Critical Issues Update:


1
Critical Issues Update

• H.R. 3140 The Fairness to Contact Lens
  Consumers Act

Victor J. Connors O.D. President
Tommy Crooks O.D. Secretary-Treasurer
January 9 2004
2
Historical Review

• June 1994 AOA served with the CL lawsuit
• October 1994 Congressman Stark introduces the
  1st CL release bill

3
Historical Review

• April 1995 Stark reintroduces CL release bill
  with a 2 year Rx expiration date. AOA opposes
  the bill and the bill goes nowhere.

4
Historical Review

• May 2001 The CL lawsuit is settled.
• The settlement did not address the contact lens
  prescription release issue.

5
Historical Review

• July 2001 Congressman Stark reintroduces
  essentially the same CL release bill.
  
• September 2001 Philadelphia AOA Advocacy
  meeting Suggested that AOA consider federal
  legislation to address the entire CL issue.

6
Historical Review

• January 2002 Presidents Council recommends
  that we pursue federal legislation on this issue
  with special attention to
  
• Enforcement sellers selling with
• no regard for Rx
• 2) Expiration/Verification 1 year expiration
• date and a reasonable response time for Rx
  verification i.e. 48 clock hours

7
Historical Review

• June 2002 Senator Leahy (D-VT) and Schumer
  (D-NY) introduce similar legislation with
  passive verification
  
• July August 2002 Congressman Burr (R-NC)
  joins in when his assistant is refused her CL Rx.
  North Carolina ODs Louisiana ODs all AOA
  keypersons AOA AAO Congressman Boozman
  Congressman Cooksey all work on Congressman Burr
  and Chairman Tauzin (R-LA) to push for positive
  verification

Keyperson memo July 31 2002
8
Historical Review

• August 21 2002 ABC World News airs a story
  doctors who wont let you spend less on contact
  lenses because optometrists have a monopoly
  
• September 2002 California passes legislation
  with essentially a 24 clock hour verification
  time frame

9
Historical Review

• November 2002 Congressman Burr introduces the
  Fairness to Contact Lens Consumers Act which
  did not address verification. It left it to a
  study by the FTC. Congress adjourns with no
  action.
• December 2 2002 Vistakon and 1-800 Contacts
  announce an agreement with an 8 business hour
  verification time frame

10
Historical Review

• June 2003 Burr reintroduces similar legislation
  
  
• Keyperson Memo with attachment June 3 2003
• AOA NEWS June 16 2003
• Presidents Council Minutes AOA Congress June
  18 2003
  
• Keyperson Memo July 31 2003

11
Historical Review

• August 28 2003 AOA is notified of the hearing
  on the Burr bill and we are asked to testify
  
• InSite Online August 2003
• AOA News August 25 2003
• Memo to Energy Commerce SubcommitteeCommerce
  Trade Consumer Protection Keypersons w/2
  attachments Sept. 2 2003

12
Historical Review

• September 9 2003 Dr. Pat Cummings testifies
  before the committee along with the Consumers
  Union Texas Citizens for a Sound Economy the
  assistant A.G. of New York an individual patient
  from Texas the FTC and 1-800 Contacts.
• The primary issue for AOAthat lenses are
  provided to patients only when the prescription
  has in fact been positively verified.

13
Historical Review.

• September 13 2003 - After discussion AOA goes
  back to Burr and the committee and reaffirms
  position on seller requirements and positive
  verification

14
Historical Review

• September 22 2003 Burr and committee staff
  present a revised bill including all suggested
  changes by AOA except for positive verification.
  Asks for endorsement and notifies AOA that the
  bill will be scheduled for sub-committee
  consideration on September 24.

15
Historical Review

• September 22 2003 (contd) AOA executive
  committee and subsequently entire board are
  apprised of the situation and the consensus was
  to endorse the bill but ask for the 8 hours to
  be extended. Committee does not agree to extend
  the hours but agrees to change the language to
  insert or similar time as defined by the FTC.

Memo to State Presidents EDs Sept. 26 2003
16
Changes/Improvements in CL Rx Release Legislation
from Introduced Versions
17
Changes/Improvements in CL Rx Release Legislation
from Original/Previous Version
18
Historical Review

• September 24 2003 Sub-committee approves by
  voice vote
  
• October 1 2003 Full committee approves by
  voice vote

Memo to Keypersons Oct. 6 2003
19
Historical Review

• November 20 2003 Burr bill comes to a vote in
  the House and passes 406 to 12
  
• November 21 2003 Bill comes to a vote in the
  Senate and passes unanimously
  
• December 6 2003 President Bush signs the bill
  into law
  
• February 4 2004 Law goes into effect

20
Rationale -- Frequently Asked Questions

• Why mandatory release
• This follows the eyeglass rule which the
  proponents (the primary movers on the committee)
  believed to be serving the public well. They
  felt there should not be two different
  standards.

21
Rationale -- Frequently Asked Questions

• Why pre-emption of state laws
• Proponents believed single method of
  release/verification was important to establish
  uniform ground rules for enforcement. They also
  strongly believed open ended or extended time
  periods for response to requests were
  inconsistent with the intent to provide consumers
  ease of access to prescriptions/lenses.

22
Rationale -- Frequently Asked Questions

• Why 8 business hours
• Eight business hours was based upon the Vistakon
  settlement and California statute. Proponents
  saw evidence it was working would work with
  appropriate designation of business hours and
  direct communication.

23
Rationale -- Frequently Asked Questions

• Why did we not activate the keyperson network to
  kill the bill
  
• When you seek to kill a bill you should be sure
  it is going to stay dead. Killing this bill
  which we did not believe was possible would have
  been temporary.

24
Rationale -- Frequently Asked Questions

• Why did we not activate the keyperson network to
  kill the bill
  
• It would have come back very likely in a less
  palatable form
  
• There was inevitably going to be a federal
  contact lens prescription release bill
  
• Would have resulted in further damage to the
  professions reputation on this issue

25
Rationale -- Frequently Asked Questions

• Why did we not activate the keyperson network to
  kill the bill
  
• Would not address the problem of lenses being
  sold without Rx
  
• As it stands we have framework for dealing with
  the issue of sales without Rx
  
• If the rule making and enforcement process does
  not produce intended results we have open
  invitation to return to the Hill for further
  redress

26
Rationale -- Frequently Asked Questions

• Why did we not count votes at the committee
  level
  
• The chairmans chief of staff made it clear this
  bill had chairmans full support and it was his
  intent to pass it with or without us.

27
Rationale -- Frequently Asked Questions

• Why would we trust the FTC
• The FTC has spoken publicly twice on this issue
• May 2002 in a proceeding in Connecticut
• September 9 2003 hearing. Both times they
  displayed balanced approach spending
  considerable time on health aspects of
  purchasing/wearing contact lenses.

28
Rationale -- Frequently Asked Questions

• Why did AOA tell the state affiliates to push for
  positive verification and then accept an 8
  business hour verification process
  
• There were several reasons
• First and foremost positive verification is the
  preferable method of prescription verification
  and it remains so today.

29
Rationale -- Frequently Asked Questions

• Why did AOA tell the state affiliates to push for
  positive verification and then accept an 8
  business hour verification process
  
• Second the Congressional approach was to request
  a study of two systems leaving means of
  verification up to the states. States with no
  verification process would default to passive
  verification with the sellers setting the rules.
  
• Finally it was hoped if a preponderance of
  states adopted this approach it would have effect
  on outcome of federal debate.

30
What Does This Mean to Our Members

• Drs. will have to release the CL Rx (same as
  Eyeglasses II)
  
• Patients will have to furnish a seller with a
  valid hard copy prescription or
  
• Sellers will have to verify the Rx with the
  doctor (neither of which is being done today)

31
What Does This Mean to Our Members

• Drs. will have the opportunity to verify/deny the
  Rx for accuracy expiration date and quantity of
  lenses
  
• Sellers will have rules to abide by and face
  enforcement and penalties as mandated by
  Congress
  
• The law serves to encourage patients to get
  yearly eye examinations due to the requirement
  for a prescription and the general one year
  prescription expiration rule

32
Where Do We Go From Here

• AOA will present a comprehensive and progressive
  case to the FTC for promulgating FCLCA rules and
  regulations with balance of public safety and
  patients freedom of choice assuring a balance
  of patient health and competition.

33
Where Do We Go From Here

• AOA will develop and distribute a comprehensive
  FCLCA compliance and practice management program
  assuring patient health and freedom of choice
  through effective and ethical patient care and
  education.

34
Where Do We Go From Here

• AOA will develop and initiate a program to assure
  Contact Lens Seller compliance and standards of
  fairness to protect patient health and fair
  competition.

35
Where Do We Go From Here

• AOA in concert with Affiliates will work to
  gain confidence of members in the AOA the law
  gives each optometrist an opportunity to provide
  more effective contact lens patient care.

36
Where Do We Go From Here

• Communicate to the public the professions
  commitment to proper eye care as it relates to
  contact lens wear and use emphasizing the
  patients health above all else.

37
Thank You