Understanding the Eyeglass and Contact Lens Rules

As an eyecare professional, you must take the following actions to comply with the Eyeglass and Contact Lens Rules:

• Provide each patient a copy of the eyeglass prescription following a refractive exam or a copy of the contact lens prescription at the end of the fitting—even if the patient doesn't ask for it. You must provide the patient with the prescription prior to attempting to sell them glasses or contact lenses.
• Ask the patient to sign and date a form acknowledging receipt of the prescription. If the patient refuses, staff may sign the form noting the refusal. Retain the acknowledgment for three years.
• If you provide prescriptions digitally, obtain and retain written affirmative consent from patients to receive prescriptions in a specific electronic format (e.g., patient portal, secure message). You must allow the patient to revoke their consent at any time to go back to receiving a printed copy of their prescriptions.
• Verify or confirm contact lens prescriptions within eight business hours when requested by sellers. If the prescription is expired or invalid, you must correct any inaccuracies or explain why the prescription is no longer valid.
• Transmit contact lens prescriptions to sellers within 40 business hours, when sellers request the prescription on behalf of the patient.

As an eyecare professional, you must not engage in the following activities:

• Require patients to buy glasses or contact lenses from you, pay additional fees, or sign a waiver or release in exchange for a copy of their prescription.
• Disown liability or responsibility for the accuracy of a prescription.

You must give a patient a copy of the prescription

• immediately after completing any refractive eye examination or contact lens fitting (no matter the purpose of the patient's visit, and regardless of whether you charge for refractions or contact lens fittings;
• whether or not the patient asks for it; and
• before offering to sell the patient glasses or contact lenses.

After the refractive exam or contact lens fitting, you should print two copies of the prescription and ask the patient to sign and return one of the copies to you. You don't need to print the prescription if the patient has consented to receive the prescription digitally. In either case, this is an opportunity to address the patient's consumer rights.

All of the following conditions must be met to share prescriptions with patients digitally:

• The patient affirmatively agrees—in writing or electronically—to get the prescription digitally instead of on paper. Digital prescription delivery shouldn’t be the default option, and if the patient wants a paper prescription, you must honor their preference.
• The patient affirmatively agrees—in writing or electronically—to the specific method of delivery you will use (for example, patient portal); and
• The patient can access, download, and print the digital prescription. If you provide the prescription through the patient portal, the patient should be able to access it as long as the prescription is valid.

You may combine consent for the glasses and contact lens prescription digital delivery as long as it's clear the patient is consenting to both. However, you may not combine this consent with other types of consents, like HIPAA authorizations.

You may obtain a patient's consent for digital delivery once as long as you allow the patient to revoke that consent at any time and as long as the delivery method spelled out in the consent form doesn't change (for example, changing from patient portal delivery to secure messaging). If you change the delivery method, you must obtain the patient's affirmative consent again.

When you print a prescription for a patient, you must keep the patient's signed acknowledgment of receipt for at least three years. If the patient refuses, staff may sign the form noting the refusal.

If a patient, consents to digital prescription delivery, you must keep the patient's consent for three years beyond when the consent was in force. For example, if a patient revokes consent or you change delivery methods, you'll need to keep the signed consent three years beyond those dates.

Patients may take their prescriptions and purchase their contact lenses elsewhere. Additionally, eyecare providers must perform the following:

• Confirm the details of the prescription, within eight business hours, if contacted by contact lens seller. If the eyecare provider does not respond within eight business hours, the seller may provide contact lenses to the patient.
• Furnish the contact lens prescription, within 40 business hours, when requested by a contact lens seller on behalf of the patient.

If an exam does not require a refraction or contact lens fitting, you're not required to provide the patient with a prescription.

The Eyewear and Contact Lens Rules do not preclude you from offering promotional pricing for exam services and products, but you must also give the patient the choice to pay the routine examination fee.

Failure to comply with the Eyeglass and Contact Lens Rules requirements may result in legal action and civil monetary penalties for each violation. The maximum monetary payments are pegged to the rate of inflation.