thereof. When electronic notification is used, it is the responsibility of the licensee to ensure that the electronic notification was received by the department. Electronic notification to the department shall be sent only using an email option that generates an electronic return receipt and that the licensee requesting the change address have an email address of record with DOH before electronic notification can be used. It requires the notification to DOH must be made using the licensee’s previously established email address of record. The term “place of practice” means the address(es) of the physical location(s) where the licensee practices optometry. (This allows the use of e-mail to update a practice address.)

2012 Rule Changes64B13-4.002 Re-examination� An applicant who fails Part I or Part II of the state examination for

licensure shall be required to retake only that portion of the examination on which he or she failed to achieve a passing grade, provided that the applicant shall be limited to two (2) retakes within a twenty-eight (28) month period from the date of original failure. The Board may grant an extension of time of one additional year to allow a second retake based on medical disability substantiated by documentation from the applicant’s physician. If the applicant fails to achieve a passing grade as provided above, he or she shall be required to take the complete state examination for licensure and certification examination in order to be entitled to be licensed.

2012 Rule Changes64B13-15.005 Designation of Administrative Violations; Minor (1)� (a) Section 456.062, F.S., entitled “Advertisement by Health Care Provider of Free or

Discounted Services; Required Statement.”� (b) Section 456.057, F.S., entitled “Ownership and control of patient records; report or

copies of records to be furnished.”� (c) Section 463.011, F.S., entitled “Exhibition of License.”� (d) Subsection (1), paragraphs (2)(a) and (b) of Section 463.012, F.S., entitled

“Prescriptions; Filing; Release; Duplication.”� (e) Paragraphs (1)(d) and (e) of Section 463.014, F.S., entitled “Certain Acts Prohibited.”� (f) Subsections (4) and (5) of Section 499.028, F.S., entitled “Drug samples or

complimentary drugs; starter packs; permits to distribute” or subsection 465.276(5), F.S., entitled “Dispensing Practitioner,” if the violation is of a technical nature not related to patient care.

� (g) Rule 64B13-3.002, F.A.C., entitled “Responsibility to Patient.”� (h) Rule 64B13-3.005, F.A.C., entitled “Entrance Sign.”� (i) Rule 64B13-3.006, F.A.C., entitled “Licenses and Signs in Office.”� (j) Rule 64B13-3.012, F.A.C., entitled “Prescriptions” if the violation consists of failing to

release a prescription or technical omissions or errors on the prescription not related to patient care.

� (k) Section 456.072(1)(nn), F.S., violating any provision of Section 790.338, F.S.

2012 Rule Changes64B13-15.005 Designation of Administrative Violations; Major (2)� (a) Paragraphs 456.072(1)(a), (b), (c), (e), (f), (g), (h), (i), (k), (m), (q), (r), (s), (w), (x), (cc), (gg), (ii), (jj), (kk),

(ll), F.S., entitled “Grounds for Discipline; Penalties; Enforcement.”� (b) Subsections 463.0055(2)(a), (b) and (c), F.S., entitled “Administration and prescription of topical ocular

pharmaceutical agents; committee.”� (c) Subsection 463.0135(7) and (8), F.S., entitled “Standards of Practice.”� (d) Subsection 463.014(1)(a) and (b), F.S., entitled “Certain Acts Prohibited.”� (e) Subsections 463.015(1)(a), (b), (c) and (2)(a), (c) and (d), F.S., entitled “Violations and Penalties.”� (f) Subsections 463.016(1)(a), (b), (c), (d), (e), (f), (g), (h), (i), (k), (l), (m), (n), (o), (q), (r), and (s), F.S., entitled

“Grounds for Disciplinary Action; Action by the Board.”� (g) Subsections 499.028(4) and (5), F.S., entitled “Drug samples or complimentary drugs; starter packs;

permits to distribute” if the violation is substantially likely to affect patient care.� (h) Rule 64B13-3.001, F.A.C., entitled “Confidential Information; Disclosure.”� (i) Rule 64B13-3.003, F.A.C., entitled “Patient Records; Transfer or Death of Licensed Practitioner.”� (j) Paragraphs (2)(a), (b), (c), (d), (e), (f), and subsections (4), (5), and (6), of Rule 64B13-3.009, F.A.C.,

entitled “False, Fraudulent, Deceptive and Misleading Advertising Prohibited; Policy; Definitions; Affirmative Disclosure.”

� (k) Rule 64B13-3.012, F.A.C., entitled “Prescriptions” if the violation is substantially likely to affect patient care.

� (l) Subsection (3) of Rule 64B13-11.001, F.A.C., entitled “Inactive Status.”� (m) Rule 64B13-5.001, F.A.C., entitled “Hours Requirement.”

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2012 Rule Changes

� 64B13-4.004, F.A.C. – Manner of Application added Fraud Questions to application for licensure.

� 64B13-4.007, F.A.C.- Optometry Faculty Certificate Fraud Questions were added to the application.

2012 Rule Changes

� Remember you must list all locations you practice at by e-mail, and/or certified mail. This applies to fill-in OD’s and OD’s with multiple practice locations.

TOPA Committee Meeting 2/14/2012

Jim Watts, OD, ChairMark Dunbar, ODLee Duffner, MD

Emanuel Newmark, MDMagdi Soliman, Pharm.D.

A discussion of adding the FDA Approved Anti-FungalNatacyn (Natamycin) ophthalmic suspension 5% to the formulary.

PASSED TOPA 5-0 (Approved by the Board 4/6/2012)

Manny Newmark, MD was concerned about Corneal Scraping by OD’s.Newmark wrote a letter to Attorney General Pam Bondi.

Chuck Slonim, MD, President of FSO, addressed the 7/11/12 Board MeetingAs of July 1, 2013 the TOPA Committee no longer exixts.

Zioptan Approved for use

� Approved for use by certified OD’s Optometry Board Meeting 7/11/2012

� ZIOPTAN is indicated for reducing elevated IOP in patients with OAG or OHT.

� The recommended dose is 1 drop of ZIOPTAN in the conjunctival sac of the affected eye(s) once daily in the evening

� Request Samples from Merck at http://www.merckservices.com/portal/site/merckproductservices/rcps/

MQA Director Lucy Gee Memo� The DOH will outsource the Florida Practical Board of Optometry

Exam by a legislative initiative; HB 5311 which passed in 2010. Chapter 456 states we must use a National Exam.

� Optometry was the only state practical given in 2012.

� Eventually, Part I, II, and III* of the NBEO will be required.

� *The NBEO says it modify Part III to meet the Florida Board of Optometry and Chapter 463’s requirements. However, Chapter 463 says the board can offer a practical exam.

� The DOH 2013 Practical Examination will probably be the last one.

2013 Formulary Update

SIMBRINZA™ (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2% is a fixed combination of a carbonic anhydrase inhibitor and an alpha 2 adrenergic receptor agonist.

Rescula (unoprostone isopropyl) A Synthetic Docosanoid, Ophthalmic Solution 0.15% is indicated for the lowering of intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

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2013 Rule Changes64B13-5.001 Hours Requirement

No more than two hours of continuing education in the area of Florida jurisprudence may be applied to the 30 clock hour requirement in subsection (1).

No more than two hours of continuing education relating to the prevention of medical errors may be applied to the 30 clock hour requirement in subsection (1).

The board did not vote in favor of on line courses for the 30 hour requirement. However, the 20 Hour Orals Course is approved as an on-line course.

2013 Rule Changes64B13-10.002 Administration and Prescription of Ocular Pharmaceutical Agents.

Only certified optometrists who have successfully completed the Board approved pharmaceutical course and examination specified in subsection 463.0055(1)(b),F.S. and provided proof of such to the Department are authorized to administer and prescribe the oral ocular pharmaceutical agents or their therapeutic equivalents specified in subsection 463.0055(3),F.S..Controlled substances listed on the statutory formulary of oral ocular pharmaceutical agents may only be administered or prescribed by a certified optometrist who has successfully completed the board approved oral drug course and examination specified in subsection 463.0055(1)(b),F.S., provided proof of such to the Department, and after the certified optometrist has acquired a United States Drug Enforcement Administration registration number.

2013 Rule Changes64B13-10.002 Administration and Prescription of Ocular Pharmaceutical Agents.

All written prescriptions must comply with the requirements of sections 456.42, F.S. Written prescriptions for medicinal drugs.—(1) A written prescription for a medicinal drug issued by a health care practitioner licensed by law to prescribe such drug must be legibly printed or typed so as to be capable of being understood by the pharmacist filling the prescription; must contain the name of the prescribing practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed, and the directions for use of the drug; must be dated; and must be signed by the prescribing practitioner on the day when issued. However, a prescription that is electronically generated and transmitted must contain the name of the prescribing practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed in numerical format, and the directions for use of the drug and must be dated and signed by the prescribing practitioner only on the day issued, which signature may be in an electronic format as defined in s. 668.003(4).(2) A written prescription for a controlled substance listed in chapter 893 must have the quantity of the drug prescribed in both textual and numerical formats, must be dated with the abbreviated month written out on the face of the prescription, and must be either written on a standardized counterfeit-proof prescription pad produced by a vendor approved by the department or electronically prescribed as that term is used in s. 408.0611. As a condition of being an approved vendor, a prescription pad vendor must submit a monthly report to the department which, at a minimum, documents the number of prescription pads sold and identifies the purchasers. The department may, by rule, require the reporting of additional information.

2013 Rule Changes64B13-10.0011 Administration and Prescription of Oral Pharmaceutical Agents

In order to administer or prescribe oral ocular pharmaceutical agents, a Certified Optometrist must submit proof of successful completion of a course and subsequent examination, approved by the Board, on general and ocular pharmaceutical agents and the side effects of those agents.

2013 Rule Changes64B13-15.005 Designation of Administrative Violations; Major; Minor

Subsection 463.0135(11), F.S. entitled "Standards of Practice," if the violation is of a technical nature not related to patient care.Subsection 463.0135(11), F.S. entitled "Standards of Practice," if the violation is substantially likely to affect patient care.

463.0135(11) Co-management of postoperative care shall be conducted pursuant to the requirements of this section and a patient-specific transfer of care letter that governs the relationship between the physician who performed the surgery and the licensed practitioner. The patient must be fully informed of, and consent in writing to, the co-management relationship for his or her care. The transfer of care letter shall confirm that it is not medically necessary for the physician who performed the surgery to provide such postoperative care to the patient and that it is clinically appropriate for the licensed practitioner to provide such postoperative care. Before co-management of postoperative care commences, the patient shall be informed in writing that he or she has the right to be seen during the entire postoperative period by the physician who performed the surgery. In addition, the patient must be informed of the fees, if any, to be charged by the licensed practitioner and the physician performing the surgery, and must be provided with an accurate and comprehensive itemized statement of the specific postoperative care services that the physician performing the surgery and the licensed practitioner render, along with the charge for each service.

Rule Changes 201364B13-15.005 Designation of Administrative Violations; Major; Minor.

For the first violation of subsection 463.0141, F.S., entitled "Reports of adverseincidents in the practice of optometry.“For a second or subsequent violation of subsection 463.0141, F.S., entitled"Reports of adverse incidents in the practice of optometry.“463.0141 Reports of adverse incidents in the practice of optometry.—(1) Effective January 1, 2014, an adverse incident occurring in the practice of optometry must be reported to the department in accordance with this section.(2) The required notification must be in writing and submitted to the department by certified mail. The required notification must be postmarked within 15 days after the adverse incident if the adverse incident occurs when the patient is at the office of the licensed practitioner. If the adverse incident occurs when the patient is not at the office of the licensed practitioner, the required notification must be postmarked within 15 days after the licensed practitioner discovers, or reasonably should have discovered, the occurrence of the adverse incident.(3) For purposes of notification to the department, the term “adverse incident,” as used in this section, means any of the following events when it is reasonable to believe that the event is attributable to the prescription of an oral ocular pharmaceutical agent by the licensed practitioner:(a) Any condition that requires the transfer of a patient to a hospital licensed under chapter 395.(b) Any condition that requires the patient to obtain care from a physician licensed under chapter 458 or chapter 459, other than a referral or a consultation required under this chapter.(c) Permanent physical injury to the patient.(d) Partial or complete permanent loss of sight by the patient.(e) Death of the patient.(4) The department shall review each incident and determine whether it potentially involved conduct by the licensed practitioner who may be subject to disciplinary action, in which event s. 456.073 applies. Disciplinary action, if any, shall be taken by the board.

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2013 Rule Changes64B13-15.006 Designation of Patient Care Violations; Major; Minor.Subsection 893.05(1), F.S., entitled "Practitioners and persons administering controlled substances in their absence.“893.05 Practitioners and persons administering controlled substances in their absence.—(1) A practitioner, in good faith and in the course of his or her professional practice only, may prescribe, administer, dispense, mix, or otherwise prepare a controlled substance, or the practitioner may cause the same to be administered by a licensed nurse or an intern practitioner under his or her direction and supervision only. A veterinarian may so prescribe, administer, dispense, mix, or prepare a controlled substance for use on animals only, and may cause it to be administered by an assistant or orderly under the veterinarian’s direction and supervision only.(2) When any controlled substance is dispensed by a practitioner, there shall be affixed to the original container in which the controlled substance is delivered a label on which appears:(a) The date of delivery.(b) The directions for use of such controlled substance.(c) The name and address of such practitioner.(d) The name of the patient and, if such controlled substance is prescribed for an animal, a statement describing the species of the animal.(e) A clear, concise warning that it is a crime to transfer the controlled substance to any person other than the patient for whom prescribed.(3) Any person who obtains from a practitioner or the practitioner’s agent, or pursuant to prescription, any controlled substance for administration to a patient during the absence of such practitioner shall return to such practitioner any unused portion of such controlled substance when it is no longer required by the patient.

2013 Rule Changes64B13-18.001 Purpose.

Subsection 463.0055 (2)(a), F.S., requires the Board to establish a formulary of topical ocular pharmaceutical agents that may be prescribed and administered by a certified optometrist. The formulary is required to consist of those topical ocular pharmaceutical agents which are appropriate to treat or diagnose ocular diseases and disorders that a certified optometrist is qualified to use in the practice of optometry. The Board is required to establish, add to, delete from, or modify the topical formulary by rule.

2013 Rule Changes64B13-18.003 Procedures Regarding Topical Ocular Pharmaceutical Agents.(1) Requests for the addition, deletion or modification of categories of agents or for the addition of agents on the formulary of topical ocular pharmaceutical agents shall be filed with the Board. The request shall be in writing and shall contain the following information:(a) the name, address, and telephone number of the individual or entity filing the request;(b) the chemical name of the agent;(c) the brand name(s) of the agent;(d) the concentration of the agent;(e) the United States FDA approved information sheet for the agent;(f) the date the FDA released the agent for sale; and(g) an explanation why the requested addition, deletion or modification isconsistent with the provisions of section 463.0055, F.S. and should be made.(2) If, after receipt of a request as specified in subsection (1), the Board determinesan addition, deletion, or modification of the formulary should be made, the Board shall initiate rulemaking to accomplish said change.

2013 Rule Changes64B13-4.001, F.A.C. – Examination Requirements

The licensure examination authorized in section 463.006(2), F.S., shall consist of the following parts:(a) Part I – the Applied Basic Science (ABS) portion of the examination developed by the National Board of Examiners in Optometry (NBEO).(b) Part II – the Patient Assessment and Management (PAM) portion of the

examination developed by the NBEO which includes an embedded Treatment and Management of Ocular Disease (TMOD) examination. An applicant for licensure in Florida must obtain a passing score on the TMOD section of the examination.(c) Part III – the Clinical Skills (CSE) portion of the examination developed by the NBEO. An applicant for licensure in Florida must obtain a passing score on each skill within the CSE portion of the examination.(d) Part IV –a written examination on applicable Florida laws and rules governing the practice of optometry developed by the Florida Department of Health, which may not betaken prior to graduation.

2013 Rule Changes64B13-4.001, F.A.C. – Examination Requirements

(2) An applicant for licensure must achieve a passing score on all four parts of the licensure examination. A score of 84 percent (84%) or better must be obtained in order to achieve a passing score on Part IV.Passing scores on Part I, Part II, and Part III and Part IV of the licensure examination must be obtained within the seven (7) year period immediately preceding application to take Part IV of the licensure examination.Certification Examination. A licensee applying for certification must obtain a passing score on either the TMOD examination embedded in the Patient Assessment and Management portion of the examination developed by the NBEO or a passing score on the stand alone TMOD examination developed by the NBEO.

NBEO Part III Examination

The board determined the following skills would be required to successfully pass the NBEO Part III examination. The candidate must obtain 75% on each skill below to pass.

1.Biomicroscopy2.Binocular Indirect Opthalmoscopy3.Dilated Biomicroscopy and Non-Contact Fundus Lens Evaluation

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2013 Rule Changes64B13-4.002 ReexaminationAn applicant who fails to achieve a passing score on Part IV shall be limited to two (2) retakes within a twelve (12) month period from the date of the original failure. The applicant’s passing scores on Part I, Part II, and Part III of the licensure examination must have been obtained within the time period set forth in Rule 64B13-4.001(2) before the applicant will be allowed any further attempts to obtain a passing score on Part IV.If the applicant fails to achieve a passing score grade on Part IV as provided above, the applicant’s passing scores on Part I, Part II, and Part III of the licensure examination (including scores of 75% or better on the three skills identified in Rule 64B13-4.001(1)(c)) must have been obtained within the time period set forth in Rule 64B13-4.001 (2) before the applicant will be allowed any further attempts to obtain a passing score on Part IV.

2013 Rule Changes64B13-4.004 Manner of Application.(3) Has graduated from a school or college of optometry approved by the board which has been accredited by the Accreditation Council on Optometric Education (ACOE) and which remains accredited by ACOE.

(4) Any licensed practitioner licensed to practice optometry in Florida prior to July 1, 1993 who is not a certified optometrist and who desires to be licensed as a certified optometrist shall apply to the department for certification. The board will approve a licensed practitioner for licensure as a certified optometrist who satisfies the requirements of subsection (1)(b) 4. and 5, successfully completes the certification examination set forth in Rule 64B13-4.001 (3), F.A.C., and remits the fee established in Rule 64B13-6.001 (7), F.A.C..

Rule 64B13-4.005, F.A.C. – Criteria for Selections of Examiners and Consultants

Rule 64B13-4.005, F.A.C. – Criteria for Selections of Examiners and Consultants has been deleted .

The NBEO will be responsible for selection of examiners and consultants through a contractual relationship.

Rule 64B13-4.006, F.A.C. – Security and Monitoring Procedures for Licensure Examinations

Rule 64B13-4.006, F.A.C. – Security and Monitoring Procedures for Licensure Examinations has been deleted.

Prometrics and the NBEO will provide Security and Monitoring through a contractual relationship.

FEES FOR COPYING PATIENTRECORDSTo follow the community standard of care, you cannot condition release of patient records on payment of fees owed for services, however, you may condition release of copies of patient records on the reasonable costs of reproducing the records.

Reasonable costs of reproducing copies of written ortyped documents or reports should not be more than $1.00 per page.

Petition for Variance

� Petition for Variance can only address a rule within 64B13.

� A petition for Variance cannot usurp our statute; Chapter 463.

� There are no Reciprocity Agreements of the Florida Board of Optometry with any other States or Countries.

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JAPC

The Joint Administrative Procedures Committee conducts continuous oversight of executive branch actions implementing legislatively delegated powers ensuring that each action has an adequate statutory basis, that all applicable procedures are followed, and that no illegal rules are imposed on the people of Florida.

Profiling Website

http://www.floridahealth.gov/licensing-and-regulation/practitioner-profile/index.html

This site contains self-reported information from licensed Medical Physicians, Osteopathic Physicians, Podiatric Physicians, Chiropractic Physicians, and Advanced Registered Nurse Practitioners.

Optometry could be added in future legislation.

Jurisprudence Websites

Florida Board of Optometry: (NEW)

http://www.floridasoptometry.gov/

Florida Optometry Board Rules:https://www.flrules.org/gateway/Division.asp?DivID=304&Sort=ID

Florida Optometry Board Statutes :http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0463/0463ContentsIndex.html&StatuteYear=2013&Title=-%3E2013-%3EChapter%20463

Florida Statutes affiliated with Optometry

� Chapter 463, Florida Statutes: Optometry Practice Act� Chapter 456, Florida Statutes: Health Professions and Occupations:

General Provisions� Chapter 120, Florida Statutes: Administrative Procedure Act� Chapter 119, Florida Statutes: Public Records� Chapter 408, Florida Statutes: Health Care Administration� Chapter 112, Florida Statutes: Public Officers and Employees:

General Provisions

Florida Jurisprudence Websites

For clarification of board discussion in which the board minutes do not detail, go to the audio versions of the Florida Board of Optometry Meetings at:

http://www.floridasoptometry.gov/meeting-information/past-meetings/

Florida Optometric Association Links*

Florida State Board

http://florida.aoa.org/x12767.xml

Legal Cornerhttp://florida.aoa.org/x9690.xml

These links* are easier to navigate through.

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Protect your LicenseKnow your laws 463 and follow the rules 64B13.

Practice ethically and with integrity.

Build communication skills with othermembers of the healthcare team to preventmedical errors and optimize patient care.

When you are in doubt, contact the ED of the Board of Optometry, not the Optometry Board members.

If you get disciplined: Hire an attorney specialized in Administrative-Health Care Law.

Read the handout and listen to the Jurisprudence LecturesWhen you are not sure, ask questions, do not assume!

To Verify your license or any other practitioner’s license go to:https://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

In Memory ofDr. Edward Kirkland Walker

Edward Kirkland Walker, OD FAAO, 84, passed away Monday, October 29, 2012 at his residence.” It was an honor to serve with him on the State Board. He cared more about the profession than anyone I have known. RIP Brother Ed.”

In Memory of Dr. Peter D. Liane

Dr. Peter D. Liane, 57, of Jacksonville, Florida passed away Sunday, December 30, 2012 in North Carolina. Dr. Liane was born August 2, 1955 in Dayton, Ohio. After graduating from Optometry school at THE Ohio State University, he moved to Jacksonville to set up practice in 1979. Dr. Liane practiced at Liane Downtown Eye Associates and also owned a consulting firm, THE Eye Consultants. He served as a local and state president of the Florida Optometric Association. Dr. Liane was awarded Optometrist of the Year, Optometrist of the Decade, and was the youngest member ever appointed to the State Board. Whether in his profession, organizations, or sports he always gave 110%. His greatest love of all was his family.

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Chapter 456

Chapter 456 includes all health care professions under the Department of Health

Florida Patient Self –Referral ActChapter 456.053

Provides that a health care provider may not refer a patient for designated health services to an entity in which the provider is an investor or has an investment interest, nor may a referral be made for any other health care item or service to an entity in which the provider is an investor.

Florida Anti-Kickback Law Chapter 456.054Makes it unlawful for a health care provider to offer, pay, solicit, or receive remuneration or payment, directly or indirectly, overtly or covertly, for referring or soliciting patients.The Co-management process must have an informed consent , transfer of care documentation, and a patient fees schedule for co-management.

Chapter 456.072 Grounds for discipline; penalties; enforcement as it relates to 463

456.072 Grounds for discipline; penalties; enforcement.--(1) The following acts shall constitute grounds for which the disciplinary actions specified in subsection (2) may be taken:

(a) Making misleading, deceptive, or fraudulent representations in or related to the practice of the licensee's profession.

(b) Intentionally violating any rule adopted by the board or the department, as appropriate.

(c) Being convicted or found guilty of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime in any jurisdiction which relates to the practice of, or the ability to practice, a licensee's profession.

Chapter 456.0635 (2a)

� US Code Section 21 Violation- Felony� Disallows and OD to apply for licensure for the

Board Exam until 15 years after probation is completed.

� In 2009, SB 1986ER - primarily deals with reducing health care fraud. It also requires health care boards to deny licensure or to revoke licensure of an individual, who has certain felony (F.S. 409, 817, 893)

456.041 Profiling

� Optometry will probably be profiled in a future legislative package. At this time all primary health care providers are profiled except Optometry. Criminal background checks for OD’s will be required who provide care in hospitals and nursing homes.

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(d) Using a Class III or a Class IV laser device or product, as defined by federal regulations, without having complied with the rules adopted pursuant to s. 501.122(2) governing the registration of such devices. (No YAG or PRK)


(f) Having a license or the authority to practice any regulated profession revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of any jurisdiction, including its agencies or subdivisions, for a violation that would constitute a violation under Florida law. The licensing authority's acceptance of a relinquishment of licensure, stipulation, consent order, or other settlement, offered in response to or in anticipation of the filing of charges against the license, shall be construed as action against the license.

(g) Having been found liable in a civil proceeding for knowingly filing a false report or complaint with the department against another licensee.


h) Attempting to obtain, obtaining, or renewing a license to practice a profession by bribery, by fraudulent misrepresentation, or through an error of the department or the board.

(i) Except as provided in s. 465.016, failing to report to the department any person who the licensee knows is in violation of this chapter, the chapter regulating the alleged violator, or the rules of the department or the board.

(j) Aiding, assisting, procuring, employing, or advising any unlicensed person or entity to practice a profession contrary to this chapter, the chapter regulating the profession, or the rules of the department or the board.


(k) Failing to perform any statutory or legal obligation placed upon a licensee. For purposes of this section, failing to repay a student loanissued or guaranteed by the state or the Federal Government in accordance with the terms of the loan or failing to comply with service scholarship obligations shall be considered a failure to perform a statutory or legal obligation, and the minimum disciplinary action imposed shall be a suspension of the license until new payment terms are agreed upon or the scholarship obligation is resumed, followed by probation for the duration of the student loan or remaining scholarship obligation period, and a fine equal to 10 percent of the defaulted loan amount. Fines collected shall be deposited into the Medical Quality Assurance Trust Fund.


(l) Making or filing a report which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, or willfully impeding or obstructing another person to do so. Such reports or records shall include only those that are signed in the capacity of a licensee.

(m) Making deceptive, untrue, or fraudulent representations in or related to the practice of a profession or employing a trick or scheme in or related to the practice of a profession.

(n) Exercising influence on the patient or client for the purpose of financial gain of the licensee or a third party.


(o) Practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities the licensee knows, or has reason to know, the licensee is not competent to perform.

(p) Delegating or contracting for the performance of professional responsibilities by a person when the licensee delegating or contracting for performance of such responsibilities knows, or has reason to know, such person is not qualified by training, experience, and authorization when required to perform them.

(q) Violating a lawful order of the department or the board, or failing to comply with a lawfully issued subpoena of the department.

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(r) Improperly interfering with an investigation or inspection authorized by statute, or with any disciplinary proceeding.

(u) Engaging or attempting to engage in sexual misconduct as defined and prohibited in s. 456.063(1).

(w) Failing to report to the board, or the department if there is no board, in writing within 30 days after the licensee has been convicted or found guilty of, or entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction. Convictions, findings, adjudication's, and pleas entered into prior to the enactment of this paragraph must be reported in writing to the board, or department if there is no board, on or before October 1, 1999. (You must report!)


(y) Being unable to practice with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition .. The department shall be entitled to the summary procedure provided in s. 51.011. A licensee or certificateholder affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that he or she can resume the competent practice of his or her profession with reasonable skill and safety to patients.


(z) Testing positive for any drug, as defined in s. 112.0455, on any confirmed pre-employment or employer-ordered drug screening when the practitioner does not have a lawful prescription and legitimate medical reason for using such drug.

(aa) Performing or attempting to perform health care services on the wrong patient, a wrong-site procedure, a wrong procedure, or an unauthorized procedure or a procedure that is medically unnecessary or otherwise unrelated to the patient's diagnosis or medical condition. For the purposes of this paragraph, performing or attempting to perform health care services includes the preparation of the patient. ( 2 hours/biennium Medical Errors CE Required)

(cc) Violating any provision of this chapter, the applicable practice act, or any rules adopted pursuant thereto.


(dd) With respect to making a personal injury protection claim as required by s. 627.736, intentionally submitting a claim, statement, or bill that has been "upcoded" as defined in s. 627.732.

(ee) With respect to making a personal injury protection claim as required by s. 627.736, intentionally submitting a claim, statement, or bill for payment of services that were not rendered.


(3)(a) Notwithstanding subsection (2), if the ground for disciplinary action is the first-time failure of the licensee to satisfy continuing education requirements established by the board, or by the department if there is no board, the board or department, as applicable, shall issue a citation in accordance with s. 456.077 and assess a fine, as determined by the board or department by rule. In addition, for each hour of continuing education not completed or completed late, the board or department, as applicable, may require the licensee to take 1 additional hour of continuing education for each hour not completed or completed late. (If you are short, according to CE Broker’s Compliance Calculation, you will be audited!)


(4) In addition to any other discipline imposed through final order, or citation, entered on or after July 1, 2001, pursuant to this section or discipline imposed through final order, or citation, entered on or after July 1, 2001, for a violation of any practice act, the board, or the department when there is no board, shall assess costs related to the investigation and prosecution of the case. Such costs related to the investigation and prosecution include, but are not limited to, salaries and benefits of personnel, costs related to the time spent by the attorney and other personnel working on the case, and any other expenses incurred by the department for the case.. In any case where the board or the department imposes a fine or assessment and the fine or assessment is not paid within a reasonable time, such reasonable time to be prescribed in the rules of the board, or the department when there is no board, or in the order assessing such fines or costs, the department or the Department of Legal Affairs may contract for the collection of, or bring a civil action to recover, the fine or assessment.($$$$)

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(5) In addition to, or in lieu of, any other remedy or criminal prosecution, the department may file a proceeding in the name of the state seeking issuance of an injunction or a writ of mandamus against any person who violates any of the provisions of this chapter, or any provision of law with respect to professions regulated by the department, or any board therein, or the rules adopted pursuant thereto.

(6) In the event the board, or the department when there is no board, determines that revocation of a license is the appropriate penalty, the revocation shall be permanent. However, the board may establish by rule requirements for reapplication by applicants whose licenses have been permanently revoked. Such requirements may include, but shall not be limited to, satisfying current requirements for an initial license.

(National Boards Part I, II and the Florida Board Exam may be required)

456.004 (6)

There will be quarterly review by the department of the legally insufficient complaints to be sure they have been properly handled by experts assigned to evaluate the complaint. Those reports will be available to all boards. This will be tracked by our rule 64B-3.008.

SB 1986ER passed in 2009 SB 1986ER - primarily deals with reducing health care fraud. It also requires health care boards to deny licensure or to revoke licensure of an individual, who has certain felony (F.S. 409, 817, 893) convictions or was terminated for cause from the Medicare or Medicaid programs. Similar restrictions apply to health care entities and their officers and affiliated persons. The bill also outlines four new disciplinary violations and requires the Department of Health to work with the Agency for Health Care Administration to prosecute Physicians who have not remitted amounts owed to the state for overpayments. This bill also exempts sleep related testing facilities from the Patient Self Referral Act. (15 Year Window Retroactive, since 1995) Modifies our Optometry Rule 64B13-15.005.

Online renewal of licensees will be a future requirement under 456. There is no bill number as of yet. Optometry will be the first profession to move to an online application process. Next renewal date will be 2/28/2011.

456.0635 License Renewal(1) Medicaid fraud in the practice of a health care profession is prohibited.(2) Each board within the jurisdiction of the department, or the department if there is no board,

shall refuse to admit a candidate to any examination and refuse to issue or renew a license, certificate, or registration to any applicant if the candidate or applicant or any principal, officer, agent, managing employee, or affiliated person of the applicant, has been:

(a) Convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;

(b) Terminated for cause from the Florida Medicaid program pursuant to s. 409.913, unless the applicant has been in good standing with the Florida Medicaid program for the most recent 5 years;

(c) Terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program or the federal Medicare program, unless the applicant has been in good standing with a state Medicaid program or the federal Medicare program for the most recent 5 years and the termination occurred at least 20 years prior to the date of the application.

(3) Licensed health care practitioners shall report allegations of Medicaid fraud to the department, regardless of the practice setting in which the alleged Medicaid fraud occurred.

(4) The acceptance by a licensing authority of a candidate’s relinquishment of a license which is offered in response to or anticipation of the filing of administrative charges alleging Medicaid fraud or similar charges constitutes the permanent revocation of the license.

Section 456.0635, Florida Statutes, enacted into law by SB1986 (2009)Pursuant to Section 456.0635, Florida Statutes, you are being notified that effective July 1, 2009,

health care boards or the department shall refuse to renew a license, certificate or registration, issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant has been:

1) Convicted or plead guilty or nolo contendre, regardless of adjudication, to a felony violation of: chapters 409, 817, or 893, Florida Statutes; or 21 U.S.C. ss. 801-970 or 42 U.S.C. ss 1395-1396, unless the sentence and any probation or pleas ended more than 15 years prior to the application.

2) Terminated for cause from Florida Medicaid Program (unless the applicant has been in good standing for the most recent 5 years).

3) Terminated for cause by any other State Medicaid Program or the Medicare Program (unless the termination was at least 20 years prior to the date of the application and the applicant has been in good standing with the program for the most recent 5 years).

For license renewal, this law applies to offenses concluded after July 1, 2009. Since it takes some time to establish the business process, you may be allowed to renew at this time, even if you have committed a disqualifying offense. However, when the department completes the implementation of this law, if you meet one of the disqualifying requirements above, you will be asked to return your license.

456.44 Controlled substance prescribing

(1) (e) Chronic nonmalignant pain” means pain unrelated to cancer which persists beyond the usual course of disease or the injury that is the cause of the pain or more than 90 days after surgery.

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Unlicensed PracticeULA Reporting http://doh.state.fl.us/mqa/unlicensed/unlic_home.html

The unlicensed practice of a health care profession or the performance or delivery of medical or health care services to residents and visitors in Florida without a valid, active license to practice that profession, regardless of the means of the performance or delivery of such services, is strictly prohibited by law. Many ULA cases are forwarded to the State Attorneys Office for further investigation.Florida is the only State that has a unit called ULA.

ULA Reporting

If you know of any ULA, such as selling medical devices ; Contact Lenses, plano or prescriptive, without a valid CL Prescription or performing eye examinations without a current Florida Optometry License, report such activity to 1-877-HALT-ULA and inform the Board of Optometry to ensure we follow-up on the actions taken.Email: [email protected]

To verify a provider

http://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

ROBERT MORRELL EASTON JR

LICENSE NUMBER: OPC1736Profession CERTIFIED OPTOMETRIST License/Activity Status CLEAR/ACTIVE License Expiration Date 2/28/2015License Original Issue Date 09/07/1982Discipline on File NOAddress of Record1560 EAST OAKLAND PARK BLVD OAKLAND PARK, FL 33334-4425 UNITED STATES

FOR IMMEDIATE RELEASE Contact: Maureen Doherty January 6, 2004 850-245-4111 DOH CONTINUES INVESTIGATION INTO UNLICENSED ACTIVITY IN JACKSONVILLE ~Successful sweep leads to three cease and desist orders~

TALLAHASSEE---The Florida Department of Health’s (DOH) unlicensed activity unit today announced that their on-going investigation with the Jacksonville Sheriff’s Office (JSO) has resulted in three cease and desist orders being served on individuals selling contact lenses without a license. A Florida Department of Health license is required by law to sell contact lenses in Florida. “DOH’s unlicensed activity unit and JSO have developed a very successful partnership,” said DOH Deputy Secretary Tom Arnold. “Together we are working to protect the Jacksonville community from those who seek to avoid the consumer protection and quality standards which are built into the licensure process.” During this unlicensed activity sweep of several Jacksonville area flea markets, three cease and desist agreements were served on vendors selling colored contact lenses without the licenses required by law. The use of contact lenses from unlicensed person may result in permanent eye damage or disease. The vendors’ operations were stopped immediately.

2006 ULA in Palm Beach CountyA joint investigation with the Palm Beach Sheriff’s Office and The

Department of Health Unlicensed Activity Unit led to the arrest today of Denis Palmer for the Unlicensed Practice of a Healthcare Profession. Denis Palmer of Highland Beach has been practicing optometry by impersonating another Florida Licensed O.D.

Palmer was also charged with Organized Scheme to Defraud and Grand Theft. A search warrant was served on Palmer’s home this morning and as a result of the search warrant additional charges may be forthcoming. This case began when it was discovered that Palmer was working at Walmart in Royal Palm Beach as an Optometrist and using the name a licensed Optometrist. Palmer may have been working at several locations throughout Palm Beach and Broward County working as an Optometrist at each location.

Palmer’s girlfriend, Nadia Becovic was also arrested for her involvement in the fraud. Ms. Becovic is the owner of Florida Eyes, Inc.

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FOR IMMEDIATE RELEASE Contact: Lauren Buzzelli March 20, 2007 (850) 245-4111 DOH INVESTIGATION LEADS TO ARREST IN LARGO

TALLAHASSEE— Florida Department of Health’s (DOH) St. Petersburg Unlicensed Activity (ULA) Unit announced that their joint investigation with the Largo Police Department has led to the arrest of Helene Britton Urbin for the unlicensed practice of a health care profession.

Urbin owned and operated “The Terror Shop,” a gothic-themed retail store without a license to be an optical establishment. Urbin sold contact lenses with patterns and colors to undercover agents. Urbin is not licensed as an optician or optometrist with the Florida Department of Health.

The ULA office works closely with many police agencies in Florida, including the Largo Police Department, to combat all types of unlicensed health care practices.

Illegal Sale of Cosmetic CL’s Leads to Arrest in South Florida

Thanks to a Boca Raton optician reporting the illegal sale of contact lenses though the POF Unlicensed Activity form. The Florida Department of Health's (DOH) along with the Palm Beach County Sheriff's Office arrested of Mr. Mushtaq Sajwani on June 10th for violating Florida Opticianry laws. He was caught dispensing contact lenses, without first being furnished with a prescription. This crime is a third degree felony that is punishable by up to five years in prison or a $5,000.00 fine.

Sajwani was employed at a 99 Cents Plus & Beauty Supply Store located in Boca Raton, which (among other items) was selling various types of colored contact lenses from behind the counter. Sajwani was arrested after he sold a pair of the contacts to an undercover ULA investigator who did not present a doctors' prescription. He was taken into physical custody and booked into the Palm Beach County Jail. His bond was set at $3,000.00.The owner of the store, Mr. Saleem Shivji, is also facing a potential administrative citation for violating Florida Statute 484.013(4): Unlawfully allowing Sajwani to open and operate an unlicensed optical establishment.

POF makes a one page Unlicensed Activity Form available on our website www.pof.org that allows opticians and other to report unlicensed practice of Opticianry through the POF office, quickly and anonymously, if they choose. (July 2, 2008 E-Mail Letter)

ULA in 2012 from Bradford Jones

2 Cases in Tampa

1. Cease and desist ordered and agreed upon.2. Citation was issued.

A request for public record will be requested by the Florida Board of Optometry for more detail.

Statewide sweep during Halloween for Colored CL’s sold without an RX.

408.812 ULA Statute(1) A person or entity may not offer or advertise services that require licensure as defined by this part, authorizing statutes, or applicable rules to the public without obtaining a valid license from the agency. A license holder may not advertise or hold out to the public that he or she holds a license for other than that for which he or she actually holds thelicense.(2) The operation or maintenance of an unlicensed provider or the performance of any services that require licensure without proper licensure is a violation of this part and authorizing statutes. Unlicensed activity constitutes harm that materially affects the health, safety, and welfare of clients. The agency or any state attorney may, in addition to other remedies provided in this part, bring an action for an injunction to restrain such violation, or to enjoin the future operation or maintenance of the unlicensed provider or the performance of any services in violation of this part and authorizing statutes, until compliance with this part, authorizing statutes, and agency rules has been demonstrated to the satisfaction of the agency.(3) It is unlawful for any person or entity to own, operate, or maintain an unlicensed provider. If after receiving notification from the agency, such person or entity fails to cease operation and apply for a license under this part and authorizing statutes, the person or entity shall be subject to penalties as prescribed by authorizing statutes and applicable rules. Each day of continued operation is a separate offense.(4) Any person or entity that fails to cease operation after agency notification may be fined $1,000 for each day of noncompliance.(5) When a controlling interest or licensee has an interest in more than one provider and fails to license a provider rendering services that require licensure, the agency may revoke all licenses and impose actions under s. 408.814 and a fine of $1,000 per day, unless otherwise specified by authorizing statutes, against each licensee until such time as the appropriate license is obtained for the unlicensed operation.(6) In addition to granting injunctive relief pursuant to subsection (2), if the agency determines that a person or entity is operating or maintaining a provider without obtaining a license and determines that a condition exists that poses a threat to the health, safety, or welfare of a client of the provider, the person or entity is subject to the same actions andfines imposed against a licensee as specified in this part, authorizing statutes, and agency rules.(7) Any person aware of the operation of an unlicensed provider must report that provider to the agency.

ULA Contact InfoDOH has several resources to combat unlicensed activity:

Consumers are encouraged to use DOH’s Web site www.flhealthsource.com where they can conveniently view the license information of their health care practitioner.

ULA Complaints may be filed anonymously by completing and mailing the complaint form on the DOH Web site or calling 1-877-HALT-ULA or 1-877-425-8852.

You can verify licensure of the Optometrist by going to:http://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

It is up to you to report Unlicensed Activity!

Ms. Nancy Snurkowski is the ULA Attorney.

Broward County has a local ULA office.

ULA GuidelinesThe Florida Department of Health’s (DOH) unlicensed activity program protects Florida residents and visitors from the potentially serious and dangerous consequences of receiving medical and health care services from an unlicensed person. DOH’s Division of Medical Quality Assurance (MQA) investigates and refers for prosecution all unlicensed health care activity complaints and allegations. The unlicensed activity unit works in conjunction with law enforcement and the state attorney’s offices to prosecute individuals practicing without a license. Unlicensed activity is a felony level criminal offense. More importantly, receiving health care from unlicensed people is dangerous and could result in injury, disease or even death.

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Medical Quality AssuranceThe mission of MQA is to protect the public through healthcare licensure, enforcement and information. MQA, in conjunction with 22 boards and six councils, regulates six types of facilities and more than 40 health care professions. MQA evaluates the credentials of all applicants for licensure, issues licenses, analyzes and investigates complaints, inspects facilities, assists in prosecuting practice act violations, combats unlicensed activity and provides credential and discipline history about licensees to the public.

Please visit http://www.doh.state.fl.us/mqa/ for additional information about MQA.

CE Broker- A Florida CE Compliance Corporation

LICENSEE

Benefits of Subscribing

View your continuing education renewal status

View your continuing education posted by date completed

Request to be notified via e-mail when completed course credit has been posted to your license transcript(s)

Review lists of approved, upcoming continuing education that meet your license renewal requirements

Set-up personalized alert notification

Establish license renewal reminders

CE Broker

Know how and if a course will count towards your license renewal before taking the course

Search Statewide database for meaningful continuing education that will improve patient care

Know your continuing education renewal status and outstanding hours needed to renew your license(s)

CE Broker is integrated with the licensing system and will transmit to the Florida Department of Health when you have met your license renewal continuing education requirements.

By subscribing you can verify your hours since only CE hours contained in CE Broker will be allowed in meeting CE requirements. By subscribing and tracking your CE hours, you will avoid renewal problems because only licensees who have completed all their CE requirements will be renewed.

CE Broker

Congratulations Dr Easton!

You are now registered with CE Broker.

Licensees can begin using these features on February 1, 2004.

Search for available course offerings

Inquire about your continuing education status

View continuing education requirements for your license or combination of licenses

With just a single click, CE Broker will provide a listing of continuing education tailored to correspond

with your outstanding requirements

Set up "Alerts" which will inform you of upcoming continuing education based on a particular course title or educational provider. These alerts will appear in your CE Broker message center and if designated in your profile to your e-mail address.

CE Broker will transmit your transcript to the Florida Department of Health when you have met your license renewal continuing education requirements.

With CE Broker providing access to continuing education course history and transcripts, you will know exactly where you stand at all times!

CE Broker Rule 64B-5.00164B-5.001 Definitions.

For the purposes of this rule chapter, the following definitions will apply:

(1) “Approved provider” means a person approved by a board, or the department when there is no board, to provide continuing education or whose continuing education program has been approved by a board, or the department when there is no board. “Approved provider” also means an institution of higher learning or a school

approved by a board, or the department when there is no board, to provide continuing education or whose continuing education program has been approved by a board, or the department when there is no board.

(2) “Continuing education (CE) tracking system” means the Department of Health designated electronic system through which approved providers and licensees submit necessary information on program attendance.

(3) “Program” includes a class, seminar, lecture, presentation, symposium, convention at which continuing education is presented by a professional trade association, self-study or home-study hours, or other activity offered for the purpose of complying with continuing education requirements established in statute or rule approved by the board or the department when there is no board.

CE Broker Rule 64B-5.001(4) “Electronically” refers to the submission of information and data via the

Internet.

(5) “Maximum Allowable” refers to the total number of hours that a licensee can possibly earn for attending an approved provider program.

(6) “Hours Earned” refers to the total number of hours that a licensee is awarded during the approved provider program.

(7) “Mandatory Hours” refers to those specific hours, which are designated by law or by board rule, or by rule of the department when there is no board, as mandatory.

Specific Authority 456.004(1), (5), 456.025(7) FS. Law Implemented 456.013(9), 456.025(7) FS. History–New 3-15-05.

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CE Broker Rule 64B-5.00264B-5.002 Submission of Program Information, Submission of Licensee Program Completion Data, Licensee

Self-Submission, Address.

For the purposes of implementing and maintaining the CE tracking system, the following requirements apply:

(1) Submission of program information. Unless otherwise provided by rule of a board or the department when there is no board, prior to the date a program is to be offered, all approved providers must electronically submit the following program information through the CE tracking system: the provider name, the name of the program, when the program is being offered, and the maximum allowable credit hours approved by the board or the department when there is no board according to procedures set forth in the rules of each board or by the department when there is no board. Upon receipt of such information the CE tracking system will assign a program number for the purpose of tracking each continuing education program, or at an approved provider’s request, the CE tracking system can use a program number convenient to and assigned by the approved provider or a board. Program information can be updated, as necessary, by the approved provider up until the day the program is offered.

CE Broker Rule 64B-5.002(2) Submission of licensee program completion data; licensee self-submission.

(a) All approved providers shall submit licensee program completion data through the CE tracking system within ninety (90) days of program completion, unless otherwise provided by rule of a board or the department when there is no board. Required information includes the provider number, the program name, the number for the program assigned by the CE tracking system or the number provided to the CE tracking system by the approved provider or a board, the date the program was completed and the license numbers of licensees who participated in the program. The approved provider may submit the total hours earned during the program by each licensee without specifically delineating the individual courses or lectures constituting the total. The approved provider shall specifically list the licensee’s completion of any subject hours mandated by law.

CE Broker Rule 64B-5.002(b) Such licensee program completion data shall be submitted electronically

through the CE tracking system by using either the designated spreadsheet format, the designated text file format, entering the data directly to the CE tracking system, using a compatible format, or through submission of the scan card which is hereby incorporated by reference and effective, all of which are available through the Department of Health at the internet or street address in subsection (4) below. The scan card shall contain the appropriate designation for submission of detailed information for each profession’s required continuing education and mandatory hours, and shall be completed according to the instructions on the scan card.

(c) Licensees may, at their option, self-report any CE hours earned electronically to the internet address in subsection (4) below. Licensees shall not be charged any fees for electronically self-reporting CE hours through the CE tracking system. A board or the department when there is no board may restrict, by rule, which hours may be self-reported.

CE Broker Rule 64B-5.002(3) An approved provider or licensee who unsuccessfully attempts to

electronically submit any information as provided in this rule, has the option of submitting that information in one of the formats specified in subsection (2) together with a statement regarding the unsuccessful attempted compliance. It must be sent by certified U.S. mail as indicated in subsection (4). Such submission will meet the requirements of this rule.

(4) Address. All information and data required by this rule shall be submitted electronically to the following Internet address: https://www.cebroker.com For the purposes of subsection (3), the information may be mailed to the CE Tracking Unit, Division of Medical Quality Assurance, Department of Health, 4052 Bald Cypress Way, Bin #C00, Tallahassee, FL 32399-3250.

Specific Authority 456.004(1), (5), 456.025(7) FS. Law Implemented 456.013(9), 456.025(7) FS. History–New 3-15-05.

Questions Commonly AskedHow Do I . . .

Change the Name of a Current Licensee?Provide a written request that clearly indicates your new name, your license number, including alpha prefix or profession, and a copy of the legal document showing the change of name, for example a marriage license or divorce decree. Send your request by certified mail along with supporting documentation to MQA Communication Services, 4052 Bald Cypress Way Bin #C01, Tallahassee, FL 32399-3251, or fax to 850-487-9626. If the name change is for a facility, a licensure application must be submitted.

Questions Commonly Asked

Change the Address of a Licensee?

You may complete the Change of Address form, print, and submit or you may write a letter requesting the change or submit your change of address electronically. You will need to indicate whether you are requesting a Mailing Address or Practice Location Address change and provide your full name as it appears on your license, your new address, and your license number (including the alpha prefix). If you have applied for a license and have not received a license number, please include the profession.

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Change the Address of a Licensee?

The practice location address will display on the Internet and your license. The mailing addresswill only display on the Internet if you have notprovided a practice location address to us. Mail to: MQA Communication Services, 4052 Bald Cypress Way Bin #C01, Tallahassee, FL 32399-3251, or fax to 850-487-9626.


Change the Address of an Establishment?If the address change is for a facility that

has changed location, a licensure application must be submitted. See your profession's web page for additional information. Use Certified Mail to ensure the department receives your request.


Obtain a Duplicate License?Send your current license or a letter requesting a duplicate license stating your full name, license number, profession, and the reason for requesting a duplicate, along with a $25.00 check or money order made payable to the Department of Health. Please mail your request and fee to Department of Health, MQA, Post Office Box 6320, Tallahassee, FL 32314-6320. You should receive a new license in approximately 6 weeks.


Request a Variance or Waiver - "Strict application of uniformly applicable rule requirements can lead to unreasonable, unfair, and unintended results in particular instances. ... " (Florida Statutes, 120.542)

Request a declaratory statement? - Pursuant to Rule 28-105.002, Florida Administrative Code, a petition seeking a declaratory statement shall be filed with the Department of Health's Agency Clerk's Office at 4052 Bald Cypress Way, Bin #A02, Tallahassee, Florida 32399-1703. The petition must contain certain information.


Request a Variance or Waiver - "Strict application of uniformly applicable rule requirements can lead to unreasonable, unfair, and unintended results in particular instances. ... " (Florida Statutes, 120.542)

Request a declaratory statement? - Pursuant to Rule 28-105.002, Florida Administrative Code, a petition seeking a declaratory statement shall be filed with the Department of Health's Agency Clerk's Office at 4052 Bald Cypress Way, Bin #A02, Tallahassee, Florida 32399-1703. The petition must contain certain information.


Cost for Florida Board Exam in 2009=$1775 + Application Fee and Licensing Fee.

Optometry Pass Rates for 2010Clinical 81%Laws & Rules (CBT) 99%Pharmacology & Ocular Disease Clinical (CBT) 90%

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Obtain the Summary of the Florida Patient's Bill of Rights and Responsibilities? - Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider's or health care facility's right to expect certain behavior on the part of patients.

Obtain a written verification (certification) of a license? - Written Certification of the licensure status and disciplinary history of an individual licensee of the Division of Medical Quality Assurance.

Obtain a written verification (certification) of non-licensure? - Written certification that there is no record of licensure for an individual under the name and/or spelling of the name provided.


Obtain a list of licensees? - The purpose of this site is to provide public information, as defined in Chapter 119, Florida Statutes, maintained in the electronic database of the Department of Health in a variety of formats - lists, diskette, or CD.

Check on my doctor's education, experience and discipline? - This Web site has been designed to provide consumers access to extensive information about Medical Physicians, Osteopathic Physicians, Podiatric Physicians and Chiropractic Physicians.

OPTOMETRY IS NOT PROFILED. I think we should be!


Obtain a copy of:a disciplinary file? - Disciplinary documents

usually refer to Board Orders and any attachments (e.g., complaint, Consent Agreement, Recommended Order, etc.). Civil Medical Malpractice suits are not maintained in this office as a part of the disciplinary documents.

an application file? - The application file includes the application for licensure, supporting documents submitted at the time of initial licensure, and any subsequent updates to the file, excluding those documents deemed confidential under Florida Statutes.

The Complaint Process

Health Care Practitioner Complaint Process Effective July 1, 2002, the Department of Health, Division of Medical Quality Assurance will assume responsibility of analysis of complaints and reports involving potential misconduct of a licensee and initiates investigations when appropriate. Previously this was performed by the Agency for Health Care Administration. The mission of the Division of Medical Quality Assurance is to protect and promote the health of all persons in Florida

by diligently regulating health care practitioners and facilities.


Discipline Reports - These reports will only contain recent discipline taken against a practitioner by the professional regulatory boards within Department.

How do I file a complaint? You may print the Complaint Form with the Authorization for Release of Patient Records from the list below or call 1-888 419-3456 or (850) 414-1976 to request one by mail. To avoid delays in the process, please complete all sections of the form and attach the requested information. All complaints must be legibly written or typed, and signed.

As of 5/2011, a past board member will review all consumer complaints. This will help department and probable cause in their efforts to prosecute.


Issues NOT within the authority of the Department?·Fee disputes (i.e. broken or missed appointments) ·Billing disputes ·Personality conflicts ·Bedside manner or rudeness of practitioners

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Complaints with incidents occurring on or after July 1, 2001 must be filed within 6 years of the occurrence of the incident.

In cases where it can be shown that fraud, concealment or intentional misrepresentation of facts prevented the discovery of the alleged violation, the time limit is extended to 12 years of the occurrence of the incident. These time limits do not apply to complaints involving criminal actions, diversion of controlled substances, sexual misconduct, or impairment by a licensee.

Additionally, patient records may be destroyed according to time limits (generally after 5 years) provided by Florida Administrative Code.


Consumer Services receives and responds to complaints against health care practitioners and determines whether complaints warrant investigation. Appointed OD’s have been assigned to determine legal sufficiency and guidance support for the department.

The boards and councils within MQA determine probable cause and disciplinary action in cases involving the misconduct of their licensees.

Investigative Services investigates possible rule or statutory violations by health care practitioners and conducts statutorily mandated inspections of certain facilities. Appointed OD’s will help in this matter.

“One of the essential qualities of the clinician is interest in humanity, for the secret in the care of the patient is caring for the patient.”Frances Weld Peabody

Thank You!

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