An Act To Promote Cost-effective and Broad-based Vision Care for Maine Citizens by Clarifying the Scope of Prescription Authority by an Optometrist
Maine Legislature, Session 124, LD 0683
Committee Amendment CA_A_S147 (Senate)
Amends: Title 21, Section 812, 32 MRSA §2411, 32 MRSA §241, 32 MRSA §2417, 32 MRSA §2430-A, 32 MRSA §2430-B

COMMITTEE AMENDMENT ,A " to S.P. 258, L.D. 683, Bill, "An Act To 
Promote Cost-effective and Broad-based Vision Care for Maine Citizens by Clarifying 
the Scope of Prescription Authority by an Optometrist" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 32 MRSA §2411, sub-§l, ~A, as amended by PL 1995, c. 439, §1, is 
further amended to read: 
A. The examination of the eye and related structures without the use of invasive 
surgery or tissue-altering lasers to ascertain diagnose defects, abnormalities or 
diseases of the eye; 
Sec. 2. 32 MRSA §241l, sub-§3, as amended by PL 1995, c. 606, § 1, is further 
amended to read: 
3. Pharmaceutical agent. 
"Pharmaceutical agent" means any topical medicinal 
diagnostic and therapeutical therapeutic substances for use in the diagnosis, cure, 
treatment, management or prevention of ocular conditions and diseases, and oral 
medicinal diagnostic and therapeutical substances and quantities for use in the diagnosis, 
cure, treatment or prevention of ocular conditions and diseases under section 2430, 
subsection 2 but does not include drugs administered exclusively by injection, except 
injections for the emergency treatment of anaphylactic shock. 
Sec. 3. 32 MRSA §2411, sub-§5, GjfB, as amended by PL 1995, c. 439, §4, is 
further amended to read: 
B. 
Any pharmaceutical agent administered exclusively by subdermal injection, 
intramuscular injection, intravenous injection, subcutaneous injection or retrobulbar 
injections, except injections for the emergency treatment of anaphylactic shock; and 
Sec. 4. 32 MRSA §2417, sub-§4, ~, as amended by PL 1993, c. 600, Pt. A, 
§ 146, is further amended to read: 
D. For pharmaceutical agents all prescriptions must include: 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to S.P. 258, L.D. 683 
(1) The patient's name; 
(2) The date; 
(3) The name, quantity and dosage of drugs; 
(4) The number of refills; 
(5) The name of the prescriber; 
(6) The drug license number of the prescriber; 
(7) A sequential number; and 
(8) The prescriber's directions for usage. 
Sale of pharmaceutical agents by an optometrist is prohibited. 
Nothing in this 
paragraph may be construed to restrict the dispensation or sale by an optometrist of 
contact lenses that contain and deliver pharmaceutical agents authorized under. this 
chapter for use or prescription. 
Sec. 5. 32 MRS A §2417, sub-§5, ~C, as enacted by PL 1973, c. 788, § 16, is 
amended to read: 
C. The conduct of the lawful practice of optometry in accordance with the standards 
established by this section chapter. 
Sec. 6. 32 MRS A §2430, sub-§2, as enacted by PL 1995, c. 606, §9, is amended 
to read: 
2. Therapeutic pharmaceutical agents; use permitted. An optometrist who has 
received an advanced therapeutic license may use and prescribe any topical therapeutic 
pharmaceutical agent, except for the treatment of glaucoma unless the requirements of 
section 2430 A 2430-B have been met, and any of the follo','v'ing types and quantities of 
oral therapeutic pharmaceutical agents including any drug identified in schedules III, IV 
and V as described in 21 United States Code, Section 812, for any purpose associated 
with ocular conditions and diseases.;. except for oral chemotherapeutic agents, oral 
immunosuppressive agents and oral immunostimulant agents, and except that an 
optometrist who has received an advanced therapeutic license may prescribe one 5-day 
supply of any analgesic identified in schedules III, IV and V as described in 21 United 
States Code, Section 812. 
A. One 10 day supply of oral antibiotics; 
B. One 72 hour supply of oral antivirals ';vith referral to a physician; 
C. One 72 hour supply of oral antihistamines; 
D. One 7 day supply of oral nonsteroidal antiinflammatories; and 
E. 
One 3 day supply of any analgesic identified in schedules III, IV and V as 
described in the United States Code, Title 21, Section 812. 
Sec. 7. 32 MRSA §2430-A, as enacted by PL 1995, c. 606, §9, is repealed. 
Sec. 8. 32 MRSA §2430-B is enacted to read: 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT '·A "to S.P, 258, L.D, 683 
§2430-B. Treatment of glaucoma 
1. Optometrists qualified. An optometrist who graduated from optometric college 
in the year 1996 or thereafter and who is an advanced therapeutic licensee is authorized to 
independently treat glaucoma. 
2. 
Consultation required. 
In order to be authorized to independently, treat 
glaucoma, an advanced therapeutic licensee who graduated from optometric college prior 
to 1996 must provide evidence to the board of no more than 30 glaucoma-related 
consultations with a physician in accordance with this section. For purposes of this 
section, "physician" means a licensed physician specializing in diseases of the eye. The 
board shall form a glaucoma consultation subcommittee comprised of 2 optometrists 
appointed by the board and 2 physicians appointed by the Board of Licensure in Medicine 
to review evidence of consultations submitted pursuant to this section in accordance with 
the following criteria. 
. 
A. The glaucoma-related consultations must be conducted as follows: 
(1) A new or existing glaucoma or glaucoma-suspect patient is examined and 
diagnosed by the optometrist; 
(2) The optometrist develops a proposed treatment plan and forwards the plan 
with examination documentation to a physician for consultation; 
(3) 
The physician examines the patient and reviews the optometrist's 
examination documentation and proposed treatment plan; and 
(4) The physician, optometrist and patient mutually agree to and document a 
treatment plan. 
B. 
An advanced therapeutic licensee may petitiOJi the glaucoma consultation 
subcommittee to reduce or waive the number of consultations required. A reduction 
or waiver may be granted by a majority vote of the subcommittee. 
If the 
subcommittee is evenly divided on the question of a specific waiver or reduction, 
then the request for waiver or reduction must be referred to the board. The board 
shall hold a hearing on the request for waiver or reduction and shall render a decision. 
The subcommittee or the board, in evaluating a request for a waiver or reduction in 
the number of cases, shall consider, among other things: 
(1) Optometric college education and course work; 
(2) Any residency or practical experience; 
(3) Certifications in other states; 
(4) Any partial completion of the consultation regimen under paragraph A; 
(5) Ongoing education; and 
(6) Any other factors considered relevant by the subcommittee or board. 
C. An optometrist who has been licensed and practiced under the laws of another 
state and has been authorized to independently treat glaucoma in that state may 
petition the glaucoma consultation subcommittee for a waiver of the consultation 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A " 
to S.P. 258, L.D. 683 
requirement. 
If the optometrist graduated from optometric college in 1996 or 
thereafter, the waiver must be granted. 
The subcommittee shall evaluate the 
education, licensure and experience of an optometrist who gjaduated prior to 1996 
and, if they are equivalent to that of an advanced therapeutic licensee in this State 
authorized under this section to treat glaucoma independently, shall waive the 
consultation requirements of this section.' 
SUMMARY 
This amendment replaces the bill and clarifies that optometrists may not administer 
therapeutic drugs by injection, other than for emergency treatment of anaphylaxis, 
provides optometrists with the authority to dispense or sell contact lenses that contain and 
deliver pharmaceutical agents that are authorized under the Maine Revised Statutes, Title 
32, chapter 34-A, removes restrictions on prescribing certain oral therapeutic drugs and 
provides an optometrist with an advanced therapeutic license the authority to use and 
prescribe any therapeutic pharmaceutical agent, including any drug identified in 
schedules III, IV and V as described in 21 United States Code, Section 812, for any 
purpose associated with ocular conditions and diseases, except for oral chemotherapeutic 
agents, oral immunosuppressive agents and oral immunostimulant agents, and except that 
an optometrist who has received an advanced therapeutic license may prescribe one 5-day 
supply of any analgesic identified in schedules III, IV and V as described in 21 United 
States Code, Section 812. The amendment also provides the standards pursuant to which 
optometrists are authorized to independently treat glaucoma. 
COMMITTEE AMENDMENT 
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