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Medical Forum / General / Vision / April 2005Valid period for spectacles Rx - Texas
I can't find anything on point in regard to this issue. I know that federal law (and by extension Texas law as enacted) requires an Rx for contact lenses to be valid for a minimum of one year. Most dispensaries interpret this as "no more than one year", but that isn't my issue. What is the valid length of an Rx for spectacle lenses in Texas and what's your source for the information? Thanks :) Unless specified by the doctor on the prescription, there is no limit in Texas. As a practical matter, there seems to be an unwritten rule that dispensers will refuse to fill a prescription that is more than two years/old. DrG Hmm. I didn't think an Rx was valid unless it had a date of Rx AND an expiration date... w.stacy, o.d. > Unless specified by the doctor on the prescription, there is no limit > in Texas. As a practical matter, there seems to be an unwritten rule > that dispensers will refuse to fill a prescription that is more than > two years/old. > > DrG Thanks for the info. A friend is getting the runaround at (where else) Wally WRT an Rx dated a year ago last week. I've suggested she take her business elsewhere but she's hell-bent on shoving some sharp corners into the little twerp giving her the bad time. >Unless specified by the doctor on the prescription, there is no limit >in Texas. As a practical matter, there seems to be an unwritten rule >that dispensers will refuse to fill a prescription that is more than >two years/old. > >DrG > Thanks for the info. A friend is getting the runaround at (where > else) Wally WRT an Rx dated a year ago last week. I've suggested she > take her business elsewhere but she's hell-bent on shoving some sharp > corners into the little twerp giving her the bad time. I would trust a retail optician more than an OD to know the answer to this question. It is not in the retailer's interest to turn away customers unless they legally cannot service them. OK, wiseguy, this is right from the Texas Optometry Board website: ***************************************************************************************** Does the Texas Optometry Act require that I have an examination each year? The Act does not speak to mandatory examination dates; that decision lies with your optometrist. When a contact lens prescription is issued, the doctor is required to place an expiration date on that prescription. Optometrists are not required to place an expiration date on spectacle prescriptions, but the majority do. Optometrists cannot prescribe without performing an eye examination. Determining when an eye examination and health check of the eye are required is a professional determination by the doctor based upon the appropriate "standard of care." Can opticians change my prescription from bifocals or trifocals into progressive lenses or change the type of contact lens? No. Opticians must fill the prescription as written. If changes are desired or if the optician has a question regarding the prescription, the optometrist must be contacted. For an optician to change any prescription without authorization constitutes the practice of optometry without a license. ******************************************************************************************** DrG I'm not sure about Texas, but my guess is it is whatever is written on the Rx, or at least that's what it *should* be. I can envision situations where I'd want it to expire in a month (like if the patient is going in for LASIK in a month), and situations where I'd write it for 3 years (yes there *are* times when I doubt the Rx will change much in 3 years). But in California, the law says 2 years on spectacles, "unless the doctor has a reason to make it less". You should be able to find the Texas law on line by searching on "Texas board of optometry" or something like that. w.stacy, o.d. > I can't find anything on point in regard to this issue. I know that > federal law (and by extension Texas law as enacted) requires an Rx for [quoted text clipped - 6 lines] > > Thanks :) I've practiced in Texas for more than 20 years. I am not aware that a spectacle prescription "requires" an expiration date, but that expiration dating is optional. There is no defacto expiration date for a spectacle RX in Texas, unless I am totally off the reservation. DrG It wouldn't surprise me; y'all are a bunch of cowboys and indians anyway, no? > I've practiced in Texas for more than 20 years. I am not aware that a > spectacle prescription "requires" an expiration date, but that > expiration dating is optional. There is no defacto expiration date for > a spectacle RX in Texas, unless I am totally off the reservation. > > DrG I'm a Texan by choice, not by birth. I graduated from ICO in 1983. I have a great practice in a great community with great medical institutions located nearby. Until three or four years ago, I did not file insurance. I always thought that ODs acted in their individual interests at the expense of the profession. They created a monster called VSP. I believe it originated in Caleefornyah, no? We now spend 50% of our time catering to the 16% of my practice that is managed care. Texas has been one of the last states to feel the impact of managed care. I think that speaks of innate native intelligence. DrG Maybe we should take this thread private, since it's not exactly science, but there may be some interest; I'll defer to any complaints. As a Californian by birth and by choice (I practiced one year in Alabama right after graduation, then 2 years in Tx (Reese AFB Lubbock), then moved back. As a heavy VSP doc, I sympathize with your feelings. Until Intel chose EyeMed over VSP in Jan, 2005, I was about 80% vsp since my office is a stone's throw from Intel's big Folsom plant ~6000 employees. Now it's about 60% vsp, 20% eyemed. vsp has problems, for sure, but eyemed is worse. Eyemed treats prescribed items like prism, high powers, etc as patient options (like the patient can choose what parts of his Rx is filled... guys like otis would love this). And their reimbursements are lower than vsp, even though they promised they would mirror the old vsp plan. Not. Anyway, I don't think I could survive without managed care, and I have found that medical diagnoses certainly open up some new possibilities for o.d.s who aren't afraid to play the insurance game. My advice to all o.d.s is to get your medical service fees up to par with medicare levels (at least!) and bill the medical plan whenever you can code a medical diagnosis. Hope the FTC isn't listening... w.stacy, o.d. > I'm a Texan by choice, not by birth. I graduated from ICO in 1983. I > have a great practice in a great community with great medical [quoted text clipped - 7 lines] > > DrG Dear William, I dare say that you could not survive w/o managed care. Please accept my condolences. My usual and customary fees are still below Medicare. If all of my patients paid me out-of-pocket, I could continue to make a very good living with fees below Medicare rates. I dare say, so could you. Managed care steals from Peter(you) to pay Paul(?). Last time I checked, I did not do surgery. Do you? I am a primary care doctor. I don't have a single billing code that is more than $250. I also pay for private healthcare insurance for me and my family. It is almost $1000/month, with a deductible of $1000. That pays for a whole lot of eye examinations and contact lenses. We are under the radar screen....or should be. Best of luck to you. DrG DrG >Anyway, I don't think I could survive without managed care, and I have >found that medical diagnoses certainly open up some new possibilities [quoted text clipped - 3 lines] >with medicare levels (at least!) and bill the medical plan whenever you >can code a medical diagnosis. Hope the FTC isn't listening... My ophthalmologist doesn't accept any insurance - cash in hand is his policy and he does quite well. The hospital at which he maintains his surgical priveleges does accept insurance but the doctor's fee is billed separately and is, again, a cash proposition. He doesn't seem to be hurting from what I can see (and I see quite well thanks to his excellent service). My optician also doesn't accept any type of insurance payments. Both offices provide detailed billing statements for my convenience - as if filing an insurance claim is "convenient". The "vision insurance" offered through my husband's employer is a joke. Total annual premiums total more than my glasses cost, and I don't buy cheap frames or cheap lenses. The "benefit" is laughable - two boxes of contact lenses or $100 reimbursement toward "approved" frames and/or lenses. Puh-leez, they need to simply label it "highway robbery" and adhere to truth-in-advertising laws. Nice to hear a comment like that from the patient's perspective. I also heard some encouragment from a financial person who works in the employee benefits area. He indicated that medical savings accounts are becoming more popular. Seems like if you know in advance how much you need to put aside for eyecare each year, pre-tax savings would be the way to go. People with chronic diseases like glaucoma can use major medical, provided their deductibles are reasonable. Regarding the eyeglass prescription thing, I did call the optometry board some years ago for clarification. They told me that there is no mandatory limit for an eyeglass prescription. It is only what the doctor says it is. Personally, if the eye exam is more than one year old, I can generally appeal successfully to the patient's common sense and talk them into an updated refraction. Most opticians don't like to fill old prescriptions because of the assumed liability, not because of any laws. There is usually an O.D. next door anyway. DrG >Nice to hear a comment like that from the patient's perspective. I have a low opinion of managed care generally. It would be incredibly OT for me to relate the entire story of my accident last year. Let's just say that my advertised $50 ER copay bloomed into a $9k event because the ER/hospital didn't actually provide any services and all of the care providers were independent contractors who billed separately; gee, indies aren't covered by my health insurance. I'm still paying the bill and probably will be for another couple of years. |
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