Telehealth Expansion Sheds Light on Protectionist Rules
All of these efforts point toward a new future for healthcare access. But not every medical field is reaping the full benefits of innovative telehealth reforms. Depending on where you live, you may be out of contact lenses and unable to get your prescription refilled online because of protectionist regulatory rules.
Contact lens prescriptions can be obtained online either by taking an online vision exam or allowing an online vendor to contact your eye doctor to confirm your existing prescription. This method, known as asynchronous or “store-and-forward” telehealth, is unique in that it doesn’t require a patient and doctor to speak in real time via phone or video. Instead, patients enter medical information through the online portal and complete any necessary tests, and then the information is forwarded to a doctor for review.
The ability to use asynchronous ocular telehealth has eased the process of getting eye care for millions of Americans. However, some states prohibit store-and-forward telehealth, preventing consumers from accessing this innovative care. This makes vision care more expensive and time-consuming than it has to be. These barriers are burdensome enough in normal times, but during a pandemic, they are indefensible.
Currently, residents of Georgia, New Mexico and South Carolina are unable to use ocular telehealth services because they are banned outright. For residents in Arizona, Delaware, D.C., Louisiana, Michigan, New Jersey and West Virginia, online vision services are extremely limited because they require a live audio and/or video component, meaning that asynchronous technology cannot be used.
Millions of people in these states cannot renew their contact lens prescriptions online during the pandemic. Fortunately, there are some examples of progress: Arkansas has temporarily suspended regulations restricting the use of asynchronous telehealth services. And Maryland Governor Larry Hogan recently signed into a law a broad pro-telehealth bill that permanently allows for asynchronous telehealth in the state. It’s far past time that more states follow suit.
Historically, the contact lens market has been rife with economic protectionism, and unfortunately these impulses have not been entirely eliminated. Prior to a 2003 Congressional bill called the Fairness to Contact Lens Consumers Act, eye doctors were not even required to release contact lens prescriptions to patients so that they could shop around at alternative retailers (including online retailers). Instead, patients only had one option: buy contact lenses directly from their eye doctor.
The Contact Lens Rule of 2004, implemented by the Federal Trade Commission (FTC), furthered the 2003 law by specifying that optometrists could not charge patients a fee for releasing their prescription and that third-party contact lens sellers could supply patients with lenses if optometrists refused to release the prescription. These reforms gave more Americans access to affordable contact lenses. And people took advantage of this: The number of Americans who buy their contact lenses online has steadily grown over the years. Now, it’s important that state governments start clearing away their anti-competitive and anti-telehealth rules as well.
The ongoing pandemic brought with it a shift in how many policymakers think about regulations restricting the use of telehealth. Fortunately, this has led many states to temporarily relax telehealth restrictions so patients can get the care they need without risking an in-person visit. These reforms should include eye care; otherwise, we’re continuing to let protectionist rules hinder America’s ability to see clearly.
Image credit: Proxima Studio