85R11918 SLB-F
By: Sheffield H.B. No. 3710
A BILL TO BE ENTITLED
AN ACT
relating to the comanagement of glaucoma by ophthalmologists and
therapeutic optometrists and the establishment of a comanagement
registry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 153, Occupations Code, is
amended by adding Section 153.017 to read as follows:
Sec. 153.017. GLAUCOMA COMANAGEMENT REGISTRY AND
DISCIPLINARY INFORMATION. (a) The board and the Texas Optometry
Board shall:
(1) jointly maintain a registry of ophthalmologists
and therapeutic optometrists engaged in the comanagement of
patients under Section 351.3581; and
(2) make the registry available to the public through
a link on each board's Internet website.
(b) The registry must be searchable by:
(1) the name of the ophthalmologist;
(2) the name of the therapeutic optometrist;
(3) the county that an ophthalmologist in the registry
lists as a primary practice location; and
(4) the county that a therapeutic optometrist in the
registry lists as a primary practice location.
(c) The board and the Texas Optometry Board shall jointly
develop a process to share information regarding license holders
under the jurisdiction of either board who:
(1) become the subject of an investigation involving
the comanagement or treatment of glaucoma, including information
regarding the final disposition of the investigation; or
(2) have been subject to a final adverse disciplinary
action for an act involving the comanagement or treatment of
glaucoma.
(d) The board or the Texas Optometry Board, as applicable,
may use information shared under Subsection (c) to initiate an
investigation of a license holder.
SECTION 2. Chapter 160, Occupations Code, is amended by
adding Subchapter D to read as follows:
SUBCHAPTER D. PARTICIPATION IN GLAUCOMA COMANAGEMENT REGISTRY
Sec. 160.151. PROVISION OF INFORMATION TO GLAUCOMA
COMANAGEMENT REGISTRY. (a) An ophthalmologist engaged in the
comanagement of patients under Section 351.3581 shall provide to
the board the name, license number, and county of primary practice
location of each therapeutic optometrist with whom the
ophthalmologist is comanaging patients for inclusion in the
comanagement registry maintained as required under Section
153.017.
(b) The board shall establish procedures to allow an
ophthalmologist who provides information under Subsection (a) to
update the information through the registry's Internet website.
The board shall require the ophthalmologist to update the
information at least annually.
SECTION 3. Section 351.3581, Occupations Code, is amended
by amending Subsection (c) and adding Subsections (c-1), (c-2),
(k), and (l) to read as follows:
(c) A therapeutic optometrist required to engage in
comanagement consultation with an ophthalmologist shall:
(1) inform the patient diagnosed with or undergoing or
beginning treatment for glaucoma that the therapeutic optometrist
is required to have the diagnosis confirmed and comanaged with an
ophthalmologist with whom the therapeutic optometrist has a
glaucoma comanagement agreement or by an ophthalmologist of the
patient's choosing; and
(2) obtain signed, written consent from a patient
described by Subdivision (1) that meets the requirements of
Subsection (c-1) [or, if the patient does not choose an
ophthalmologist, an ophthalmologist practicing in the geographic
area in which the therapeutic optometrist practices].
(c-1) Consent obtained under Subsection (c) must
acknowledge receipt by the patient of the following information:
(1) that the patient has been diagnosed with glaucoma
by the therapeutic optometrist or is undergoing or beginning
treatment for glaucoma;
(2) that the therapeutic optometrist obtaining the
consent is not a physician licensed to practice medicine by the
Texas Medical Board;
(3) that the patient should have the diagnosis of
glaucoma confirmed by an ophthalmologist licensed to practice
medicine by the Texas Medical Board not later than the 30th day
after the date the diagnosis is determined by the therapeutic
optometrist and that the diagnosis should be reconfirmed annually
by an ophthalmologist;
(4) that the therapeutic optometrist obtaining the
consent is required to comanage the treatment for glaucoma with an
ophthalmologist licensed to practice medicine by the Texas Medical
Board; and
(5) that the Texas Medical Board and the Texas
Optometry Board maintain a searchable registry of ophthalmologists
and therapeutic optometrists who comanage glaucoma patients.
(c-2) A therapeutic optometrist shall maintain a patient's
consent obtained under Subsection (c) in the patient's medical
record and forward a copy of the consent to the comanaging
ophthalmologist with whom the therapeutic optometrist has a
glaucoma comanagement agreement under Subsection (l) or to an
ophthalmologist of the patient's choice on the written request of
the patient.
(k) A therapeutic optometrist engaged in the comanagement
of patients under this section shall provide to the board the name,
physician license number, and county of primary practice location
of each ophthalmologist with whom the therapeutic optometrist is
comanaging patients for inclusion in the glaucoma comanagement
registry maintained as required by Section 153.017. The board
shall establish procedures to allow a therapeutic optometrist who
provides information under this subsection to update the
information through the registry's Internet website. The board
shall require the therapeutic optometrist to update the information
at least annually.
(l) A therapeutic optometrist who is required to engage in
consultation with an ophthalmologist under this section shall enter
into a written glaucoma comanagement agreement, signed and dated by
the parties to the agreement, that:
(1) contains the following information:
(A) the names, addresses, and applicable license
numbers of the parties;
(B) the practice locations and settings of the
parties;
(C) a general plan for addressing consultation
and referral; and
(D) a general process for communications between
the parties;
(2) requires the agreement and any amendment to the
agreement to be reviewed, dated, and signed by each party at least
annually;
(3) requires a party to the agreement who is notified
that the party is the subject of an investigation by the party's
licensing board to immediately notify the other party of the
investigation; and
(4) provides that the agreement may be terminated by
any party not later than the 30th day after the date the party
seeking termination notifies all other parties.
SECTION 4. (a) Not later than March 1, 2018, the Texas
Medical Board and the Texas Optometry Board shall establish the
registry and adopt rules to implement the changes in law made by
this Act.
(b) Notwithstanding Section 351.3581, Occupations Code, as
amended by this Act, a therapeutic optometrist or ophthalmologist
is not required to comply with that section until April 1, 2018.
SECTION 5. This Act takes effect September 1, 2017.