In a huge victory for optometry following more than a decade of uncertainty, Governor Brown signed COA-negotiated AB 684, Alejo, which addresses the practice of optometry in retail settings. The bill establishes new – and importantly for doctors, enforceable - rules for business relationships between optometrists and opticians, optical companies and health plans, including the outlawing of employment by opticians of ODs. Crucial to this win for optometry was the active grassroots outreach by COA Key Persons to their lawmakers.
This law will go into effect on January 1, 2016, at which time an RDO, optical company and health plan will no longer be allowed to newly employ an optometrist. For those businesses and plans that currently employ optometrists, there will be a three-year transition period during which they must convert their OD employees to a landlord-tenant arrangement.
AB 684 has three main components:
1. Designates leasing as the authorized business arrangement. It allows optometrists to lease space from an optician, optical company or health plan. It also specifies how these leases must be structured.
2. Adds protections for doctors. The bill adds protections to ensure the doctor will be able to maintain exclusive control over his or her practice and clinical judgement.
3. Provides enforcement mechanisms. It consolidates enforcement under the State Board of Optometry (SBO) and authorizes the SBO to issue citations and fine companies that violate the law.
Additionally, AB 684 has the following built-in and enforceable protections to safeguard the independence of a doctor who has a lease:
- Lease term cannot be less than one year and cannot be terminated for a reason that interferes with the practice of optometry.
- Lease payments cannot be based on number of eye exams performed, prescriptions written, patient referrals or the sale or promotion of the products of an optician, optical company or health plan.
- Optometrists have exclusive control over their schedules, how many patients they see, the time interval for appointments and their patient records.
- The optometrist has exclusive control over the selection and supervision of optometric staff.
The optometrist has exclusive control over the fees charged for products and services, examination procedures and treatments provided; and, may collect fees for services that are not included in a health plan's products and services.
- The optometrist's leased space shall be definite and distinct with a sign designating that the leased space is occupied by an independent optometrist.
- The optometrist is free to contract with a health plan of their choice.
Going into the bill negotiations, the cards seemed stacked against COA. The governor’s office, RDOs, health plans and other stakeholders supported the adoption of a moratorium on enforcing the laws governing the corporate practice of optometry. Together, the COA Legislation-Regulation Committee, COA Board of Trustees, staff and lobbyists spent several months crafting language to protect doctors of optometry and patients while working with these stakeholders to find a common-sense solution. COA’s Key Persons played an important role in this legislative victory by educating their local lawmakers on the benefits to patients of the COA-proposed approach for solving this longstanding problem. THANK YOU!
This is a hard-fought success for doctors of optometry as well as consumers, who can now be assured they will receive the highest level of care, free from outside influence.
COA will prepare a fact sheet in the upcoming weeks explaining in more detail the measure’s historic doctor and patient protections.
If you have any questions, please contact Kristine Shultz at firstname.lastname@example.org.