Text to be removed highlighted in red.
1 Optometrists; Treatment of Glaucoma. Amend RSA 327:6-c, II-IV to read as follows:
II.(a) To be authorized to initiate treatment of glaucoma for patients 18 years of age or older, a therapeutic pharmaceutical agent certified optometrist shall complete the educational requirements in paragraph I and provide evidence of written referrals and consultations with an ophthalmologist . For purposes of this section, "glaucoma" means primary open-angle glaucoma; and "ophthalmologist"; means a physician licensed under RSA 329 with a specialty in ophthalmology. The joint credentialing committee shall review evidence of glaucoma co-management submitted pursuant to subparagraph (b).
(b) Except as provided in subparagraph I(c) or paragraph III, therapeutic pharmaceutical agent certified optometrists are required to provide evidence of successful collaborative treatment and co-management of 25 glaucoma patients, up to 5 of which may be established patients, during a period of not less than 18 months for each patient, to ophthalmologists according to the following criteria:
(1) A new or existing glaucoma patient is examined and diagnosed by the optometrist;
(2) The optometrist develops a proposed treatment plan and forwards the plan with examination documentation to an ophthalmologist for consultation;
(3) The ophthalmologist examines the patient and reviews the optometrist's examination documentation and proposed treatment plan;
(4) The ophthalmologist , optometrist, and patient mutually agree to and document a treatment plan;
(5) The optometrist shall consult with the co-managing ophthalmologist when any of the following occurs: the patient's target pressure is not reached within 90 days; the patient is experiencing documented progression of optic nerve damage; the patient develops documented and repeated progression of visual field loss; or the patient develops angle-closure or other secondary glaucoma; and
(6) For each successfully co-managed glaucoma patient the optometrist and co-managing ophthalmologist shall complete a glaucoma credentialing reporting form and submit the form to the joint credentialing committee upon completion of the 18 months of treatment.
III. The joint credentialing committee may waive or reduce the requirements of RSA 327:6-c, I and II for the following categories of optometrists:
(a) Optometrists with a license and proof of practice for 12 months treating glaucoma patients in another state that currently authorizes the treatment of glaucoma by optometrists; or
(b) Optometrists who have proof of successful completion of a 12-month accredited optometric residency program or its equivalent.
IV. Upon certification to treat glaucoma patients:
(a) For a period of 24 months, optometrists shall consult with an ophthalmologist within 30 days for each new glaucoma patient for confirmation of diagnosis and review of treatment plan.
(b) An optometrist shall consult with an ophthalmologist within 30 days when any of the following occurs:
(1) The patient is experiencing documented progression of optic nerve damage or the patient develops documented and repeated progression of visual field loss on maximum tolerated topical medical therapy; or
(2) The patient develops angle-closure or other secondary glaucoma.
2 Optometrists; Disciplinary Action; Reference Changed. Amend RSA 327:20, II(i) to read as follows:
(i) The use of any pharmaceutical agent by an optometrist not authorized under RSA 327:6-a or the use of any pharmaceutical agent other than those agents described in RSA 327:1 or those previously approved by the joint credentialing committee .
3 Repeal. RSA 327:6-b, relative to the joint credentialing committee, is repealed.
4 Effective Date. This act shall take effect 60 days after its passage.
Text to be added highlighted in green.
1 Optometrists; Treatment of Glaucoma. Amend RSA 327:6-c, II-IV to read as follows:
II.(a) To be authorized to initiate treatment of glaucoma for patients 18 years of age or older, a therapeutic pharmaceutical agent certified optometrist shall complete the educational requirements in paragraph I and provide evidence of written referrals and consultations with a co-manager who shall be an ophthalmologist or an optometrist certified to treat glaucoma under this section . For purposes of this section, "glaucoma" means primary open-angle glaucoma; and "ophthalmologist"; means a physician licensed under RSA 329 with a specialty in ophthalmology. The board shall review evidence of glaucoma co-management submitted pursuant to subparagraph (b).
(b) Except as provided in subparagraph I(c) or paragraph III, therapeutic pharmaceutical agent certified optometrists are required to provide evidence of successful collaborative treatment and co-management of 25 glaucoma patients, up to 5 of which may be established patients, during a period of not less than 18 months for each patient, to ophthalmologists according to the following criteria:
(1) A new or existing glaucoma patient is examined and diagnosed by the optometrist;
(2) The optometrist , or an optometrist certified to treat glaucoma under this section, develops a proposed treatment plan and forwards the plan with examination documentation to an ophthalmologist for consultation;
(3) The ophthalmologist , or an optometrist certified to treat glaucoma under this section, examines the patient and reviews the optometrist's examination documentation and proposed treatment plan;
(4) The co-manager , optometrist, and patient mutually agree to and document a treatment plan;
(5) The optometrist shall consult with the co-manager when any of the following occurs: the patient's target pressure is not reached within 90 days; the patient is experiencing documented progression of optic nerve damage; the patient develops documented and repeated progression of visual field loss; or the patient develops angle-closure or other secondary glaucoma; and
(6) For each successfully co-managed glaucoma patient the optometrist and co-managing ophthalmologist shall complete a glaucoma credentialing reporting form and submit the form to the board upon completion of the 18 months of treatment.
III. The board may waive or reduce the requirements of RSA 327:6-c, I and II for the following categories of optometrists:
(a) Optometrists with a license and proof of practice for 12 months treating glaucoma patients in another state that currently authorizes the treatment of glaucoma by optometrists; or
(b) Optometrists who have proof of successful completion of a 12-month accredited optometric residency program or its equivalent.
IV. Upon certification to treat glaucoma patients:
(a) For a period of 24 months, optometrists shall consult with an ophthalmologist , or an optometrist certified to treat glaucoma under this section, within 30 days for each new glaucoma patient for confirmation of diagnosis and review of treatment plan.
(b) An optometrist shall consult with an ophthalmologist , or an optometrist certified to treat glaucoma under this section, within 30 days when any of the following occurs:
(1) The patient is experiencing documented progression of optic nerve damage or the patient develops documented and repeated progression of visual field loss on maximum tolerated topical medical therapy; or
(2) The patient develops angle-closure or other secondary glaucoma.
2 Optometrists; Disciplinary Action; Reference Changed. Amend RSA 327:20, II(i) to read as follows:
(i) The use of any pharmaceutical agent by an optometrist not authorized under RSA 327:6-a or the use of any pharmaceutical agent other than those agents described in RSA 327:1 or those previously approved by the board .
3 Repeal. RSA 327:6-b, relative to the joint credentialing committee, is repealed.
4 Effective Date. This act shall take effect 60 days after its passage.