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Inside this issue
  COA forces significant amendments to branch office legislation  
  The California State Board of Optometry (SBO) sponsored SB 1386 by Senator Mike McGuire to allow optometrists to own an unlimited number of offices, along with numerous punitive provisions. After months of negotiations, COA secured amendments that limit the number of offices and protect optometrists from being singled out for increased scrutiny and disciplinary actions. COA amendments include:
  • Optometrists, whether as an individual or a group, will be limited to owning 11 offices total.
  • A requirement for optometrists to report to the SBO disciplinary action they take against an employee was removed from the bill.
  • An onerous new evidentiary standard was removed from the bill which would have allowed the SBO to take enforcement action if the doctor "should have known" they were helping an employee violate the law. The existing standard required is that the SBO must prove the optometrist knew the employee was violating the law.
  • A new reference to the standard of care was removed from the bill.
COA's amendments are consistent with the direction given by COA's House of Delegates at its meeting earlier this year. The amendments allow a modest expansion of the current, two-office limit, without opening up the law to allow an unlimited number of offices.

Background: In recent years, the SBO has come to the conclusion that the restriction on allowing optometrists to have multiple offices is overly burdensome with no direct benefit for consumers. Other healing arts licensees possess the ability to own any number of offices under their license. Meanwhile, the existing  branch office limit effectively ties the hands of optometrists who wish to open a number of locations under their license, and this can result in less access to care in rural areas where few optometrists are likely to locate their primary office. Many believe that forming group practices may make it easier for private practice optometrists to join health plan medical provider panels.

There has been concern from many in the optometric community, however, that completely eliminating the limit on how many offices an optometrist can have would be problematic. Some doctors believe that allowing one optometrist to open a large number of offices would distance the licensed optometrist's professional judgment and accountability for licensed activities taking place under their auspices as the optometrist whose license is connected to the office spends very little time practicing there. The concern is that if a single optometrist could maintain an ownership interest in an unlimited number of offices, this could potentially lead to full corporatization of optometry, in which optometrist-owners run massive chains of optometry offices in a way that cannot be distinguished from a retail model of services.

The solution reached in this bill is to replace the restrictive branch office license requirement with a less stringent allowance for an optometrist or several partnered optometrists to maintain multiple offices, with a cap placed at 11 total offices. The intent of the author is to modernize how optometrists may maintain multiple offices without creating optometric empires resembling retail chains.


  Immunization fix bill passes first hearing  
  COA's legislation to establish a path for immunization training passed its first committee this week. The bill, SB 762 by Senator Ed Hernandez, would allow the immunization training program for optometrists to be endorsed by the Accreditation Council for Pharmacy Education. COA sponsored this bill to allow optometrists to take immunization training courses developed by the pharmacy profession. Successful completion of the coursework will allow optometrists to administer the flu, shingles and pneumonia vaccines to adults.  


  COA and VSP reached agreement on new anti-fraud procedures  
  VSP has amended AB 1092, by Assembly Member Ken Cooley, to give VSP the statutory authority needed for its existing anti-fraud recovery program. This legislation only applies to VSP's anti-fraud program and has nothing to do with routine audits.

COA secured amendments to the bill that would put additional restrictions on VSP's statistical methods for recoupment and provide greater protections to any doctors who are under fraud investigation. As a result of these amendments, COA has a "neutral" position on the bill.


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